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Previous literature indicates that digitalization offers enterprises competitive advantages. However, However, its potential impact on risk management remains uncertain. Thus, this study explores the causality between digital transformation and systematic risk of Chinese public companies during 2007–2020. We developed a digital‐related keywords dictionary using textual analysis to identify investments in digital assets which serve as a measure of corporate digitalization. Our findings suggest a negative correlation between digital transformation and enterprise systematic risk. This relationship is further supported by robustness tests, adjustments for endogeneity, and random forest predictions. The risk‐reducing effect of digitalization is more pronounced in non‐state‐owned, small, high‐asset‐density, and low‐investor‐attention enterprises. Additionally, we explore potential mechanisms: the financial leverage channel, operating leverage channel, and investor loyalty channel. Empirical observations indicate that enterprise digitalization: (1) lowers financing costs, curbing an inclination towards excessive debt; (2) enhances operational cost management and stimulates sales growth; and (3) boosts long‐term investor holdings, decreases stock price synchronization, and mitigates crash risks. This study offers new insights into assessing the sustainability of digitalization and mitigating systematic risks of enterprises. [ABSTRACT FROM AUTHOR]

How the government subsidies will change the performance of firm's innovative projects has long been debated. We attempt to narrow this gap from a dynamic perspective by employing Chinese A-share listed firms as a sample. Based on the novel innovation index, we studied the impact of government subsidies on the persistence of firm innovation. Findings show that total government subsidies promote the persistence of overall firm innovation. However, when we divided the total government subsidies into technological subsidies and non-technological subsidies, we found that technological subsidies cast an inhibitory effect on the persistence of self-sustaining firm innovation. In further analysis, we discover that 'self-sustaining firm innovation investment replacement' phenomenon can explain the crowding-out effect of technological subsidies on self-sustaining firm innovation persistence. Based on empirical evidence, we also observed that the substitution of private innovation investment by technological subsidies may result in management costs. These findings offer a theoretical foundation for further enhancing the effectiveness of government subsidy policies. [ABSTRACT FROM AUTHOR]

Background: For patients with sepsis receiving non-invasive ventilation (NIV), early rehabilitation is crucial. The Sitting Baduanjin (SBE) is an efficient early rehabilitation exercise suitable for bed patients. There is no consensus about the effect of SBE on the early rehabilitation of septic patients with NIV. This study focused on how the SBE affected the early rehabilitation of sepsis patients with NIV. Methods: 96 sepsis patients with NIV were randomly assigned to either an Baduanjin group that received the SBE based on the routine rehabilitation exercise (n = 48) or a control group (n = 48) that received routine rehabilitation exercise. The primary outcome was the Medical Research Council(MRC)score, and the Barthel Index score, the duration of NIV, length of ICU stay, length of total stay, hospitalization expense as secondary outcomes. Results: A total of 245 sepsis patients were screened, with 96 randomly assigned. The study was completed by 90 patients out of the 96 participants.Results revealed that the MRC score increased in both groups, but the improvement of muscle strength in Baduanjin group was more obvious, with statistical significance (p < 0.001).There was statistically significantly difference between the two groups in Barthel Index at the day of transfer out of ICU(P = 0.028).The patients in the Baduanjin group had an average reduction of 24.09 h in the duration of NIV and 3.35 days in total length of hospital stay compared with the control group (p < 0.05).Of note, the Baduanjin group had significantly reduction the total hospitalization expense. No serious adverse events occurred during the intervention period. Conclusions: In patients with sepsis, the SBE appears to improve muscle strength and activities of daily living (ADL), and lowed the duration of NIV, the length of the total stay, and the hospitalization expense. Trial registration: The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR1800015011 (28/02/2018). [ABSTRACT FROM AUTHOR]

Introduction: With China's urbanization and demographic shifts significantly affecting elder care, this study examines the alignment of community‐based elder care services in Hangzhou's Hemu Community. It addresses the gap in understanding how these services meet the needs of an aging population in a rapidly changing social context. Methods: A comprehensive mixed‐methods approach was utilized, involving interviews with community residents, observations of elder care service operations and thorough document analysis. The objective was to evaluate the adequacy, utilization and satisfaction levels concerning these elder care services. Results: The research identified that, although the services generally meet the community's needs, there are notable challenges in content specificity, quality assurance and promotional efforts. These challenges lead to resistance among older adults. Additionally, issues with service visibility and the lack of robust feedback mechanisms were noted. Conclusion: This study highlights the critical need for a cooperative strategy involving government, community organizations, social entities and businesses in enhancing elder care services. It suggests that improvements in service visibility, content quality and targeted promotion are crucial to address the evolving needs of the aging population and to reduce reluctance in service utilization. [ABSTRACT FROM AUTHOR]

