A Nationwide Evaluation of the State of Practice of Performance Measurements for Intelligent Transportation Systems

State departments of transportation’s (DOTs) decisions to invest resources to expand or implement intelligent transportation systems (ITS) programs or even retire existing infrastructure need to be based on performance evaluations. Nonetheless, an apparent gap exists between the need for ITS performance measurements and the actual implementation. The evidence available points to challenges in the ITS performance measurement processes. This paper evaluated the state of practice of performance measurement for ITS across the US and provided insights. A comprehensive literature review assessed the use of performance measures by DOTs for monitoring implemented ITS programs. Based on the gaps identified through the literature review, a nationwide qualitative survey was used to gather insights from key stakeholders on the subject matter and presented in this paper. From the data gathered, performance measurement of ITS is fairly integrated into ITS programs by DOTs, with most agencies considering the process beneficial. There, however, exist reasons that prevent agencies from measuring ITS performance to greater detail and quality. These include lack of data, fragmented or incomparable data formats, the complexity of the endeavor, lack of data scientists, and difficulty assigning responsibilities when inter-agency collaboration is required. Additionally, DOTs do not benchmark or compare their ITS performance with others for reasons that include lack of data, lack of guidance or best practices, and incomparable data formats. This paper is relevant as it provides insights expected to guide DOTs and other agencies in developing or reevaluating their ITS performance measurement processes.

Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers

OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs)at primary care health(PHC)settings in China,and to examine the factors contributing to the of effectiveness.variations METHODS We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards.All LHWs were required to parti-cipate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension man-agement knowledge.We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups.Afterwards,we used multilevel logistic regression to examine the individual regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.and RESULTS There were 1,208,610 LHWs who completed training and were certificated.Nationally,the scores of LHWs in-creased significantly from 62.87±21.14 out of 100 in the pre-test to 88.30±11.31 in the post-test by 25.43(95%confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36)in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hyperten-sion management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working institutions.Geographical variations were shown at the provincial level,with the majority of them being ex-by factors at the regional level.plained CONCLUSIONS Accessible web-based training modality,government efforts,accompanied with experiences derived from the training,could be generalized to other low-and middle-income countries in facilitating the hypertension management capacity of LHWs.Localization and evaluation is warranted on the way to its further application.

Chinas Has Basically Established a Nationwide Unitary Certification and Accreditation System

Through three-year’s efforts, a nationwide unitary certification and accreditation system has already been established in China, which has legalized and standardized China’s certification and accreditation work. Apporved by the State Council, the Certification and Accreditation Administration of China (CNCA), which is in charge of supervising, administrating and coordinating certification and accreditation departments of the whole nation, has done a lot of work to achieve this goal.

Readmission rates and outcomes in adults with and without COVID-19 following inpatient chemotherapy admission:A nationwide analysis

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has received considerable attention in the scientific community due to its impact on healthcare systems and various diseases.However,little focus has been given to its effect on cancer treatment.AIM To determine the effect of COVID-19 pandemic on cancer patients’care.METHODS A retrospective review of a Nationwide Readmission Database(NRD)was conducted to analyze hospitalization patterns of patients receiving inpatient chemotherapy(IPCT)during the COVID-19 pandemic in 2020.Two cohorts were defined based on readmission within 30 d and 90 d.Demographic information,readmission rates,hospital-specific variables,length of hospital stay(LOS),and treatment costs were analyzed.Comorbidities were assessed using the Elixhauser comorbidity index.Multivariate Cox regression analysis was performed to identify independent predictors of readmission.Statistical analysis was conducted using Stata■Version 16 software.As the NRD data is anonymous and cannot be used to identify patients,institutional review board approval was not required for this study.RESULTS A total of 87755 hospitalizations for IPCT were identified during the pandemic.Among the 30-day index admission cohort,55005 patients were included,with 32903 readmissions observed,resulting in a readmission rate of 59.8%.For the 90-day index admission cohort,33142 patients were included,with 24503 readmissions observed,leading to a readmission rate of 73.93%.The most common causes of readmission included encounters with chemotherapy(66.7%),neutropenia(4.36%),and sepsis(3.3%).Comorbidities were significantly higher among readmitted hospitalizations compared to index hospitalizations in both readmission cohorts.The total cost of readmission for both cohorts amounted to 1193000000.00 dollars.Major predictors of 30-day readmission included peripheral vascular disorders[Hazard ratio(HR)=1.09,P<0.05],paralysis(HR=1.26,P<0.001),and human immunodeficiency virus/acquired immuno-deficiency syndrome(HR=1.14,P=0.03).Predictors of 90-day readmission included lymphoma(HR=1.14,P<0.01),paralysis(HR=1.21,P=0.02),and peripheral vascular disorders(HR=1.15,P<0.01).CONCLUSION The COVID-19 pandemic has significantly impacted the management of patients undergoing IPCT.These findings highlight the urgent need for a more strategic approach to the care of patients receiving IPCT during pandemics.

