Effect analysis of applying high-quality service model to surgical nursing

BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.

The Chinese Consumers’Service Quality Satisfaction Differences of Cruise Tourism and Precision Marketing Strategy

The paper selected Chinese Cruise Line as the case study. Having based on the survey data of Chinese cruise tourism consumers, the factor analysis method, one-way analysis of variances method, cluster analysis method, and other quantitative and qualitative methods were taken to analyze Chinese consumers’ satisfaction differences of cruise tourism service quality with different segmentation markets and clusters markets, and the reasons of satisfaction differences were also explored. Then precision marketing strategy of Chinese cruise tourism with different segmentation markets and clusters markets from the supply-side reform perspective was discussed. The purpose of current research was to provide suggestions of precision management and precision marketing of Chinese cruise tourism for relevant enterprises and government departments.

Failure to Rescue as a Quality Metric in Congenital Heart Surgeries in a High-Complexity Service Provider Institution Located in a Middle-Income Country

Background:Failure to rescue has been an effective quality metric in congenital heart surgery.Conversely,mor-bidity and mortality depend greatly on non-modifiable individual factors and have a weak correlation with better-quality performance.We aim to measure the complications,mortality,and risk factors in pediatric patients undergoing congenital heart surgery in a high-complexity institution located in a middle-income country and compare it with other institutions that have conducted a similar study.Methods:A retrospective observational study was conducted in a high-complexity service provider institution,in Cali,Colombia.All pediatric patients undergoing any congenital heart surgery between 2019 and 2022 were included.The main outcomes evaluated in the study were complication,mortality,and failure to rescue rate.Univariate and multivariate logistic regression analysis was performed with mortality as the outcome variable.Results:We evaluated 308 congenital heart sur-geries.Regarding the outcomes,201(65%)complications occurred,23(7.5%)patients died,and the FTR of the entire cohort was 11.4%.The presence of a postoperative complication(OR 14.88,CI 3.06–268.37,p=0.009),age(OR 0.79,CI 0.57–0.96,p=0.068),and urgent/emergent surgery(OR 8.14,CI 2.97–28.66,p<0.001)were the most significant variables in predicting mortality.Conclusions:Failure to rescue is an effective and comparable quality measure in healthcare institutions and is the major contributor to postoperative mortality in congenital heart surgeries.Despite our higher mortality and complication rate,we obtained a comparable failure to rescue rate to high-income countries’health institutions.

Construction and Application of a Quality Evaluation System for Group Elderly Care Services Based on the Internet of Things

With the continuous intensification of global aging,the issue of elderly care has become an increasingly prominent social problem.The Internet of Things(IoT)technology,as an emerging field,holds broad application prospects.This article focuses on the application of IoT technology in group elderly care services and constructs a quality evaluation system for these services based on IoT technology.Through the analysis of practical application cases,the advantages and challenges of IoT technology in group elderly care services have been examined,confirming the feasibility and effectiveness of the evaluation system.

Trade-offs and synergies between ecosystem services in Yutian County along the Keriya River Basin,Northwest China

The Keriya River Basin is located in an extremely arid climate zone on the southern edge of the Tarim Basin of Northwest China,exhibiting typical mountain-oasis-desert distribution characteristics.In recent decades,climate change and human activities have exerted significant impacts on the service functions of watershed ecosystems.However,the trade-offs and synergies between ecosystem services(ESs)have not been thoroughly examined.This study aims to reveal the spatiotemporal changes in ESs within the Keriya River Basin from 1995 to 2020 as well as the trade-offs and synergies between ESs.Leveraging the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)and Revised Wind Erosion Equation(RWEQ)using land use/land cover(LULC),climate,vegetation,soil,and hydrological data,we quantified the spatiotemporal changes in the five principal ESs(carbon storage,water yield,food production,wind and sand prevention,and habitat quality)of the watershed from 1995 to 2020.Spearman correlation coefficients were used to analyze the trade-offs and synergies between ES pairs.The findings reveal that water yield,carbon storage,and habitat quality exhibited relatively high levels in the upstream,while food production and wind and sand prevention dominated the midstream and downstream,respectively.Furthermore,carbon storage,food production,wind and sand prevention,and habitat quality demonstrated an increase at the watershed scale while water yield exhibited a decline from 1995 to 2020.Specifically,carbon storage,wind and sand prevention,and habitat quality presented an upward trend in the upstream but downward trend in the midstream and downstream.Food production in the midstream showed a continuously increasing trend during the study period.Trade-off relationships were identified between water yield and wind and sand prevention,water yield and carbon storage,food production and water yield,and habitat quality and wind and sand prevention.Prominent temporal and spatial synergistic relationships were observed between different ESs,notably between carbon storage and habitat quality,carbon storage and food production,food production and wind and sand prevention,and food production and habitat quality.Water resources emerged as a decisive factor for the sustainable development of the basin,thus highlighting the intricate trade-offs and synergies between water yield and the other four services,particularly the relationship with food production,which warrants further attention.This research is of great significance for the protection and sustainable development of river basins in arid areas.

