AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a succ...Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.展开更多
Dear Editor,In this letter,the multi-objective optimal control problem of nonlinear discrete-time systems is investigated.A data-driven policy gradient algorithm is proposed in which the action-state value function is...Dear Editor,In this letter,the multi-objective optimal control problem of nonlinear discrete-time systems is investigated.A data-driven policy gradient algorithm is proposed in which the action-state value function is used to evaluate the policy.In the policy improvement process,the policy gradient based method is employed.展开更多
H9N2 virus has been widely distributed in wild birds and poultry around the world since its first emergence in the United States of America in 1966(Gu et al.2017;Carnaccini and Perez 2020).The virus appeared in chicke...H9N2 virus has been widely distributed in wild birds and poultry around the world since its first emergence in the United States of America in 1966(Gu et al.2017;Carnaccini and Perez 2020).The virus appeared in chickens in China in the early 1990s,and over the last two decades has gradually become the dominant epidemic subtype(Sun and Liu 2015;Bi et al.2020).Although H9N2 virus infection alone cannot cause severe disease or death in poultry,H9N2 virus-infected birds experience a degree of egg production drop and can be easily infected by other pathogens,thus causing economic losses for poultry industry.展开更多
The River Chief System (RCS) has evolved from local innovative practices to a national water governance strategy to address the current challenges in China’s water environmental management. In contrast to existing re...The River Chief System (RCS) has evolved from local innovative practices to a national water governance strategy to address the current challenges in China’s water environmental management. In contrast to existing research that focuses on the strengths, weaknesses, and improvements of RCS, this study uses literature study to reveal the dynamic evolution of RCS through three phases, with RCS spreading from developed coastal areas to central and western inland regions. RCS’s diffusion path involves vertical diffusion between central and local levels and horizontal diffusion among local governments. Moreover, RCS has also achieved conceptual spillover, gradually expanding into other governance domains, such as the Lake Chief System, the Field Chief System, the Forestry Chief System, and the integration of multiple chief roles. However, it is essential to scrutinize the phenomenon of applying similar governance mechanisms to different areas, as it may result in challenges such as overburdening local governments, insufficient public participation, oversimplification of differences in natural resource endowments, and limited applicability. This study also provides suggestions on how to address these challenges. The study contributes theoretical insights and policy implications, providing a foundation for practical policy innovation.展开更多
BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study pre...BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.展开更多
Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest f...Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.展开更多
Autonomous driving has witnessed rapid advancement;however,ensuring safe and efficient driving in intricate scenarios remains a critical challenge.In particular,traffic roundabouts bring a set of challenges to autonom...Autonomous driving has witnessed rapid advancement;however,ensuring safe and efficient driving in intricate scenarios remains a critical challenge.In particular,traffic roundabouts bring a set of challenges to autonomous driving due to the unpredictable entry and exit of vehicles,susceptibility to traffic flow bottlenecks,and imperfect data in perceiving environmental information,rendering them a vital issue in the practical application of autonomous driving.To address the traffic challenges,this work focused on complex roundabouts with multi-lane and proposed a Perception EnhancedDeepDeterministic Policy Gradient(PE-DDPG)for AutonomousDriving in the Roundabouts.Specifically,themodel incorporates an enhanced variational autoencoder featuring an integrated spatial attention mechanism alongside the Deep Deterministic Policy Gradient framework,enhancing the vehicle’s capability to comprehend complex roundabout environments and make decisions.Furthermore,the PE-DDPG model combines a dynamic path optimization strategy for roundabout scenarios,effectively mitigating traffic bottlenecks and augmenting throughput efficiency.Extensive experiments were conducted with the collaborative simulation platform of CARLA and SUMO,and the experimental results show that the proposed PE-DDPG outperforms the baseline methods in terms of the convergence capacity of the training process,the smoothness of driving and the traffic efficiency with diverse traffic flow patterns and penetration rates of autonomous vehicles(AVs).Generally,the proposed PE-DDPGmodel could be employed for autonomous driving in complex scenarios with imperfect data.展开更多