Time Transfer in a 1839-km Telecommunication Fiber Link Demonstrating a Picosecond-Scale Stability

An implementation of high-precision time transfer over a 1839-km field fiber loop back link between two provincial capitals of China,Xi’an and Taiyuan,is reported.Time transfer stabilities of 6.5 ps at averaging time of 1 s and 4.6 ps at 40000 s were achieved.The uncertainty for the time transfer system was evaluated,showing a budget of 56.2 ps.These results stand for a significant milestone in achieving high-precision time transfer over a field fiber link spanning thousands of kilometers,signifying a record-breaking achievement for the real-field time transfer in both stability and distance,which paves the way for constructing the nationwide high-precision time service via fiber network.

Chinese Economy Scales New Heights

The positive figures of last year confirm the strength,resilience,and prospects of the Chinese economy.CHINA’S government work report delivered to the 2024“Two Sessions”in early March released some important statistics.The GDP surpassed RMB 126 trillion,an increase of 5.2 percent.A total of 12.44 million urban jobs were added,and the average surveyed urban unemployment rate stood at 5.2 percent by average.The consumer price index(CPI)rose by 0.2 percent.The production and sales of new-energy vehicles accounted for over 60 percent of the world’s total.Grain output hit a record high of 695 million tonnes.The installed renewable energy capacity surpassed its thermal power for the first time in Chinese history,accounting for over half of newly installed renewable energy capacity worldwide.The per capita disposable income of residents also rose by 6.1 percent nationwide.

Whole-Process People’s Democracy from a Global Comparative Perspective

A recent global survey by the Academy of Contemporary China and World Studies reveals that the value and practice of whole-process people’s democracy have won widespread plaudits throughout the international community.DEVELOPING whole-process people’s democracy is one of the intrinsic requirements of China’s modernization.It is a creation of the Communist Party of China in the process of advancing democratic theories and practices through drawing on the historical lessons of China and the world in governance.Whole-process people’s democracy fits Chinese conditions,as manifested in China’s nationwide vibrant vitality.It also contributes Chinese wisdom to the global promotion of democratic practice.

Overseas Treasures of Longquan Celadon The history of localization of overseas Longquan celadon from the perspectives of 'inlaying' and 'riveting'

The Longquan celadon industry entered a rapid development period during the Northern Song Dynasty,achieving a long period of prosperity with its opaque and thick glaze during the Southern Song Dynasty.Over the hundreds of years from the 12th to the 15th century,the high-quality Longquan celadon was not only supplied for imperial use and marketed nationwide but also exported to many countries and regions across Asia,Africa and Europe through intercontinental trade.When Longquan celadon crossed thousands of mountains and rivers to arrive in foreign lands,the barriers of time and space and the differences in culture made "re-encoding"possible.

遵义红——遵义红茶

Zunyi,a city renowned nationwide for its historical significance,has a vibrant environment that has given birth to the famous Zunyi Red―Zunyi black tea.When it comes to Zunyi,the most well-known thing may be the Zunyi Conference,but few might be familiar with Zunyi black tea.What kind of historical connection does this tea have with the city’s red history?

A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic:implications and policy recommendations

The Coronavirus Disease 2019(COVID-19)epidemic emerged in Wuhan,China,spread nationwide and then onto half a dozen other countries between December 2019 and early 2020.The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people's lives.It has also triggered a wide variety of psychological problems,such as panic disorder,anxiety and depression.This study is the first nationwide largescale survey of psychological distress in the general population of China during the COVID-19 epidemic.