Background. This study aims to assess and explore the different effects of national centralized drug procurement (NCDP) on three targeted antitumor drugs' use in clinical practice. Materials and Methods. Clinical drug volume data were collected covering 18 months before, during, and after the seventh round of the NCDP in Inner Mongolia. The interrupted time‐series method was employed to estimate the net effect of policy impact. Results. The volume of generic afatinib (30 mg) increased by 25.78 DDDs, the expenditures decreased by 3641.14 yuan (p = 0.001), and the DDDc decreased by 124.35 yuan (p < 0.001). The volume of generic afatinib (40 mg) increased by 65.19 DDDs (p < 0.001), the expenditures increased by 1304.93 yuan (p < 0.001), and the DDDc decreased by 120.2 yuan (p < 0.001). The volume of generic sunitinib increased by 75.79 DDDs (p < 0.001), the expenditures decreased by 15869.78 yuan (p < 0.001), and the DDDc decreased by 243.28 yuan. There was no significant change trend in volume, expenditures, and DDDc of the three original‐targeted drugs after NCDP intervention. Conclusions. After the policy intervention, generic afatinib (40 mg) successfully aligned with the objectives of NCDP by reducing drug costs and enhancing patient affordability; however, the desired outcomes were not achieved for generic afatinib (30 mg) and generic sunitinib. This discrepancy may be attributed to the inherent clinical efficacy and safety profiles of these drugs. Therefore, in implementing NCDP, it is necessary to enhance the clinical efficacy and safety of generic‐targeted antitumor drugs while considering economic efficiency. [ABSTRACT FROM AUTHOR]

Rockfall poses a formidable threat to the ongoing fast-paced construction of large-scale projects in uninhabited areas in high mountain valleys. In this study, an optimization method for arranging passive nets on high and steep slopes was presented to mitigate the threat from rockfalls. This method diverges from the conventional method of subjectively arranging passive nets along the perimeter of protected regions (due to its emphasis on cost considerations), in which the quantitative appraisal of rockfall movement characteristics and interception rates is frequently omitted, consequently failing to comprehensively ensure transportation routes and temporary construction sites. The methodology encompasses the acquisition of terrain data by unmanned aerial vehicles (UAVs), identification of rockfall sources based on UAV point clouds, quantitative assessment of rockfall hazards using a 3D probabilistic model, and optimization of the layout of passive nets based on the assessment results. The aim of the optimization of passive nets is to quantitatively assess the cost–effect relationship of passive nets, accounting for construction feasibility, interception potential, and likelihood of successful rockfall interception. We applied this method to the Feishuiyan slope in southwest China as an example, and the results demonstrated an enhanced interception rate of 99% and cost reduction by a factor of three relative to the original scheme. This innovative approach could enhance rockfall mitigation in high and steep areas, providing a viable strategy for future prevention efforts in these areas. [ABSTRACT FROM AUTHOR]

We take the establishment of cross-border e-commerce comprehensive pilot zones as the quasi-natural experiment, based on China’s General Administration of Customs Database, China Customs Online Inquiry Platform, ‘Cross-Border E-Commerce Retail Import Commodity List’ and other data. By employing the staggered DID method, this paper systematically investigates the potential of cross-border e-commerce to enhance the quality of imported products. The research findings reveal the following: Since the introduction of the cross-border e-commerce comprehensive pilot zones, there has been a significant improvement in the quality of imported products in China. These effects, however, vary across different product types and regions, suggesting heterogeneous impacts. The cross-border e-commerce comprehensive pilot zones have facilitated the development of import trade in China through three main avenues: reducing search costs, resolving financing challenges, and lowering tariffs. These measures have collectively contributed to the reduction of trade costs. [ABSTRACT FROM AUTHOR]

Introduction: The national volume-based drug procurement policy initiated in China since 2018 represents a significant reform in China's pharmaceutical distribution system. It has largely squeezed out the price bubble of low-end generic drugs, making competition in the pharmaceutical sales segment more intense and transparent. This policy intervenes in the distribution link of the pharmaceutical industry by intensifying market competition, thereby enhancing the innovation willingness and R&D capabilities of pharmaceutical companies. Methods: Taking the national volume-based drug procurement policy as the policy shock, we used the multi-period difference-in-difference method to study the impact of the policy on innovation input, innovation output quantity and innovation output quality of listed pharmaceutical companies and its impact mechanism. Results: We found that the volume-based policy can significantly promote the pharmaceutical companies' innovation input and the innovation output quality, but significantly reduced the innovation output quantity. For innovative and generic drug companies, this policy has limited impact on innovative drug companies, but force generic drug companies to pay more attention to cost control and market positioning, and the quality and cost-effectiveness of R&D output to ensure competitiveness in the market. For bid-winning and nonwinning companies, the policy has a greater innovation incentive for nonwinning companies than winning companies, by imposing greater survival pressure on non-winning companies, forcing them to increase R&D investment intensity and adopt the innovation strategy of preferring quality to quantity. Discussion: The results show that the national volume-based drug procurement policy should be expanded to lower drug prices and lighten the medical burden on patients, with enhanced quality and safety supervision. Additionally, it suggests cautious application of such policies to innovative and high-end generic drugs to encourage continued pharmaceutical innovation and industry advancement. [ABSTRACT FROM AUTHOR]