Spatiotemporal variations in ecosystem services and their trade-offs and synergies against the background of the gully control and land consolidation project on the Loess Plateau,China

Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.

Effectiveness of Short Message Service Support on Adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

Deep Reinforcement Learning-Based Task Offloading and Service Migrating Policies in Service Caching-Assisted Mobile Edge Computing

Emerging mobile edge computing(MEC)is considered a feasible solution for offloading the computation-intensive request tasks generated from mobile wireless equipment(MWE)with limited computational resources and energy.Due to the homogeneity of request tasks from one MWE during a longterm time period,it is vital to predeploy the particular service cachings required by the request tasks at the MEC server.In this paper,we model a service caching-assisted MEC framework that takes into account the constraint on the number of service cachings hosted by each edge server and the migration of request tasks from the current edge server to another edge server with service caching required by tasks.Furthermore,we propose a multiagent deep reinforcement learning-based computation offloading and task migrating decision-making scheme(MBOMS)to minimize the long-term average weighted cost.The proposed MBOMS can learn the near-optimal offloading and migrating decision-making policy by centralized training and decentralized execution.Systematic and comprehensive simulation results reveal that our proposed MBOMS can converge well after training and outperforms the other five baseline algorithms.

Spatiotemporal variations of ecosystem services and driving factors in the Tianchi Bogda Peak Natural Reserve of Xinjiang,China

Nature reserves play a significant role in providing ecosystem services and are key sites for biodiversity conservation.The Tianchi Bogda Peak Natural Reserve(TBPNR),located in Xinjiang Uygur Autonomous Region,China,is an important ecological barrier area in the temperate arid zone.The evaluation of its important ecosystem services is of great significance to improve the management level and ecological protection efficiency of the reserve.In the present study,we assessed the spatiotemporal variations of four ecosystem services(including net primary productivity(NPP),water yield,soil conservation,and habitat quality)in the TBPNR from 2000 to 2020 based on the environmental and social data using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.In addition,the coldspot and hotspot areas of ecosystem services were identified by hotspot analysis,and the trade-off and synergistic relationships between ecosystem services were analyzed using factor analysis in a geographic detector.During the study period,NPP and soil conservation values in the reserve increased by 48.20%and 25.56%,respectively;conversely,water yield decreased by 16.56%,and there was no significant change in habitat quality.Spatially,both NPP and habitat quality values were higher in the northern part and lower in the southern part,whereas water yield showed an opposite trend.Correlation analysis revealed that NPP showed a synergistic relationship with habitat quality and soil conservation,and exhibited a trade-off relationship with water yield.Water yield and habitat quality also had a trade-off relationship.NPP and habitat quality were affected by annual average temperature and Normalized Difference Vegetation Index(NDVI),respectively,while water yield and soil conservation were more affected by digital elevation model(DEM).Therefore,attention should be paid to the spatial distribution and dynamics of trade-off and synergistic relationships between ecosystem services in future ecological management.The findings of the present study provide a reference that could facilitate the sustainable utilization of ecosystem services in the typical fragile areas of Northwest China.