A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

The Coronavirus Disease 2019(COVID-19)epidemic emerged in Wuhan,China,spread nationwide and then onto half a dozen other countries between December 2019 and early 2020.The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives.It has also triggered a wide variety of psychological problems,such as panic disorder,anxiety and depression.This study is the first nationwide largescale survey of psychological distress in the general population of China during the COVID-19 epidemic.

Analysis of the Results of Two Nationwide Surveys on Clonorchis sinensis Infection in China

Objective To examine Clonorchis sinensis infection in China and evaluate the effectiveness of efforts to prevent and control it,two nationwide surveys were undertaken in 31 provinces,autonomous regions,and municipalities（PAMs） during 1988-92（the 1990 survey） and during 2001-04（the 2003 survey）.Methods During the period 2001-04,two sampling methods were applied.The first method repeated the stratified cluster random sampling used in the 1990 survey;the second method applied two-characteristic stratified cluster random sampling in 27 PAMs—the 2003 endemic area（EA） survey.The Kato-Katz thick smear method was used for the nationwide survey.Results The infection rates of Clonorchis sinensis in the 1990 and 2003 surveys were 0.311% and 0.579%,respectively.The infection rate was 2.40% in the 2003 EA survey,and it was estimated that 12.49 million people in China were infected with Clonorchis sinensis.Conclusion The 2003 survey showed that the standardized infection rate of Clonorchis sinensis increased by 74.85% compared with the 1990 survey.The infection rate in males was higher than in females;the infection rate among people eating raw fish or eating out frequently was higher than among those who did not.

Early vs late endoscopic retrograde cholangiopancreatography in patients with acute cholangitis: A nationwide analysis

AIM To assess the effect of early vs late endoscopic retrograde cholangiopancreatography(ERCP) on mortality and readmissions in acute cholangitis, using a nationally representative sample.METHODS We used the 2014 National Readmissions Database to identify adult patients hospitalized with acute cholangitis who underwent therapeutic ERCP within one week of admission. Early ERCP was defined as ERCP performed on the same day of admission or the next day(days 0 or 1, < 48 h), and late ERCP was performed on days 2 to 7 of admission. Patients with severe cholangitis had any of the following additional diagnoses: Severe sepsis, septic shock, acute renal failure,acute respiratory failure, or thrombocytopenia. Multivariate logistic regression was used to calculate the adjusted odds of association of ERCP timing with inhospital mortality, 30-d mortality, and 30-d readmissions, controlling for age, sex,severe disease and comorbidities.RESULTS Four thousand five hundred and seventy patients satisfied the inclusion criteria;with a mean age of 64.1 years. Of these, 66.6% had early ERCP, while 33.4% had late ERCP. Early ERCP was associated with lower in-hospital mortality [1.2% vs2.4%, adjusted odds ratio(aOR) = 0.50, 95%CI: 0.76-0.83, P = 0.001] and lower 30-d mortality(1.5% vs 3.3%, aOR = 0.48, 95%CI: 0.33-0.69, P < 0.0001) compared to the late ERCP group. Similarly, early ERCP was associated with lower 30-d readmissions(9.7% vs 15.1%, aOR = 0.58, 95%CI: 0.49-0.7, P < 0.0001). When stratified by severity of cholangitis, there was a similar benefit of early ERCP on all outcomes in those with and without severe cholangitis. The mean length of stay was higher in the late ERCP group compared to the early ERCP group(6.9 d vs 4.5 d, P < 0.0001). The mean hospitalization cost was higher in the late ERCP group($21459 vs $16939, P < 0.0001).CONCLUSION Early ERCP is associated with lower in-hospital and 30-d mortality in those with or without severe cholangitis. Regardless of severity, we suggest performing early ERCP.