Using dynamic game theory, this paper analyzes the interest relationship between government supervision departments, railway passenger transport enterprises and integrated service agents in the service management system of railway passenger transport enterprises in China. A tripartite dynamic game model of government supervision department, railway passenger transport enterprise and integrated service agent is established. Inverse induction algorithm is used to solve the game model, and the expected return equilibrium solution of government supervision department, railway passenger transport enterprise and integrated service agent is analyzed. The results show that the cost of railway passenger transport service management and the intensity of management are important factors affecting the implementation of service requirements by railway passenger transport enterprises and integrated service agents. Therefore, the government supervision department should reduce the management cost, design a reasonable reward and punishment mechanism, and improve the enthusiasm of railway passenger transport enterprises and integrated service agents to strengthen service management and improve service quality. Railway passenger transport enterprises and integrated service agents should actively strengthen service management, improve service quality, reduce management pressure and cost at the next level, and promote the healthy development of railway passenger transport market through a virtuous cycle between the three. [ABSTRACT FROM AUTHOR]

Background: Global budget payment is currently the prevailing payment strategy internationally. In China, the concept of multi-hospital global budget payment has been proposed with the aims of achieving cost control effects while also encouraging hospital collaboration and optimising allocation of healthcare resources. This study seeks to analyse the impact of multi-hospital global budget payment in China on healthcare expenditure and service volume. Materials and Methods: A retrospective comparative study was carried out in Dangyang County, China. The exposure cases were migrants who were not locally registered in the residence registration system. The study period encompassed January 1, 2017, to December 31, 2019. Including 3,246,164 outpatient medical records and 242,685 inpatient medical records. The key variables are medical expenditure and service volume indicators. Continuous variables were reported as mean and tested by t-test. We used interrupted time series analysis models to estimate the changes in the level and trend of each outcome measure after the policy. Results: After the outpatient global budget payment reform, the monthly medical expenditure of the hospital alliance has transitioned from a discernible upward trajectory to a deceleration in the rate of growth. The outpatient volume in public and private high-level hospitals decreased at a rate of − 419.26 person/month and − 137.04 person/month, respectively. In terms of inpatient service volume, only private high-level hospitals reported a decrease, with a reduction rate of − 15.38 individuals per month. Conclusion: This study presents new evidence demonstrating that the multi-hospital global budget payment can effectively control costs and promote resource reallocation when implemented jointly with hospital alliance policies. However, overly lenient budget caps risk counterproductive effects. [ABSTRACT FROM AUTHOR]

We evaluated the operational, financial, and management challenges within China's Toilet Revolution by surveying 656 rural households across 10 provinces. The results revealed that the majority of households which renovated their toilets under the Toilet Revolution perceived positive impacts of this on their quality of life and living conditions. Households that had undertaken toilet renovations viewed the program more favorably than households which had not undertaken renovation, and were more willing to engage with the program. Despite the perceived benefits, households were generally hesitant to personally invest in toilet renovation. We uncovered a gap in strategic sanitation planning for post-construction operation and maintenance of toilets, reflecting a "build first, manage later" approach in the Toilet Revolution. We also identified a widespread lack of formal models for management of toilets and toilet products, coupled with high reliance among households on government support and subsidies to fund renovation. To address operational inefficiencies and financial sustainability issues in the program, we propose a novel "Toilet Business" model that leverages a sanitation value chain approach. In this model, private sector engagement, cost management, and market revitalization are crucial components that must be implemented to ensure the program's long-term success. Overall, our study provides valuable insights into the complexities of implementing large-scale sanitation programs such as the Toilet Revolution. [ABSTRACT FROM AUTHOR]

Background and objective A reasonable and standardized dietary plan and procedure can help patients recovering quickly from lung cancer surgery. The aim of this study is to optimize the diet plan and procedure mainly based on medium chain triglyceride (MCT) diet and explore its clinical advantages for postoperative lung cancer patients. Methods From October 2023 to December 2023, a total of 156 patients were collected, who underwent lung cancer surgery in Lung Cancer Center, West China Hospital of Sichuan University. The patients were randomized into MCT group (76 cases) and routine diet (RD) group (80 cases). Clinical symptoms, biochemical index, postoperative hospitalization time and cost, dietary satisfaction and hospitalization comfort between the two groups were analyzed. Results The mean anus exhausting time in MCT group [24.00 (9.75, 36.97) h] was significantly shorter than that in RD group [28.50 (24.00, 48.00) h] (P<0.001). And the incidence of dizziness (18.42%), nausea and vomiting (6.58%) in MCT group were remarkably lower than those in RD group (51.25%, 31.25%) (P<0.001). Hospitalization comfort score in MCT group [(16.74±1.70)] was significantly higher than that in RD group [(14.83 ±2.34)] (P=0.016). Meanwhile, the average hospitalization cost in MCT group [(39,701.82±8105.47)¥] showed an obvious decrease compared with RD group [(44,511.79±9593.19)¥] (P=0.007). Conclusion Optimizing the dietary plan and procedure mainly based on MCT diet for postoperative lung cancer patients can help the recovery of gastrointestinal function and improve hospitalization comfort, which promoted overall postoperative rehabilitation of patients with lung cancer surgery. [ABSTRACT FROM AUTHOR]

