Relationship between the Current Account Balance Ratio and Salary Ratio in Japanese Municipal Hospitals

Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. Hospitals running at a deficit may have poorer outcomes and less investment in maintenance of human or physical capital, as well as increased rates of patient adverse events. We sought to clarify the relationship between municipal hospital surpluses or deficits and salary expenditures. Methods: We extracted financial data for 253 general hospitals of 300 beds or more from financial statements for the 2013 fiscal year available in the Yearbook of Public Firms, Edition for Hospital. From these data, we calculated account balance ratios and compared the average value of the ratio of labor to the output (salary ratio) for each group using analysis of variance (ANOVA). Results: The salary ratios of hospitals in the surplus group were significantly lower than the salary ratios of hospitals in the deficit group (55.5% vs. 49.4%;p p = 0.342). In the surplus group, the average value of salary ratios was different among the three-bed count groups (mean salary ratio: 53.0% vs. 48.5% vs. 47.4%;ANOVA p = 0.012). In addition, there was a significant difference in mean value between the 300-bed group and ≥500 beds group (mean salary ratio: 53.0% vs. 47.4%;p = 0.002). Conclusion: This study suggests that maintaining a favorable salary ratio to the current account balance is a useful proxy of fiscal health, and interventions to improve the salary ratio may be effective in improving municipal hospital management. Furthermore, among well-managed municipal hospitals, larger hospital size may confer some advantage in purchasing power.

Upcycling municipal solid waste to sustainable hydrogen via two-stage gasification-reforming

As global municipal solid waste(MSW)quantities continue to escalate,serious socio-environmental challenges arise,necessitating innovative solutions.Waste-to-hydrogen(WTH)via two-stage gasification-reforming(TSGR)presents an emergent technology for MSW upcycling,offering to ease waste management burdens and bolster the burgeoning hydrogen economy.Despite early initiatives to advance TSGR technology,a cohesive and critical analysis of cutting-edge knowledge and strategies to enhance hydrogen production remains lacking.This review aggregates literature on MSW upcycling to hydrogen via TSGR,with a focus on optimizing process control and catalytic efficiency.It underscores technological avenues to augment hydrogen output,curtail catalyst costs,and refine system performance.Particularly,the review illuminates the potential for integrating chemical and calcium looping into TSGR processes,identifying opportunities,and pinpointing challenges.The review concludes with a summary of the current state of techno-economic analysis for this technology,presenting outstanding challenges and future research directions,with the ultimate goal of transitioning WTH from theoretical to practical application.

Microstructural analysis of marl stabilized with municipal solid waste and nano-MgO

Municipal solid waste(MSW)is accumulating over elapsed time across the world,and it is observed in many projects associated with weak soils,such as marl.Therefore,effective solutions to the environmental problem are essential.Conventional techniques for stabilizing marl generally use substances such as lime and cement,which could exacerbate pollution.For this,some new stabilizers,e.g.nano-MgO,are used.There are large quantities of marls and MSW in Shiraz City,Iran.The present study aims to evaluate the feasibility of using nano-MgO as a green low-carbon binder to remove MSW from the environment and make construction projects more cost-effective.Consolidated drained shear tests were conducted to evaluate the mechanical behaviors of the nano-MgO treated marl specimens at high normal stresses.The marl specimens containing MSW percentages of 15%,25%,35%,and 45%and nano-MgO percentages of 0.25%,0.5%,0.75%,and 1%,were used.It is found that the marl containing 15%and 25%MSW and 0.5%nano-MgO at 28-d curing can perform cation exchange and form new cementitious products.The soils with merely MSW show good performance due to the removal of the kaolinite and the formation of brucite.However,the soil with 25%MSW and 0.5%nano-MgO shows the same strength enhancement as the specimen with the optimal nano-MgO(0.75%)through the formation of dolomite,with a 20.59%increase in strain energy(SE).

Development of a Web-Based GIS of Flood Zones in the Municipality of Ouagadougou in Burkina Faso

This document describes the creation of an informative Web GIS aimed at mitigating the impacts of flooding in the municipality of Ouagadougou, in Burkina Faso, a region that is highly sensitive to climate change. Burkina Faso, which is undergoing rapid urbanization, faces major natural threats, particularly flooding, as demonstrated by the severe floods of 2009 that caused loss of life, injury, structural damage and economic losses in Ouagadougou. The aim of this research is to develop a web map highlighting the municipality’s flood-prone areas, with a view to informing and raising awareness of flood risk reduction. Using the Leaflet JavaScript mapping library, the study uses HTML, CSS and JavaScript to implement web mapping technology. Data on Ouagadougou’s flood zones is generated by a multi-criteria analysis combining Saaty’s AHP method and GIS in QGIS, integrating seven (7) parameters including hydrography, altitude, slope, rainfall, soil types, land use and soil moisture index. QGIS processes and maps the themes, PostgreSQL with PostGIS serves as the DBMS and GeoServer functions as the map server. The Web GIS platform allows users to visualize the different flood risks, from very low to very high, or the high-risk areas specific to Ouagadougou. The AHP calculations classify the municipality into five flood vulnerability zones: very low (24.48%), low (27.93%), medium (23.01%), high (17.11%) and very high (7.47%). Effective risk management requires communication and awareness-raising. This online mapping application serves as a tool for communication, management and flood prevention in Ouagadougou, helping to mitigate flood-related natural disasters.