Trends and risk factors of elderly-onset Crohn’s disease: A nationwide cohort study

BACKGROUND The incidence of inflammatory bowel disease(IBD)is increasing in Asia.Numerous risk factors associated with IBD development have been investigated.AIM To investigate trends and environmental risk factors of Crohn’s disease(CD)diagnosed in persons aged≥40 years in South Korea.METHODS Using the National Health Insurance Service database,a total of 14060821 persons aged>40 years who underwent national health screening in 2009 were followed up until December 2017.Patients with newly diagnosed CD were enrolled and compared with non-CD cohort.CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration program codes from the National Health Insurance Service database.The mean follow-up periods was 7.39 years.Age,sex,diabetes,hypertension,smoking,alcohol consumption,regular exercise,body mass index,anemia,chronic kidney disease(CKD)and dyslipidemia were adjusted for in the multivariate analysis model.RESULTS During the follow-up,1337(1.33/100000)patients developed CD.Men in the middle-aged group(40-64 years)had a higher risk than women[adjusted hazard ratio(aHR)1.46,95%confidence interval(CI):1.29-1.66];however,this difference tended to disappear as the age of onset increases.In the middle-aged group,patients with a history of smoking[(aHR 1.46,95%CI:1.19-1.79)and anemia(aHR 1.85,95%CI:1.55-2.20)]had a significantly higher CD risk.In the elderly group(age,≥65 years),ex-smoking and anemia also increased the CD risk(aHR 1.68,95%CI:1.22-2.30)and 1.84(95%CI:1.47-2.30,respectively).Especially in the middle-aged group,those with CKD had a statistically elevated CD risk(aHR 1.37,95%CI:1.05-1.79).Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups.[Middle-aged:aHR 0.77(95%CI:0.66-0.89)and aHR 0.73(95% CI:0.63-0.84),respectively][Elderly-group:aHR 0.57(95% CI:0.42-0.78)and aHR 0.84(95%CI 0.67-1.04),respectively].For regular physical activity and dyslipidemia,negative correlation between CD incidences was proved only in the middle-aged group[aHR 0.88(95%CI:0.77-0.89)and aHR 0.81(95%CI:0.68-0.96),respectively].CONCLUSION History of cigarette smoking,anemia,underweight and CKD are possible risk factors for CD in Asians aged>40 years.

Predictors of thirty-day readmission in nonagenarians presenting with acute heart failure with preserved ejection fraction: a nationwide analysis

BACKGROUD Acute heart failure with preserved ejection fraction(HFpEF)is a common but poorly studied cause of hospital admissions among nonagenarians.This study aimed to evaluate predictors of thirty-day readmission,in-hospital mortality,length of stay,and hospital charges in nonagenarians hospitalized with acute HFpEF.METHODS Patients hospitalized between January 2016 and December 2018 with a primary diagnosis of diastolic heart failure were identified using ICD-10 within the Nationwide Readmission Database.We excluded patients who died in index admission,and discharged in December each year to allow thirty-day follow-up.Univariate regression was performed on each variable.Vari-ables with P-value<0.2 were included in the multivariate regression model.RESULTS From a total of 45,393 index admissions,43,646 patients(96.2%)survived to discharge.A total of 7,437 patients(15.6%)had a thirty-day readmission.Mean cost of readmission was 43,265 United States dollars(USD)per patient.Significant predictors of thirty-day readmission were chronic kidney disease stage III or higher[adjusted odds ratio(aOR)=1.20,95%CI:1.07−1.34,P=0.002]and diabetes mellitus(aOR=1.18,95%CI:1.07−1.29,P=0.001).Meanwhile,female(aOR=0.90,95%CI:0.82−0.99,P=0.028)and palliative care encounter(aOR=0.27,95%CI:0.21−0.34,P<0.001)were associated with lower odds of readmission.Cardiac arrhythmia(aOR=1.46,95%CI:1.11−1.93,P=0.007)and aortic stenosis(aOR=1.36,95%CI:1.05−1.76,P=0.020)were amongst predictors of in-hospital mortality.CONCLUSIONS In nonagenarians hospitalized with acute HFpEF,thirty-day readmission is common and costly.Chronic co-morbidities predict poor outcomes.Further strategies need to be developed to improve the quality of care and prevent the poor outcome in nonagenarians.