In contrast to the traditional Western approach to macro-fiscal management,China’s proactive fiscal policy is founded on a people-centered development philosophy and,with distinctive Chinese characteristics,is a sign...In contrast to the traditional Western approach to macro-fiscal management,China’s proactive fiscal policy is founded on a people-centered development philosophy and,with distinctive Chinese characteristics,is a significant policy innovation of macroeconomic management in the Chinese modernization.Although there are notable distinctions between the Western“Keynesian”and the“nonKeynesian”schools of thought,both of these approaches’core policy goals and methodological roots are the same,composing the traditional Western macro-fiscal approach.This approach faces increasing real dilemmas.China’s proactive fiscal policy,however,places greater emphasis on future potential growth rates in addition to equilibrium between supply and demand,achieving a fiscal policy transformation with a new approach.In this paper we argue that with such a new approach,China should reconsider the nature and reasonable level of the fiscal deficit,the function and risk assessment criteria of government debt,the scope and effects of reductions in taxes and fees,its approach and focus of demand management,and the costs and resulting efficiencies of policies in order to develop a new fiscal policy paradigm that is more in line with its stated goals.展开更多
As of March 1,Malaysia,Singapore,and Thailand have all implemented visa-free entry policy for Chinese citizens,allowing stays of up to 30 days.The three Southeast Asian countries have been popular destinations for Chi...As of March 1,Malaysia,Singapore,and Thailand have all implemented visa-free entry policy for Chinese citizens,allowing stays of up to 30 days.The three Southeast Asian countries have been popular destinations for Chinese outbound tourists since the late 1980s and early 1990s.The implementation of the visa-free entry policy is expected to attract more Chinese tourists,especially young people,to travel to Southeast Asia and boost the recovery of the tourism industry in the region.展开更多
In 2023,China's energy policy primarily focused on deepening systemic and institutional reforms,enhancing energy security capabilities,strengthening energy conservation and carbon reduction,and improving the stand...In 2023,China's energy policy primarily focused on deepening systemic and institutional reforms,enhancing energy security capabilities,strengthening energy conservation and carbon reduction,and improving the standard system.It has laid the foundation for China's policy direction,which is predicated on ensuring energy security,centered on economic construction,and aimed at achieving the carbon peak and carbon neutrality goals on schedule.In the current key tasks,China has accelerated the construction of a big unified electricity market,vigorously promoted upgrading industries for low-carbon,high-end,and intelligent development,and established carbon markets and standard systems aligned with international practices,achieving substantial progress.展开更多
This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 3...This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 32 prefecture-level cities from 1990 to 2020,this study uses the multiperiod difference-in-differences approach to examine how paired assistance has contributed to economic growth in Xizang Autonomous Region and Xinjiang Uygur Autonomous Region.The findings indicate that,first,the implementation of the paired assistance policy has boosted economic growth in Xizang and Xinjiang.Second,paired assistance has stimulated economic growth in recipient communities by improving infrastructure.Third,paired assistance has contributed to economic growth in recipient communities by providing improved public services such as education and healthcare.Improvements to public services have a relatively smaller indirect effect in short term than infrastructure development on economic growth.Yet both education and healthcare are crucial to people’s quality of life in recipient communities.This paper has refined and broadened research on the effects of paired assistance,providing preference for future policymaking.展开更多
The aim of this study was to verify the existence of business and strategic intelligence policies at the level of Congolese companies and at the state level, likely to foster progress and healthy development in the ea...The aim of this study was to verify the existence of business and strategic intelligence policies at the level of Congolese companies and at the state level, likely to foster progress and healthy development in the east of the DRC. The study was based on a mixed perspective consisting of objective analysis of quantitative data and interpretative analysis of qualitative data. The results showed that business and strategic intelligence policies have not been established at either company or state level, as this is an area of activity that is not known to the players in companies and public departments, and there are no units or offices in their organizational structures responsible for managing strategic information for competitiveness on the international market. In addition, there is a real need to establish strategic information management units within companies, upstream, and to set up a national