Assessment of International GNSS Service Global Ionosphere Map products over China region based on measurements from the Crustal Movement Observation Network of China

The global ionosphere maps(GIM)provided by the International GNSS Service(IGS)are extensively utilized for ionospheric morphology monitoring,scientific research,and practical application.Assessing the credibility of GIM products in data-sparse regions is of paramount importance.In this study,measurements from the Crustal Movement Observation Network of China(CMONOC)are leveraged to evaluate the suitability of IGS-GIM products over China region in 2013-2014.The indices of mean error(ME),root mean square error(RMSE),and normalized RMSE(NRMSE)are then utilized to quantify the accuracy of IGS-GIM products.Results revealed distinct local time and latitudinal dependencies in IGS-GIM errors,with substantially high errors at nighttime(NRMSE:39%)and above 40°latitude(NRMSE:49%).Seasonal differences also emerged,with larger equinoctial deviations(NRMSE:33.5%)compared with summer(20%).A preliminary analysis implied that the irregular assimilation of sparse IGS observations,compounded by China’s distinct geomagnetic topology,may manifest as error variations.These results suggest that modeling based solely on IGS-GIM observations engenders inadequate representations across China and that a thorough examination would proffer the necessary foundation for advancing regional total electron content(TEC)constructions.

Healthcare Services Interoperability in Kenya: Challenges and Opportunities

In an attempt to assess the Kenyan healthcare system, this study looks at the current efforts that are already in place, what challenges they face, and what strategies can be put into practice to foster interoperability. By reviewing a variety of literature and using statistics, the paper ascertains notable impediments such as the absence of standard protocols, lack of adequate technological infrastructure, and weak regulatory frameworks. Resultant effects from these challenges regarding health provision target enhanced data sharing and merging for better patient outcomes and allocation of resources. It also highlights several opportunities that include the adoption of emerging technologies, and the establishment of public-private partnerships to strengthen the healthcare framework among others. In this regard, the article provides recommendations based on stakeholder views and global best practices addressed to policymakers, medical practitioners, and IT specialists concerned with achieving effective interoperability within Kenya’s health system. This research is relevant because it adds knowledge to the existing literature on how healthcare quality can be improved to make it more patient-centered especially in Kenya.

Exact Tail Asymptotics for a Queueing System with a Retrial Orbit and Batch Service

This paper discusses a queueing system with a retrial orbit and batch service, in which the quantity of customers’ rooms in the queue is finite and the space of retrial orbit is infinite. When the server starts serving, it serves all customers in the queue in a single batch, which is the so-called batch service. If a new customer or a retrial customer finds all the customers’ rooms are occupied, he will decide whether or not to join the retrial orbit. By using the censoring technique and the matrix analysis method, we first obtain the decay function of the stationary distribution for the quantity of customers in the retrial orbit and the quantity of customers in the queue. Then based on the form of decay rate function and the Karamata Tauberian theorem, we finally get the exact tail asymptotics of the stationary distribution.

Exploring the Spatiotemporal Changes and Driving Forces of Ecosystem Services of Zhejiang Coasts,China,Under Sustainable Development Goals

Ecosystem services(ESs)refer to the continuous provisioning of ecosystem goods and services that benefit human beings.Over recent decades,rapid urbanization has exerted significant pressure on coastal ecosystems,resulting in biodiversity and habitat loss,environmental pollution,and the depletion of natural resources.In response to these environmental challenges,the Sustainable Development Goals(SDGs)were proposed.Given the pressing need to address these issues,understanding the changes in ESs under the SDGs is crucial for formulating specific ecological strategies.In this study,we first analyzed land use and cover change in the Zhejiang coasts of China during 2000–2020.Then,we investigated the spatiotemporal configuration of ESs by integrating carbon storage(CS),soil retention(SR),habitat quality(HQ)and water yield(WY)using the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model.The driving mechanisms of ESs,which varied by space and time,were also explored using the Geo-detector method.The results revealed that,over the past two decades:1)the Zhejiang coasts have experienced a significant increase of 2783.72 km^(2) in built-up land areas and a continuous decrease in farmland areas due to rapid urbanization;2)owing to higher precipitation,extensive vegetation cover,and reduced anthropogenic disturbances,forests emerge as a crucial land use type for maintaining ecosystem services such as HQ,CS,WY,and SR;3)ESs have generally declined across the entire Zhejiang coasts,with a significant decrease observed in the northern areas and an increase in the southern areas spatially;4)the expansion of built-up land areas emerged as the primary factor affecting ecosystem services,while the vegetation factor has been increasingly significant and is expected to become predominant in the near future.Our study provides insights of understanding of ecosystem service theory and emphasizing the importance of preserving biodiversity for long-term sustainable development,and valuable scientific references to support the ecological management decision-making for local governments.