With strong support from national and local government policies for prefabricated buildings, China's prefabricated buildings have entered a period of rapid development. This article analyses the literature from various countries and establishes a structural model of the prefabricated building supply chain under the Engineering Procurement Construction (EPC) mode. It analyzes the factors that affect the prefabricated building supply chain under the EPC model from eight aspects: design stage, prefabricated component production and manufacturing stage, procurement stage, and EPC general contracting stage, etc. Then, it establishes an AHP fuzzy comprehensive evaluation model that combines qualitative and quantitative methods to evaluate the entire lifecycle supply chain of prefabricated buildings, providing reference for the robustness and resilience evaluation of prefabricated building supply chains, and further achieving green management of cost reduction and efficiency improvement in prefabricated building supply chains. [ABSTRACT FROM AUTHOR]

Providers have intended and unintended responses to payment reforms, such as China's new case-based payment system, i.e. Diagnosis-Intervention Packet (DIP) under global budget, that classified patients based on the combination of principal diagnosis and procedures. Our study explores the impact of DIP payment reform on hospital selection of patients undergoing total hip/knee arthroplasty (THA/TKA) or with arteriosclerotic heart disease (AHD) from July 2017 to June 2021 in a large city. We used a difference-in-differences approach to compare the changes in patient age, severity reflected by the Charlson Comorbidity Index (CCI), and a measure of treatment intensity [relative weight (RW)] in hospitals that were and were not subject to DIP incentives before and after the DIP payment reform in July 2019. Compared with non-DIP pilot hospitals, trends in patient age after the DIP reform were similar for DIP and non-DIP hospitals for both conditions, while differences in patient severity grew because severity in DIP hospitals increased more for THA/TKA (P  = 0.036) or dropped in non-DIP hospitals for AHD (P  = 0.011) following DIP reform. Treatment intensity (measured via RWs) for AHD patients in DIP hospitals increased 5.5% (P  = 0.015) more than in non-DIP hospitals after payment reform, but treatment intensity trends were similar for THA/TKA patients in DIP and non-DIP hospitals. When the DIP payment reform in China was introduced just prior to the pandemic, hospitals subject to this reform responded by admitting sicker patients and providing more treatment intensity to their AHD patients. Policymakers need to balance between cost containment and the unintended consequences of prospective payment systems, and the DIP payment could also be a new alternative payment system for other countries. [ABSTRACT FROM AUTHOR]

With a significant share of renewable power generation integrated into the power supply, it is crucial to timely adjust the regulating peak load for coal-fired power plants equipped with CO2 capture to ensure the stable operation of the multi-energy supply system. In this paper, the effects of varying boiler loads on the techno-economic performance of the retrofitted power plant were studied. Furthermore, the potential for reducing the cost of CO2 capture was investigated, and early opportunities for demonstration were discussed. Results showed that when the boiler load decreased from 100% turbine heat acceptance condition to 50% turbine heat acceptance condition, the cost of CO2 capture increased from 37.0 $/t CO2 to 57.0 $/t CO2, cost contribution of energy penalty and extra capital investment also increased from 20.6 $/t-CO2 to 25.7 $/t-CO2, and from 16.4 $/t-CO2 to 31.3 $/t-CO2, respectively. Furthermore, by improving separation efficiency from 0.15 to 0.5, a 25% to 30% reduction in CO2 capture cost can be achieved. The cost of CO2 capture could decrease by 42.2–50.5% when the cumulative capacity reaches 250 GW under the high investment learning rate scenario. According to the distribution of coal prices and renewable energy sources in China, the early demonstration projects of multi-energy supply systems should prioritize the northern region. The results of this work can provide informative references for making roadmaps and policies for CO2 emission reduction toward carbon neutrality. [ABSTRACT FROM AUTHOR]

The integration of the advanced manufacturing industry and the modern service industry is an important direction for the transformation and upgrading of China's manufacturing industry. However, the existing research focuses more on the level, motivation, and economic effects of the integration of manufacturing and producer services, and less on its environmental effects. In this paper, based on the panel data from 30 provincial regions in China from 2005 to 2019, an evaluation system for the integration of manufacturing and producer services (IMP) is constructed, and the carbon emission efficiency (CEE) is calculated through the super-efficiency SBM model. Based on the analysis of the influence mechanism of IMP on CEE, the mediation effect model and the spatial Durbin model are used to test the influence of the IMP on CEE. The results show that the IMP can significantly improve CEE, and indirectly promote CEE through four intermediary factors: value addition, cost reduction, industrial agglomeration and structure upgrading. Finally, we found the level of economic development, property rights structure and regional innovation can promote CEE to varying degrees. The intensity of environmental regulation, opening level and the energy consumption structure inhibit the efficiency of carbon emissions. The total impact of the IMP on CEE is greater in the western region than in the eastern and central regions, and the western region shows a more significant spatial spillover effect. The IMP has a greater effect on improving CEE, and shows a strong spatial spillover effect. [ABSTRACT FROM AUTHOR]