strategic information management department or agency to help local companies compete in the marketplace, downstream. This reflects the importance and timeliness of building business and strategic intelligence policies to ensure economic progress and development in the eastern DRC. Business and strategic intelligence provides companies with an appropriate tool for researching, collecting, processing and disseminating information useful for decision-making among stakeholders, in order to cope with a crisis or competitive situation. The study suggests a number of key recommendations based on its findings. To the government, it is recommended to establish the national policy of business and strategic intelligence by setting up a national agency of strategic intelligence in favor of local companies;and to companies to establish business intelligence units in their organizational structures in favor of stakeholders to foster advantageous decision-making in the competitive market and achieve progress. Finally, the study suggests that studies be carried out to fully understand the opportunities and impact of business and strategic intelligence in African countries, particularly in the DRC.展开更多
Global climate change-induced natural disasters require international efforts and the adoption of Eco-Disaster Risk Reduction(Eco-DRR)policies for sustainable development.This study examines the status of Eco-DRR in d...Global climate change-induced natural disasters require international efforts and the adoption of Eco-Disaster Risk Reduction(Eco-DRR)policies for sustainable development.This study examines the status of Eco-DRR in disaster prevention policies through word cloud analysis,providing insights for policymakers to enhance disaster prevention amid increasing climate-related challenges.Tokyo and Japan prioritize soft aspects,while Shanghai and China emphasize engineering for flood prevention,revealing a gap in Eco-DRR application.Despite these differing approaches,the shared focus on water-related disasters indicates a shift towards urban resilience.Future research should assess policy effectiveness and the impact of Eco-DRR on disaster risk reduction and ecosystem protection.展开更多
China is home to the second largest population of children and adolescents in the world.Yet demographic shifts mean that the government must manage the challenge of fewer children with the needs of an ageing populatio...China is home to the second largest population of children and adolescents in the world.Yet demographic shifts mean that the government must manage the challenge of fewer children with the needs of an ageing population,while considering the delicate tension between economic growth and environmental sustainability.We mapped the health problems and risks of contemporary school-aged children and adolescents in China against current national health policies.We involved multidisciplinary experts,including young people,with the aim of identifying actionable strategies and specific recommendations to promote child and adolescent health and wellbeing.Notwithstanding major improvements in their health over the past few decades,contemporary Chinese children and adolescents face distinct social challenges,including high academic pressures and youth unemployment,and new health concerns including obesity,mental health issues,and sexually transmitted infections.Inequality by gender,geography,and ethnicity remains a feature of health risks and outcomes.We identified a mismatch between current health determinants,risks and outcomes,and government policies.展开更多
With China’s economic development entering a new normal,high-quality regional economic development has become an important goal of current economic development.As one of the important means to promote high-quality de...With China’s economic development entering a new normal,high-quality regional economic development has become an important goal of current economic development.As one of the important means to promote high-quality development of the regional economy,industrial policies are increasingly receiving attention in terms of their role and impact.This article mainly conducts an in-depth analysis of the mechanism and impact path of industrial policies,exploring the role and impact of industrial policies in promoting high-quality regional economic development.Firstly,industrial policies play an important role in promoting high-quality regional economic development.Secondly,the impact path of industrial policies on the high-quality development of the regional economy mainly includes promoting industrial structure upgrading,promoting technological innovation,guiding resource allocation,and enhancing enterprise competitiveness.Therefore,it is necessary to increase research and practice on industrial policies,continuously optimize policy measures,and promote high-quality development of the regional economy.展开更多