Cloud Datacenter Selection Using Service Broker Policies:A Survey

Amid the landscape of Cloud Computing(CC),the Cloud Datacenter(DC)stands as a conglomerate of physical servers,whose performance can be hindered by bottlenecks within the realm of proliferating CC services.A linchpin in CC’s performance,the Cloud Service Broker(CSB),orchestrates DC selection.Failure to adroitly route user requests with suitable DCs transforms the CSB into a bottleneck,endangering service quality.To tackle this,deploying an efficient CSB policy becomes imperative,optimizing DC selection to meet stringent Qualityof-Service(QoS)demands.Amidst numerous CSB policies,their implementation grapples with challenges like costs and availability.This article undertakes a holistic review of diverse CSB policies,concurrently surveying the predicaments confronted by current policies.The foremost objective is to pinpoint research gaps and remedies to invigorate future policy development.Additionally,it extensively clarifies various DC selection methodologies employed in CC,enriching practitioners and researchers alike.Employing synthetic analysis,the article systematically assesses and compares myriad DC selection techniques.These analytical insights equip decision-makers with a pragmatic framework to discern the apt technique for their needs.In summation,this discourse resoundingly underscores the paramount importance of adept CSB policies in DC selection,highlighting the imperative role of efficient CSB policies in optimizing CC performance.By emphasizing the significance of these policies and their modeling implications,the article contributes to both the general modeling discourse and its practical applications in the CC domain.

Growing Market Demand for After-Sales Service Management

With the background of the current economic globalization and informatization,how to improve the quality of after-sales services and meet the diversified needs of consumers has become an important issue that the industry has had to face and solve.Recently,the“report on 2022-2028 after-sales service management industry market competition analysis and development strategic planning assessment forecast”(hereinafter referred to as the“Report”)released by CICC Consulting pointed out that the high penetration rate of electronic information products.

Regional Digital Financial Services Security Clinic for Asia Pacific Region

April 24-25, Seoul, Republic of Korea The International Telecommunication Union(ITU) is organizing the Regional Digital Financial Services Security Clinic for Asia Pacific Region on April 24-25, 2024 in Seoul, Republic of Korea. The event is being jointly held with FNSV Korea and the Korean Fintech Center.

A Hybrid Machine Learning Approach for Improvised QoE in Video Services over 5G Wireless Networks

Video streaming applications have grown considerably in recent years.As a result,this becomes one of the most significant contributors to global internet traffic.According to recent studies,the telecommunications industry loses millions of dollars due to poor video Quality of Experience(QoE)for users.Among the standard proposals for standardizing the quality of video streaming over internet service providers(ISPs)is the Mean Opinion Score(MOS).However,the accurate finding of QoE by MOS is subjective and laborious,and it varies depending on the user.A fully automated data analytics framework is required to reduce the inter-operator variability characteristic in QoE assessment.This work addresses this concern by suggesting a novel hybrid XGBStackQoE analytical model using a two-level layering technique.Level one combines multiple Machine Learning(ML)models via a layer one Hybrid XGBStackQoE-model.Individual ML models at level one are trained using the entire training data set.The level two Hybrid XGBStackQoE-Model is fitted using the outputs(meta-features)of the layer one ML models.The proposed model outperformed the conventional models,with an accuracy improvement of 4 to 5 percent,which is still higher than the current traditional models.The proposed framework could significantly improve video QoE accuracy.