Global Research Progress on Municipal Waste and Future Prospect Based on the Cross-national Comparisons

Due to the acceleration of urbanization,the municipal waste(MW)problem has transformed into a global challenge for urb-an sustainability.To elucidate historical trends,current focal points,and future directions in MW research,we conducted a bibliometric analysis and employed knowledge graph visualization to scrutinize a total of 34212 articles,which were published between 1991 and 2021 in the Web of Science(WoS)core database.The results indicated that current major research themes encompass waste classifica-tion and recycling,waste management and public behavior,waste disposal methods and technologies,as well as environmental impact and evaluation.There has been a shift in the research focus from the environmental impacts of waste incineration to sustainable manage-ment related issues.A comparison of research from six typical countries revealed the differences in research priorities and techniques advantages.Scholars from the USA and Britain initiated MW research earlier than other countries and investigated management issues in depth,such as public behavior and willingness to pay.Meanwhile,Japanese,German,and Swedish scholars conducted extensive studies on advanced waste treatment technologies,such as disposal and recycling,risk assessment,and waste-to-energy techniques.Chinese scholars placed particular emphasis on end-of-pipe treatments and their associated environmental impacts.Hotspots and poten-tial future frontiers were identified by burst detection analysis.Keywords with high value of burst index(BI)worldwide are food waste and circular economy.Chinese scholars have put great efforts on waste environmental impact and its recycling technologies,while we’re expecting to further investigating vulnerable population.Furthermore,this study contributes to bridging the regional gap of scientific research among different countries and fostering international collaboration.

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

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

Research on the Coupled and Coordinated Development of Tourism and Transport in Chongqing Municipality

By examining the current status of tourism and transport research both domestically and internationally,and analyzing the development trends of Chongqing’s tourism and transport industry,this study evaluates the weight indices and performs a coupling and coordination analysis of various indicators of Chongqing’s tourism and transport industry from 2011 to 2019.The following conclusions are drawn:(1)The value of the comprehensive evaluation function for tourism is higher than that of the transport industry,indicating that Chongqing’s tourism industry is in a period of vigorous development;(2)The degree of coupling coordination development between Chongqing’s tourism and transportation industries from 2011 to 2019 is rising.As the coupling coordination stage continues to improve,the level of coupling coordination also improves,with the overall trend showing a progression from mild dysfunction to primary coordination.Based on these conclusions,corresponding countermeasures are proposed to promote the coupling coordination between tourism and transport in Chongqing,and suggestions are made for the overall improvement of the transport industry and the sustainable development of the tourism industry.

Analysis of Municipal Water Supply and Drainage Pipe Design Technology

The quality and safety of residents’water rely heavily on the design of municipal water supply and drainage pipes.Therefore,this paper aims to enhance the optimization of municipal water supply and drainage pipe design by focusing on design requirements,principles,and key elements.Drawing from relevant design optimization experiences,technology advancements,and optimization measures,the research will analyze and consolidate the essential aspects of municipal water supply and drainage pipe design.The goal is to fundamentally elevate the quality standards of these designs,ensuring they meet the criteria for engineering project excellence.Through this comprehensive approach,we aim to contribute to the improvement and sustainability of water supply and drainage systems,safeguarding the well-being of residents.

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

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

Selection of Water Transmission Method and Analysis of Pipe Network Zoning in Municipal Water Supply and Drainage Design

With the acceleration of urbanization,the demand for water supply and drainage pipe networks has increased significantly.In the planning of urban construction,it is necessary to optimize the design of the water supply and drainage system pipe network to effectively save energy while providing residents with more accessible water resources.Therefore,the municipal water supply and drainage system and the water transmission methods should be designed according to the geographical conditions of the city.In this paper,we mainly analyze the design of municipal water supply and drainage systems and the selection of water transmission methods.Besides,the optimization of the water supply and drainage network zoning process and pipe network maintenance is also discussed,so as to provide a reference for municipal water supply and drainage work.

Model Prediction and Optimal Control of Gas Oxygen Content for A Municipal Solid Waste Incineration Process

In the municipal solid waste incineration process,it is difficult to effectively control the gas oxygen content by setting the air flow according to artificial experience.To address this problem,this paper proposes an optimization control method of gas oxygen content based on model predictive control.First,a stochastic configuration network is utilized to establish a prediction model of gas oxygen content.Second,an improved differential evolution algorithm that is based on parameter adaptive and t-distribution strategy is employed to address the set value of air flow.Finally,model predictive control is combined with the event triggering strategy to reduce the amount of computation and the controller's frequent actions.The experimental results show that the optimization control method proposed in this paper obtains a smaller degree of fluctuation in the air flow set value,which can ensure the tracking control performance of the gas oxygen content while reducing the amount of calculation.