Problem definition: Multistage service is common in healthcare. One widely adopted approach to manage patient visits in multistage service is to provide patients with visit itineraries that specify personalized appointment time for each patient at each service stage. We study how to design such visit itineraries. Methodology/results: We develop the first optimization modeling framework to provide each patient with a personalized visit itinerary in a tandem (healthcare) service system. Due to interdependencies among stages, our model loses those elegant properties (e.g., L-convexity and submodularity) often utilized to solve the classic single-stage models. To address these challenges, we develop two original reformulations. One is directly amenable to off-the-shelf optimization software, and the other is a concave minimization problem over a polyhedron shown to have neat structural properties, based on which we develop efficient solution algorithms. In addition to these exact solution approaches, we propose an approximation approach with a provable optimality bound and numerically validated performance to serve as an easy-to-implement heuristic. A case study populated by data from the Dana-Farber Cancer Institute shows that our approach makes a remarkable 28% cost reduction over practice on average. Managerial implications: Common approaches used in practice are based on simple adjustments to schedules generated by single-stage models, often assuming deterministic service times. Whereas such approaches are intuitive and take advantage of existing knowledge of single-stage models, they can lead to significant loss of operational efficiency in managing multistage services. A well-designed patient visit itinerary that carefully addresses the interdependencies among stages can significantly improve patient experience and provider utilization. History: This paper was selected for Fast Track in the M&SOM Journal from the 2022 MSOM Healthcare SIG Conference. Funding: The work of the last two authors was supported in part by the National Natural Science Foundation of China [Grants 71931008 and 72001220]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.0134. [ABSTRACT FROM AUTHOR]

This paper evaluates the general equilibrium trade and welfare effects of the Belt and Road Initiative (BRI). We estimate the partial trade effect of the BRI using the synthetic control method. By feeding the implied trade cost reduction into counterfactual equations, we simulate the general equilibrium trade and welfare effects of the BRI based on the structural gravity model. We find that the BRI has greatly increased China's and BRI members' trade and welfare, with little impact on non‐BRI members. [ABSTRACT FROM AUTHOR]

Major projects are the important platform for enhancing a country's comprehensive national power and strengthening its capacity for independent innovation. Although major projects in China have made remarkable achievements, willingness to cooperate and innovate has not achieved the desired target. In this paper, the evolutionary game model of cooperative innovation behavior of general contractors and subcontractors is constructed by considering reputational factors. Through theoretical derivation, the influence of the distribution ratio of collaborative innovation benefit, spillover technology absorption capacity, and reputation discounting coefficient on innovation behavior is analyzed. Finally, MATLAB software is used to simulate the dynamic evolution process of strategy selection. The results show that (1) a reasonable benefit distribution coefficient can promote the evolution of innovation behavior in a positive direction; (2) both the reduction of innovation cost and the increase of spillover technology absorption capacity can make the innovation subject more inclined to choose the active collaborative innovation strategy; and (3) it is the higher-than-threshold reputation loss that can effectively inhibit the "free-rider" behavior. The research conclusions and managerial implications can provide reference for improving the willingness to cooperate in major projects' technology innovation. [ABSTRACT FROM AUTHOR]

Currently, countries worldwide are embracing digital strategies, enabling enterprises to utilize digital technology, digital supply chains, blockchain, and additional digital measures to increase their competitiveness. This paper analyzed the correlation between the digital transformation of manufacturing export enterprises and their business and export performance, focusing on China's manufacturing export enterprises through empirical analysis. The study investigated the influence of digital transformation on enterprise performance. Using the Resource Based View theory and Trade theory, hypotheses were proposed and regression models were developed to analyze a sample of 1007 enterprises listed on the Shanghai and Shenzhen Stock markets from 2012 to 2019. The study conducted regression analysis, intermediate effect test, robustness test, stage lag, and heterogeneity analysis. The study found that (1) Manufacturing export enterprises listed in the stock market implemented digital transformation, leading to a significant positive impact on their overall performance. (2) Digital transformation led to cost reduction, improved R&D intensity, and enhanced human resources, among other benefits for enterprise performance. (3) According to the fractal analysis, non-state-owned enterprises exhibited more favorable effects on enterprise performance, and the digital transformation of manufacturing export companies in developed regions had a more significant impact on their performance. Finally, the study's empirical results yielded pertinent proposals for digital transformation. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) models have shown great accuracy in health screening. However, for real-world implementation, high accuracy may not guarantee cost-effectiveness. Improving AI's sensitivity finds more high-risk patients but may raise medical costs while increasing specificity reduces unnecessary referrals but may weaken detection capability. To evaluate the trade-off between AI model performance and the long-running cost-effectiveness, we conducted a cost-effectiveness analysis in a nationwide diabetic retinopathy (DR) screening program in China, comprising 251,535 participants with diabetes over 30 years. We tested a validated AI model in 1100 different diagnostic performances (presented as sensitivity/specificity pairs) and modeled annual screening scenarios. The status quo was defined as the scenario with the most accurate AI performance. The incremental cost-effectiveness ratio (ICER) was calculated for other scenarios against the status quo as cost-effectiveness metrics. Compared to the status quo (sensitivity/specificity: 93.3%/87.7%), six scenarios were cost-saving and seven were cost-effective. To achieve cost-saving or cost-effective, the AI model should reach a minimum sensitivity of 88.2% and specificity of 80.4%. The most cost-effective AI model exhibited higher sensitivity (96.3%) and lower specificity (80.4%) than the status quo. In settings with higher DR prevalence and willingness-to-pay levels, the AI needed higher sensitivity for optimal cost-effectiveness. Urban regions and younger patient groups also required higher sensitivity in AI-based screening. In real-world DR screening, the most accurate AI model may not be the most cost-effective. Cost-effectiveness should be independently evaluated, which is most likely to be affected by the AI's sensitivity. [ABSTRACT FROM AUTHOR]