Various transportation systems have been developed in recent years.In this study,an artificial society model is developed to examine the combination of transportation policies in urban areas.In this model,each trip ma...Various transportation systems have been developed in recent years.In this study,an artificial society model is developed to examine the combination of transportation policies in urban areas.In this model,each trip maker selects the primary and terminal transportation modes.An artificial society model is applied to the southeastern region of Osaka City,Japan.The effects of introducing BRT(bus rapid transit,primary transportation)and on-demand buses(terminal transportation)are investigated.The results confirm that BRT is used by a certain number of users.An increase in the use of BRT will increase the amount of walking,thus resulting in a healthy city.However,on-demand buses are rarely used as terminal transportation.Additionally,the development of bicycle parking stations near BRT stops is shown to be effective in the northern section of the BRT route.展开更多
This study investigated the impact of China’s monetary policy on both the money market and stock markets,assuming that non-policy variables would not respond contemporaneously to changes in policy variables.Monetary ...This study investigated the impact of China’s monetary policy on both the money market and stock markets,assuming that non-policy variables would not respond contemporaneously to changes in policy variables.Monetary policy adjustments are swiftly observed in money markets and gradually extend to the stock market.The study examined the effects of monetary policy shocks using three primary instruments:interest rate policy,reserve requirement ratio,and open market operations.Monthly data from 2007 to 2013 were analyzed using vector error correction(VEC)models.The findings suggest a likely presence of long-lasting and stable relationships among monetary policy,the money market,and stock markets.This research holds practical implications for Chinese policymakers,particularly in managing the challenges associated with fluctuation risks linked to high foreign exchange reserves,aiming to achieve autonomy in monetary policy and formulate effective monetary strategies to stimulate economic growth.展开更多
Decentralized methods for targeting poverty are widely adopted in developing countries to improve the performance of various poverty alleviation programs.A common challenge for implementing successful decentralized ta...Decentralized methods for targeting poverty are widely adopted in developing countries to improve the performance of various poverty alleviation programs.A common challenge for implementing successful decentralized targeting is the existence of elite capture.China has recently implemented a nationwide decentralized poverty targeting program,the targeted poverty alleviation(TPA)policy,to achieve the national goal of eliminating absolute poverty by the end of 2020.As the largest decentralized poverty targeting program in the world,TPA's successful implementation was believed to be threatened by elite capture in some earlier reports.Since 2015,a targeting correction mechanism,called"follow-up checks"policy,has been introduced.With the"follow-up checks"policy,the elites and other ineligible households who receive benefits under TPA were removed from the program.This paper investigates the elite capture phenomenon in TPA using village census data from a poverty-stricken county in 2017-two years after implementing the"follow-up checks"policy.We find no evidence of elite capture in TPA.The elites are unlikely to become beneficiaries or receive more benefits than non-elites.Our results contradict earlier findings that reported elite capture in TPA.We argue that the reason is the accountability emphasized by the central government in the"follow-up checks"policy.Our findings imply that having proper accountability is critical for improving targeting performance by global antipoverty initiatives.展开更多
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.
基金the National Natural Science Foundation of China(61922063,62273255,62150026)in part by the Shanghai International Science and Technology Cooperation Project(21550760900,22510712000)+1 种基金the Shanghai Municipal Science and Technology Major Project(2021SHZDZX0100)the Fundamental Research Funds for the Central Universities。
文摘Dear Editor,In this letter,the multi-objective optimal control problem of nonlinear discrete-time systems is investigated.A data-driven policy gradient algorithm is proposed in which the action-state value function is used to evaluate the policy.In the policy improvement process,the policy gradient based method is employed.
基金supported by the National Key Research and Development Program of China(2021YFD1800200,2021YFC2301700)the National Natural Science Foundation of China(32192451)+1 种基金the Innovation Program of the Chinese Academy of Agricultural Sciences(CAAS-CSLPDCP-202301)the earmarked fund for CARS-41(CARS-41).
文摘H9N2 virus has been widely distributed in wild birds and poultry around the world since its first emergence in the United States of America in 1966(Gu et al.2017;Carnaccini and Perez 2020).The virus appeared in chickens in China in the early 1990s,and over the last two decades has gradually become the dominant epidemic subtype(Sun and Liu 2015;Bi et al.2020).Although H9N2 virus infection alone cannot cause severe disease or death in poultry,H9N2 virus-infected birds experience a degree of egg production drop and can be easily infected by other pathogens,thus causing economic losses for poultry industry.