Equity Study in Health Workforce on Tuberculosis Control in China: a Nationwide Evaluation

We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distribution of TB health workers by population size, geographical area and number of annual registered TB cases. An additional stratified analysis was done by three economic regions. The Gini index were 0.33 for population size, 0.62 for geographical area and 0.30 for number of registered tuberculosis cases that indicated an acceptable average, significant inequity and a relative average distribution nationwide respectively.

The Nationwide Impact of Injury-related Deaths on Average Life Expectancy in China

To expand the evidence base to inform future public policy aimed at accident prevention, we investigated the impact of different categories of injury on average life expectancy in China. We used data from the National Death Cause Registration Information System and National Maternity and Children Health Surveillance databases, as well as 2010 population data from the National Bureau of Statistics. We then calculated the average life expectancy of the Chinese population, in addition to life expectancy after eliminating injury-related mortality. The average life expectancy of the Chinese population in 2010 was 74.93 years. After eliminating deaths due to injuries, the fourth leading cause of mortality in China, average life expectancy increased by 1.36 years. When this was broken down by population sub-groups, these gains were 1.76 and 0.79 years in men and women, 0.94 and 1.56 years in urban and rural residents, and 1.11, 1.30, and 1.67 years for residents in the Eastern, Central and Western regions respectively. After eliminating all categories of injury, the average life expectancy of the Chinese population was found to increase by 1.36 years. This figure was higher for males and residents of rural areas and Western China.

The Establishment of an Overarching Intellectual Property Judicial System

The intellectual property("IP") judicial system comprises two parts: IP judicial organization and IP judicial mechanism. China’s IP judicial system reform should be carried along with the construction of specialized IP courts, aiming to establish a specialized IP judicial system. Such a system contains five elements. First, the nation-wide specialized IP courts are both courts of first instance and of appeal, which is a mode of "first instance + appeal". Meanwhile, a state-level high court or an IP circuit court of the Supreme People’s Court("the Supreme Court") should be established. Second, IP courts should not be set up everywhere, instead, they should be set up in 10-13 central cities, supplemented with detached tribunals. Third, the judicial mechanism in the IP courts should be "3-in-1", in which civil, administrative and criminal suits are heard by one court. Fourth, the manner of reasoning inherited from administrative authority principles of the civil law system should be avoided, and judicial organs should be given the authority to make substantial judgments on the validity of IP. Finally, in technical cases, a multiidentification mechanism for technical facts should be set up, by establishing systems such as technical investigators, expert consultation, expert juries, and judicial appraisal. Thus, an overarching IP judicial system will be formed, which will separate IP trials from others and strengthen the professional traits of IP trails. Such a judicial system is an optimized choice conforming to the construction of an innovative country and is sufficient for China to present a picture of "strong judicial protection" of IP to the world.

In-hospital mortality of hepatorenal syndrome in the United States:Nationwide inpatient sample

BACKGROUND Hepatorenal syndrome(HRS)is a life-threatening condition among patients with advanced liver disease.Data trends specific to hospital mortality and hospital admission resource utilization for HRS remain limited.AIM To assess the temporal trend in mortality and identify the predictors for mortality among hospital admissions for HRS in the United States.METHODS We used the National Inpatient Sample database to identify an unweighted sample of 4938 hospital admissions for HRS from 2005 to 2014(weighted sample of 23973 admissions).The primary outcomes were temporal trends in mortality as well as predictors for hospital mortality.We estimated odds ratios from multilevel mixed effect logistic regression to identify patient characteristics and treatments associated with hospital mortality.RESULTS Overall hospital mortality was 32%.Hospital mortality decreased from 44%in 2005 to 24%in 2014(P<0.001),while there was an increase in the rate of liver transplantation(P=0.02),renal replacement therapy(P<0.001),length of hospital stay(P<0.001),and hospitalization cost(P<0.001).On multivariable analysis,older age,alcohol use,coagulopathy,neurological disorder,and need for mechanical ventilation predicted higher hospital mortality,whereas liver transplantation,transjugular intrahepatic portosystemic shunt,and abdominal paracentesis were associated with lower hospital mortality.CONCLUSION Although there was an increase in resource utilizations,hospital mortality among patients admitted for HRS significantly improved.Several predictors for hospital mortality were identified.