The chrysanthemum is a perennial herbaceous flower with a long history of cultivation dating back over 3000 years. The potted chrysanthemum is a significant type and is widely used in landscaping. Expensive substrate costs, complicated management of water and fertilizer, and uneven product quality currently plague the potted chrysanthemum industry. This study systematically investigated the growth status of potted chrysanthemums under different substrates, water, and fertilizer ratios and established a simplified cultivation system for potted chrysanthemums. The substitute substrate experiment demonstrated that coir: moss peat: perlite: pine needle mulch = 2:4:2:2 is the most suitable substitute substrate. Research on fertilizer ratios found that chrysanthemums' best growth and flowering characteristics were achieved with nitrogen, phosphorus, and potassium concentrations of 336 mg/L, 93 mg/L, and 273 mg/L, respectively. A comprehensive, simplified cultivation system was established when utilizing T4 substitute substrate (2:4:2:2 ratios of coir, moss peat, perlite, and pine needle mulch), 40% water capacity, and F9 fertilizer (336 mg/L nitrogen, 93 mg/L phosphorus, and 273 mg/L potassium). This study comprehensively and systematically explored the cultivation and maintenance schemes in the production of potted chrysanthemums and built a light, simple, and efficient production technology system of potted chrysanthemums in the open field suitable for the climatic characteristics of northern China, which provides feasible technical specifications and a theoretical basis for the refinement and large-scale management of potted chrysanthemums. This experiment lays the foundations for cost reduction and efficiency in the potted chrysanthemum industry. [ABSTRACT FROM AUTHOR]

Background: Medical service prices play a crucial role in cost containment in China. This study aimed to assess the change in medical service price levels at the macro level and the relationship with relevant macroeconomic factors. Methods: Data from the 2022 China Statistics Yearbook, the 2022 China Health Statistics Yearbook, and the 2020 China National Health Accounts Report were used. Time trends of health price levels, utilization, and health expenditure were examined. A time-series regression model was employed to measure the impact of service utilization and medical service prices on total medical service expenditure growth from 2000 to 2021. The Johansen cointegration test was conducted to test the cointegrating relationship between medical service price levels and total medical service expenditure, average wage of employees and CPI. The Granger causality test was performed to observe the direction of causality. Results: Descriptive analyses showed consistent growth in utilization and medical service price levels from 2000 to 2021. The time-series model indicated that medical service expenditure was influenced by the rise in inpatient admissions and price levels of medical service and medicine. The Johansen cointegration test identified a long-term equilibrium relationship between medical service price levels and total medical service expenditure, average wage and CPI. The change in medical service price levels was the Granger cause of the change in medical service expenditure, but it had no impact on average wage and CPI. However, the change in medical service price levels was influenced by these three macroeconomic factors. Conclusions: The growth of medical service expenditure in China was driven by inpatient use and price level. There was a long-term equilibrium relationship between medical service price levels and relevant macroeconomic factors. However, medical service price levels only affected medical service expenditure and have no impact on average wage and CPI. It is necessary to improve the value transmission mechanism of medical service prices. [ABSTRACT FROM AUTHOR]

The profit margin of construction enterprises has been continuously declining over the past few years, and the competition for contracts among construction enterprises turns out to be increasingly fierce. Construction contracting enterprises should consider the profitability of the construction contracting enterprise and its ability to continuously obtain orders when setting cost budget targets for project management departments. Thus, a dual objective decision-making model is built in this study, minimizing overall construction costs and maximizing owner satisfaction to clarify the contracting conditions of the project management department and facilitate decision-making optimization of cost and owner satisfaction goals. Moreover, the actual effect of the proposed model method is verified through case calculations. As indicated by the results, under the premise of maximizing owner satisfaction, the model optimization cost is lower than the actual cost that has already occurred. Furthermore, it conforms to the goal of maximizing owner satisfaction while fulfilling the goal of minimizing engineering costs. [ABSTRACT FROM AUTHOR]