文摘The River Chief System (RCS) has evolved from local innovative practices to a national water governance strategy to address the current challenges in China’s water environmental management. In contrast to existing research that focuses on the strengths, weaknesses, and improvements of RCS, this study uses literature study to reveal the dynamic evolution of RCS through three phases, with RCS spreading from developed coastal areas to central and western inland regions. RCS’s diffusion path involves vertical diffusion between central and local levels and horizontal diffusion among local governments. Moreover, RCS has also achieved conceptual spillover, gradually expanding into other governance domains, such as the Lake Chief System, the Field Chief System, the Forestry Chief System, and the integration of multiple chief roles. However, it is essential to scrutinize the phenomenon of applying similar governance mechanisms to different areas, as it may result in challenges such as overburdening local governments, insufficient public participation, oversimplification of differences in natural resource endowments, and limited applicability. This study also provides suggestions on how to address these challenges. The study contributes theoretical insights and policy implications, providing a foundation for practical policy innovation.
文摘BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.
文摘Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.
基金supported in part by the projects of the National Natural Science Foundation of China(62376059,41971340)Fujian Provincial Department of Science and Technology(2023XQ008,2023I0024,2021Y4019),Fujian Provincial Department of Finance(GY-Z230007,GYZ23012)Fujian Key Laboratory of Automotive Electronics and Electric Drive(KF-19-22001).
文摘Autonomous driving has witnessed rapid advancement;however,ensuring safe and efficient driving in intricate scenarios remains a critical challenge.In particular,traffic roundabouts bring a set of challenges to autonomous driving due to the unpredictable entry and exit of vehicles,susceptibility to traffic flow bottlenecks,and imperfect data in perceiving environmental information,rendering them a vital issue in the practical application of autonomous driving.To address the traffic challenges,this work focused on complex roundabouts with multi-lane and proposed a Perception EnhancedDeepDeterministic Policy Gradient(PE-DDPG)for AutonomousDriving in the Roundabouts.Specifically,themodel incorporates an enhanced variational autoencoder featuring an integrated spatial attention mechanism alongside the Deep Deterministic Policy Gradient framework,enhancing the vehicle’s capability to comprehend complex roundabout environments and make decisions.Furthermore,the PE-DDPG model combines a dynamic path optimization strategy for roundabout scenarios,effectively mitigating traffic bottlenecks and augmenting throughput efficiency.Extensive experiments were conducted with the collaborative simulation platform of CARLA and SUMO,and the experimental results show that the proposed PE-DDPG outperforms the baseline methods in terms of the convergence capacity of the training process,the smoothness of driving and the traffic efficiency with diverse traffic flow patterns and penetration rates of autonomous vehicles(AVs).Generally,the proposed PE-DDPGmodel could be employed for autonomous driving in complex scenarios with imperfect data.
文摘In contrast to the traditional Western approach to macro-fiscal management,China’s proactive fiscal policy is founded on a people-centered development philosophy and,with distinctive Chinese characteristics,is a significant policy innovation of macroeconomic management in the Chinese modernization.Although there are notable distinctions between the Western“Keynesian”and the“nonKeynesian”schools of thought,both of these approaches’core policy goals and methodological roots are the same,composing the traditional Western macro-fiscal approach.This approach faces increasing real dilemmas.China’s proactive fiscal policy,however,places greater emphasis on future potential growth rates in addition to equilibrium between supply and demand,achieving a fiscal policy transformation with a new approach.In this paper we argue that with such a new approach,China should reconsider the nature and reasonable level of the fiscal deficit,the function and risk assessment criteria of government debt,the scope and effects of reductions in taxes and fees,its approach and focus of demand management,and the costs and resulting efficiencies of policies in order to develop a new fiscal policy paradigm that is more in line with its stated goals.
文摘As of March 1,Malaysia,Singapore,and Thailand have all implemented visa-free entry policy for Chinese citizens,allowing stays of up to 30 days.The three Southeast Asian countries have been popular destinations for Chinese outbound tourists since the late 1980s and early 1990s.The implementation of the visa-free entry policy is expected to attract more Chinese tourists,especially young people,to travel to Southeast Asia and boost the recovery of the tourism industry in the region.