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

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

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

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

Hyperprolactinemia in Hospitals in Lomé: Diagnostic and Therapeutic Aspects

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

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

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

Forecasting the Municipal Solid Waste Using GSO-XGBoost Model

Waste production rises in tandem with population growth and increased utilization.The indecorous disposal of waste paves the way for huge disaster named as climate change.The National Environment Agency(NEA)of Singapore oversees the sustainable management of waste across the country.The three main contributors to the solid waste of Singapore are paper and cardboard(P&C),plastic,and food scraps.Besides,they have a negligible rate of recycling.In this study,Machine Learning techniques were utilized to forecast the amount of garbage also known as waste audits.The waste audit would aid the authorities to plan their waste infrastructure.The applied models were k-nearest neighbors,Support Vector Regressor,ExtraTrees,CatBoost,and XGBoost.The XGBoost model with its default parameters performed better with a lower Mean Absolute Percentage Error(MAPE)of 8.3093(P&C waste),8.3217(plastic waste),and 6.9495(food waste).However,Grid Search Optimization(GSO)was used to enhance the parameters of the XGBoost model,increasing its effectiveness.Therefore,the optimized XGBoost algorithm performs the best for P&C,plastics,and food waste with MAPE of 4.9349,6.7967,and 5.9626,respectively.The proposed GSO-XGBoost model yields better results than the other employed models in predicting municipal solid waste.

Prediction of NO_(x)concentration using modular long short-term memory neural network for municipal solid waste incineration

Air pollution control poses a major problem in the implementation of municipal solid waste incineration(MSWI).Accurate prediction of nitrogen oxides(NO_(x))concentration plays an important role in efficient NO_(x)emission controlling.In this study,a modular long short-term memory(M-LSTM)network is developed to design an efficient prediction model for NO_(x)concentration.First,the fuzzy C means(FCM)algorithm is utilized to divide the task into several sub-tasks,aiming to realize the divide-and-conquer ability for complex task.Second,long short-term memory(LSTM)neural networks are applied to tackle corresponding sub-tasks,which can improve the prediction accuracy of the sub-networks.Third,a cooperative decision strategy is designed to guarantee the generalization performance during the testing or application stage.Finally,after being evaluated by a benchmark simulation,the proposed method is applied to a real MSWI process.And the experimental results demonstrate the considerable prediction ability of the M-LSTM network.

Potential Risks to the Environment as a Result of Pesticide Handling in the Nanumba-North Municipality, Ghana

The present study deduced the potential risks to the environment as a result of pesticide handling in the Nanumba-North Municipality of the Northern Region of Ghana. Cluster sampling was used to select 30 communities from Nanumba-North Municipality. Simple random sampling and purposive sampling were used respectively to select 7 households from each community and one farmer from each household, giving a sample size of 210 farmers. The instrument used for the study was a questionnaire of respondents. The quantitative data obtained were analyzed using frequencies and percentages. The study concluded that 11 types of pesticides are commonly used by the farmers on their fields, with atrazine (22%) being the most commonly used pesticide which is an herbicide, and deltamethrin (1%) was the least used pesticide which is an insecticide. The study, therefore, recommends that appropriate authorities in the area should inculcate means to enlighten farmers on the best way of pesticide utilization that can beef up the ambition of sustainable agricultural production and desirable environmental conditions.

Hospital Stakeholders’ Perception on Environmental Effects Related to Biomedical Waste in Togo’s University Hospitals (UHC) in 2021

Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.

Nano-CaO_(2)Promotes the Release of Carbon Sources from Municipal Sludge and the Preparation of Double-Network Hydrogels with High Swelling Ratios

In this study,hydrogels were prepared from municipal sludge to recycle and realize the value-added utilization of the carbon components in this abundant waste material.The carbon sources were extracted from the municipal sludge using synthesised nano CaO_(2)as an oxidant,and the carbon sources were graft copolymerised with acrylic acid monomer using N,N′-methylenebisacrylamide as a crosslinking agent and ammonium persulfate as an initiator.The factors influencing the hydrogel preparation were investigated by single-factor experiments.Based on the results of the single-factor experiments,a hydrogel with a swelling ratio of up to 19768.4%at 12 h was prepared with an oxidant dosage of 0.20 g,a monomer dosage of 5.8 g,a neutralisation degree of the monomer of 70%,an initiator dosage of 0.15 g,and a crosslinking agent dosage of 0.15 g.The hydrogel preparation conditions were optimized using the response surface method,and the interactions between the different reaction conditions were analysed to obtain the best preparation conditions.X-ray diffraction results showed that hydrogels were amorphous in structure.Scanning electron microscopy images showed that the SiO_(2)particles from the sludge acted as crosslinking points between different layers of hydrogel chains.The crosslinking polymerisation and crosslinking agent worked together to form hydrogels with an inorganic-organic double network structure,and this structure was highly stretchable,resulting in hydrogels with good swelling properties.