The axle load limit represents the maximum permissible mass that an axle can carry when a vehicle is operating on a road. This limit is closely associated with the expenses incurred in highway construction, truck transportation, and other related sectors. Consequently, it needs to be determined by carefully weighing the relevant costs. As freight demand continues to rise, many rural roads have failed to meet the requirements for maximizing the social benefits derived from truck transportation in China. To address this issue, this study examines the optimization of the axle load limit for rural roads, taking into consideration advancements in road construction technology, construction funding, and vehicle manufacturing techniques. Initially, the entities affected by the axle load limit, namely, road agencies, truck companies, commodity producers, and consumers, are analyzed. Subsequently, a programming model is developed to optimize the truck axle load limit for rural roads, aiming to maximize the cost gap between the scenarios with the incremental limit and those without the incremental limit. Finally, a case study is conducted to validate the effectiveness of the model, using the rural road network in Guiyang city (China) as an illustrative example. The findings indicate that a limit below 17 tons results in a greater increase in benefits compared to costs. However, if the limit increases to 17 tons, the benefit increment decreases to a smaller value than the cost increment. In conclusion, the optimal axle load limit for the rural road network in Guiyang should be 13 tons, at which point the system cost reduction is maximized, resulting in an annual amount of 17.94 million RMB. • Identify the entities involved in the axle load limit in multiple markets. • Analyze the impact mechanisms of changes in axle load limit on the input costs of each entity. • Establish models to measure the direct impacts of the increment in axle load limit. • Modify the input‒output table to assess the spillover effects of the changes in axle load limit. • Expand application of input‒output table. [ABSTRACT FROM AUTHOR]

The Location-Routing Problem (LRP) becomes a more intricate subject when the limits of capacities of vehicles and warehouses are considered, which is an NP-hard problem. Moreover, as the number of vehicles increases, the solution to LRP is exacerbated because of the complexity of transportation and the combination of routes. To solve the problem, this paper proposed a Discrete Assembly Combination-Delivery (DACA) strategy based on, the Binary Equilibrium Optimizer (BiEO) algorithm, in addition, this paper also proposes a mixed-integer linear programming model for the problem of this paper. Our primary objective is to address both the route optimization problem and the assembly group sum problem concurrently. Our BiEO algorithm was designed as discrete in decision space to meet the requirements of the LRP represented by the DACA strategy catering to the multi-vehicle LRP scenario. The efficacy of the BiEO algorithm with the DACA strategy is demonstrated. through empirical analysis utilizing authentic data from Changchun City, China, Remarkably, the experiments reveal that the BiEO algorithm outperforms conventional methods, specifically GA, PSO, and DE algorithms, resulting in reduced costs. Notably, the results show the DACA strategy enables the simultaneous optimization of the LRP and the vehicle routing problem (VRP), ultimately leading to cost reduction. This innovative algorithm proficiently tackles both the assembly group sum and route optimization problems intrinsic to multi-level LRP instances. [ABSTRACT FROM AUTHOR]

Efficient budget management is crucial for the successful execution of construction projects. To achieve this, the design of a Construction Project Audit Budget Management System based on combinatorial optimization offers significant advantages. Combinatorial optimization techniques focus on finding optimal solutions from a vast number of possible combinations, making them well -suited for complex budget management scenarios. This system employs advanced algorithms to analyze and optimize various factors such as resource allocation, cost estimation, risk assessment, and scheduling. This paper focused on the construction of the Project Fuzzy Audit System in China. The developed model computes total investment decision, preliminary design, design, contracting, construction, completion acceptance and other stages of the investment/cost, namely investment estimation, budget estimate, control price, contract price and settlement price. According to the project total investment/cost control needs in China Project. The constructed model uses the combinatorial Optimization model for the estimation of the investment estimation of the Construction Project for the cost index. Through the Fuzzy Audit System new method abolishes the "maximum price" in the bidding document with the limit as the unit, and gradually terminates the preparation of the budget quota, highlighting the market price, so there is an urgent need for a set of cost index in line with the actual needs. The results demonstrated that with the fuzzy Audit system new method abolishes the "maximum price" in the bidding document with the limit as the unit, and gradually terminates the preparation of the budget quota, highlighting the market price, Through analysis it is concluded that with fuzzy based optimization model effectively accumulate fast and accurate calculation of the Project cost. [ABSTRACT FROM AUTHOR]

Purpose: Considering the greenwashing risk of symbolic environmental management, this study aims to distinguish the motivation for environmental investment growth (EIG) from the corporate cost stickiness and anti-stickiness perspectives. Design/methodology/approach: This study analyzes the impact of substantive and symbolic environmental management on cost stickiness. Subsequently, competing hypotheses are proposed. Finally, empirical tests are conducted on Chinese A-share listed companies from 2010 to 2019. Findings: EIG significantly improves enterprises' cost stickiness. The cost of high EIG enterprises does not decrease significantly with a decline in income compared to other enterprises, which is consistent with the motivation for substantive environmental management. Enterprises with high asset specificity and optimistic management expectations show more obvious substantive environmental management. Government and public environmental concerns cause more pronounced substantive environmental management. Practical implications: An evaluation of corporate environmental responsibility should take into account both what the company has disclosed and what it has actually done. Social implications: Governments and the public should have a comprehensive understanding of corporate environmental management. They need to strengthen their ability to recognize symbolic environmental management and support substantive environmental management. Originality/value: Fundamental to the evaluation of corporate environmental responsibility, this study distinguishes the motivations for corporate EIG disclosures from the cost stickiness perspective to avoid the risk of greenwashing. Hypotheses on the impact of substantive and symbolic environmental management on cost stickiness are presented. This study verifies the substantive environmental management characteristics of listed Chinese companies. [ABSTRACT FROM AUTHOR]