Mapping Climate Services for Disaster Risk Management: A Systematic Review and Research Gaps from a Policy Process Perspective

Climate services (CS) are crucial for mitigating and managing the impacts and risks associated with climate-induced disasters. While evidence over the past decade underscores their effectiveness across various domains, particularly agriculture, to maximize their potential, it is crucial to identify emerging priority areas and existing research gaps for future research agendas. As a contribution to this effort, this paper employs the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to review the state-of-the-art in the field of climate services for disaster risk management. A comprehensive search across five literature databases combined with a snowball search method using ResearchRabbit was conducted and yielded 242 peer-reviewed articles, book sections, and reports over 2013-2023 after the screening process. The analysis revealed flood, drought, and food insecurity as major climate-related disasters addressed in the reviewed literature. Major climate services addressed included early warning systems, (sub)seasonal forecasts and impact-based warnings. Grounded in the policy processes’ theoretical perspective, the main focus identified and discussed three prevailing policy-oriented priority areas: 1) development of climate services, 2) use-adoption-uptake, and 3) evaluation of climate services. In response to the limitations of the prevalent supply-driven and top-down approach to climate services promotion, co-production emerges as a cross-cutting critical aspect of the identified priority areas. Despite the extensive research in the field, more attention is needed, particularly pronounced in the science-policy interface perspective, which in practice bridges scientific knowledge and policy decisions for effective policy processes. This perspective offers a valuable analytical lens as an entry point for further investigation. Hence, future research agendas would generate insightful evidence by scrutinizing this critical aspect given its importance to institutions and climate services capacity, to better understand intricate facets of the development and the integration of climate services into disaster risk management.

Spatio-temporal evolution and topographic gradient effect of land use and ecosystem service value in the Lhasa River Basin

The Lhasa River Basin forms an essential human settlement area in the southern part of the Qinghai-Tibet Plateau.This study employed ecosystem service value(ESV)evaluation model,terrain gradient grading,and Geodetector to analyze land use and ESV in the Lhasa River Basin from 1985 to 2020.The findings reveal that:(1)From 1985 to 2020,grassland was the dominant land use.There was a trend of grassland reduction and the expansion of other land types.(2)ESV has increased over the research period(with a total increase of 0.84%),with higher values in the southeast and lower values in the northwest.Grassland contributed the most to ESV,and climate regulation and hydrological regulation were the ecosystem services that contribute the most to ESV.(3)Natural factors like NDVI and altitude,as well as economic factors like population density and distance from roads,influenced the spatial differentiation of ESV,the explanatory power of NDVI reached up to 0.47.The interaction between factors had a greater impact than individual factors.These research results can provide theoretical support for national spatial planning and ecological environment protection in the Lhasa River Basin and other similar areas.

Coupling Coordination Analysis of Cropland Intensification and Agroecosystem Services:Evidence from Loess Plateau in Shaanxi Province,China

One of the greatest challenges in the agroecosystem is to improve cropland intensification while preserving agroecosystem services.While many studies have investigated the effect of cropland intensification on agroecosystem service,the interactive coupling and coordination among these factors remain largely unexplored.In view of this,this study performed a case study of the Loess Plateau in Shaanxi Province,China and constructed comprehensive evaluation models to quantify the cropland intensification and agroecosystem service in this area.Balance analysis and the coupling coordination degree model were used to evaluate the interactive relationship between cropland intensification and agroecosystem service,and statistical analysis and spatial autocorrelation were used to analyze the spatial characteristics and potential mechanism of the coupling coordination.Results show that both the cropland intensification and agroecosystem service in the study area were relatively low yet gradually increased from 2000 to 2020.Agroecosystem service lag was identified as the dominant unbalanced development type.Improving the supply capacity of agroecosystem services plays a key role in the balanced development of cropland in the Loess Plateau.The coupling coordination degree between cropland intensification and agroecosystem service ranges from basic coordination to serious incoordination.Therefore,cropland intensification practices in the area should be optimized to enhance this coordination degree.An upward trend was also observed in the coupling coordination degree from2000 to 2020.The withdrawal of marginal cropland in the Grain for Green program is one of the most important reasons for this trend,especially for the northern region.Around 83.6%of the high-high clusters are concentrated in the southern region of the Loess Plateau,whereas 70.5%of the low-low clusters are distributed in the northern region.These clustering characteristics are mainly attributed to the environmental suitability of these areas for agriculture and their degree of economic development.