文摘In 2023,China's energy policy primarily focused on deepening systemic and institutional reforms,enhancing energy security capabilities,strengthening energy conservation and carbon reduction,and improving the standard system.It has laid the foundation for China's policy direction,which is predicated on ensuring energy security,centered on economic construction,and aimed at achieving the carbon peak and carbon neutrality goals on schedule.In the current key tasks,China has accelerated the construction of a big unified electricity market,vigorously promoted upgrading industries for low-carbon,high-end,and intelligent development,and established carbon markets and standard systems aligned with international practices,achieving substantial progress.
基金supported by the Major Project of the National Social Science Fund of China(NSSFC)“Economic Development for Ethnic Minorities under Socialism with Chinese Characteristics and International Comparison”(Grant No.19ZDA173),the NSSFC Project“Study on the Implementation and Development of Educational Assistance to Xizang and Xinjiang under the Horizon of the Community of the Chinese Nation”(Grant No.CMA220323),and the Elite Innovation Team of Pu’er University“Innovation Team for the Prosperity of Border Regions and Common Modernization of Ethnic Minority Regions”(Grant No.2023PEXYCXTD002).
文摘This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 32 prefecture-level cities from 1990 to 2020,this study uses the multiperiod difference-in-differences approach to examine how paired assistance has contributed to economic growth in Xizang Autonomous Region and Xinjiang Uygur Autonomous Region.The findings indicate that,first,the implementation of the paired assistance policy has boosted economic growth in Xizang and Xinjiang.Second,paired assistance has stimulated economic growth in recipient communities by improving infrastructure.Third,paired assistance has contributed to economic growth in recipient communities by providing improved public services such as education and healthcare.Improvements to public services have a relatively smaller indirect effect in short term than infrastructure development on economic growth.Yet both education and healthcare are crucial to people’s quality of life in recipient communities.This paper has refined and broadened research on the effects of paired assistance,providing preference for future policymaking.
文摘The aim of this study was to verify the existence of business and strategic intelligence policies at the level of Congolese companies and at the state level, likely to foster progress and healthy development in the east of the DRC. The study was based on a mixed perspective consisting of objective analysis of quantitative data and interpretative analysis of qualitative data. The results showed that business and strategic intelligence policies have not been established at either company or state level, as this is an area of activity that is not known to the players in companies and public departments, and there are no units or offices in their organizational structures responsible for managing strategic information for competitiveness on the international market. In addition, there is a real need to establish strategic information management units within companies, upstream, and to set up a national strategic information management department or agency to help local companies compete in the marketplace, downstream. This reflects the importance and timeliness of building business and strategic intelligence policies to ensure economic progress and development in the eastern DRC. Business and strategic intelligence provides companies with an appropriate tool for researching, collecting, processing and disseminating information useful for decision-making among stakeholders, in order to cope with a crisis or competitive situation. The study suggests a number of key recommendations based on its findings. To the government, it is recommended to establish the national policy of business and strategic intelligence by setting up a national agency of strategic intelligence in favor of local companies;and to companies to establish business intelligence units in their organizational structures in favor of stakeholders to foster advantageous decision-making in the competitive market and achieve progress. Finally, the study suggests that studies be carried out to fully understand the opportunities and impact of business and strategic intelligence in African countries, particularly in the DRC.
文摘Global climate change-induced natural disasters require international efforts and the adoption of Eco-Disaster Risk Reduction(Eco-DRR)policies for sustainable development.This study examines the status of Eco-DRR in disaster prevention policies through word cloud analysis,providing insights for policymakers to enhance disaster prevention amid increasing climate-related challenges.Tokyo and Japan prioritize soft aspects,while Shanghai and China emphasize engineering for flood prevention,revealing a gap in Eco-DRR application.Despite these differing approaches,the shared focus on water-related disasters indicates a shift towards urban resilience.Future research should assess policy effectiveness and the impact of Eco-DRR on disaster risk reduction and ecosystem protection.
文摘China is home to the second largest population of children and adolescents in the world.Yet demographic shifts mean that the government must manage the challenge of fewer children with the needs of an ageing population,while considering the delicate tension between economic growth and environmental sustainability.We mapped the health problems and risks of contemporary school-aged children and adolescents in China against current national health policies.We involved multidisciplinary experts,including young people,with the aim of identifying actionable strategies and specific recommendations to promote child and adolescent health and wellbeing.Notwithstanding major improvements in their health over the past few decades,contemporary Chinese children and adolescents face distinct social challenges,including high academic pressures and youth unemployment,and new health concerns including obesity,mental health issues,and sexually transmitted infections.Inequality by gender,geography,and ethnicity remains a feature of health risks and outcomes.We identified a mismatch between current health determinants,risks and outcomes,and government policies.
文摘With China’s economic development entering a new normal,high-quality regional economic development has become an important goal of current economic development.As one of the important means to promote high-quality development of the regional economy,industrial policies are increasingly receiving attention in terms of their role and impact.This article mainly conducts an in-depth analysis of the mechanism and impact path of industrial policies,exploring the role and impact of industrial policies in promoting high-quality regional economic development.Firstly,industrial policies play an important role in promoting high-quality regional economic development.Secondly,the impact path of industrial policies on the high-quality development of the regional economy mainly includes promoting industrial structure upgrading,promoting technological innovation,guiding resource allocation,and enhancing enterprise competitiveness.Therefore,it is necessary to increase research and practice on industrial policies,continuously optimize policy measures,and promote high-quality development of the regional economy.
基金supported by JSPS KAKENHI(grant number:21K04307).
文摘Various transportation systems have been developed in recent years.In this study,an artificial society model is developed to examine the combination of transportation policies in urban areas.In this model,each trip maker selects the primary and terminal transportation modes.An artificial society model is applied to the southeastern region of Osaka City,Japan.The effects of introducing BRT(bus rapid transit,primary transportation)and on-demand buses(terminal transportation)are investigated.The results confirm that BRT is used by a certain number of users.An increase in the use of BRT will increase the amount of walking,thus resulting in a healthy city.However,on-demand buses are rarely used as terminal transportation.Additionally,the development of bicycle parking stations near BRT stops is shown to be effective in the northern section of the BRT route.
文摘This study investigated the impact of China’s monetary policy on both the money market and stock markets,assuming that non-policy variables would not respond contemporaneously to changes in policy variables.Monetary policy adjustments are swiftly observed in money markets and gradually extend to the stock market.The study examined the effects of monetary policy shocks using three primary instruments:interest rate policy,reserve requirement ratio,and open market operations.Monthly data from 2007 to 2013 were analyzed using vector error correction(VEC)models.The findings suggest a likely presence of long-lasting and stable relationships among monetary policy,the money market,and stock markets.This research holds practical implications for Chinese policymakers,particularly in managing the challenges associated with fluctuation risks linked to high foreign exchange reserves,aiming to achieve autonomy in monetary policy and formulate effective monetary strategies to stimulate economic growth.
基金supported by the National Natural Science Foundation of China(71661147001 and 71603228)the China Postdoctoral Science Foundation(2018M630687 and 2018T110607)the Zhejiang University-IFPRI Center for International Development Studies。
文摘Decentralized methods for targeting poverty are widely adopted in developing countries to improve the performance of various poverty alleviation programs.A common challenge for implementing successful decentralized targeting is the existence of elite capture.China has recently implemented a nationwide decentralized poverty targeting program,the targeted poverty alleviation(TPA)policy,to achieve the national goal of eliminating absolute poverty by the end of 2020.As the largest decentralized poverty targeting program in the world,TPA's successful implementation was believed to be threatened by elite capture in some earlier reports.Since 2015,a targeting correction mechanism,called"follow-up checks"policy,has been introduced.With the"follow-up checks"policy,the elites and other ineligible households who receive benefits under TPA were removed from the program.This paper investigates the elite capture phenomenon in TPA using village census data from a poverty-stricken county in 2017-two years after implementing the"follow-up checks"policy.We find no evidence of elite capture in TPA.The elites are unlikely to become beneficiaries or receive more benefits than non-elites.Our results contradict earlier findings that reported elite capture in TPA.We argue that the reason is the accountability emphasized by the central government in the"follow-up checks"policy.Our findings imply that having proper accountability is critical for improving targeting performance by global antipoverty initiatives.