In recent years, the Chinese government has recognized the important role of urban green space, and each province has formulated corresponding policies to increase the area of green space. However, China’s urban land development faces problems such as insufficient preliminary research, disorganized construction management, and chaotic organization and management. These problems are also reflected in urban garden projects. Compared with developed countries, China’s urban garden engineering technology and management in the modern sense are relatively backward. The study takes the garden engineering project management as a comprehensive research subject, and elaborates on it from two perspectives, which are project management content and quota design method. First, based on the Plan-Do-Check-Act (PDCA) cycle, a standardized management system with cost management, progress management, quality management and safety management as the main content is constructed. Then, the limit design method is developed utilizing multiple linear regression analysis. Finally, the limit design method is tested. The test results show that the limit design scheme proposed in the study can optimize the traditional limit design scheme by 53.34%. The quota design methods were evaluated, and the 10 sample items received a score range of 38.22 to 86.09 points, with an average score of 62.36 points. There are six projects with scores above 60 and 4 projects with scores below 60. This verifies that the quota design is reasonable. In terms of theory, the research combines the current laws and regulations and the administrative management system to construct a complete urban landscape engineering management system, which can provide a reference for solving the existing problems in the current urban landscape engineering management. In practice, although the proposed limit design method has a prediction error of 7.84%, it is still less than 10% of the legal ceiling. In engineering practice, it can effectively strengthen construction management and organizational management. Overall, the study proposes to build a standardized management system based on the PDCA cycle, with cost management, schedule management, quality management, and safety management as the main contents. The limited design method constructed using multiple linear regression analysis has effectiveness and practicality. [ABSTRACT FROM AUTHOR]

In order to end the AIDS epidemic by 2030 that was put forward by the Joint United Nations Programme on HIV/AIDS in 2014, China needs to take more effective measures to achieve the three 90% goals (90-90-90). We establish a compartmental model to study the dynamics of HIV transmission with control strategies. The analytical results show the existence and stability of the disease-free equilibrium and endemic equilibrium. An optimal control model is constructed to evaluate the impacts of control measures. The simulation results show that the optimal control strategy proposed in this work can eradicate AIDS by 2030. The cost-effectiveness analysis indicates that the cost of the control strategy that combines screening for latent individuals and enhancing education for unaware infected individuals is the lowest. Our findings can provide guidance for public health authorities on effective mitigation strategies to achieve the goals proposed by the United Nations Program on HIV/AIDS. [ABSTRACT FROM AUTHOR]

The scale of e-commerce in China continues to expand, and it has a relatively good development prospect. However, there are many problems in cost control in the development of e-commerce in our country. E-commerce companies have many problems in terms of promotion costs, warehousing costs, and operating costs. Although predecessors have made great achievements in this field and helped e-commerce companies solve problems related to cost control, there are still many problems in e-commerce companies. Question. This article starts with big data and Internet of Things technology, and focuses on storage costs and transportation costs to solve the problems of cost control in e-commerce companies. The problems existing in the development of e-commerce enterprises are: (1) The cost control system is not mature enough, the business scope is not clear, the cost control lacks innovative awareness, the logistics cost remains high, and the logistics management model is unreasonable. In order to solve these problems, we built a transportation cost optimization model and an operation cost optimization model based on big data and Internet of Things technology. Transportation cost and operation cost are two important components of the cost of e-commerce enterprises in my country. The model has been verified to effectively reduce transportation costs and operating costs, which is of great significance to reducing the cost of e-commerce enterprises in my country, can solve the problems of e-commerce enterprise development, and promote the development of e-commerce in my country. Finally, according to the model constructed by the questionnaire survey and the article, we put forward corresponding suggestions (1) optimize customer relationship, improve the enterprise model (2) promote enterprise innovation, and promote the transformation of marketing costs (3) improve the degree of informatization of e-commerce enterprises. [ABSTRACT FROM AUTHOR]

Digital trade is an advanced form of digital transformation in the field of trade. China has made significant strides in the realm of digital trade, particularly in the domain of cross-border e-commerce. It is worthwhile to consider whether the dividend of digital trade benefits enterprises and fosters new competitive advantages at the micro level. This study constructs a framework for analyzing enterprise competitiveness under the background of digital trade. The digital trade development index is measured comprehensively across five dimensions with entropy weight method and TOPSIS, reflecting China's regional diversity. A two-way fixed effects (TWFE) model is utilized to verify the influence of digital trade on enterprise competitiveness based on panel data from Chinese A-share listed companies from 2011 to 2020. The study finds that digital trade has a positive effect on enterprise competitiveness, mainly strengthening the scale factor. Furthermore, the influence of digital trade on enterprises exhibits heterogeneous characteristics. Through moderation effect testing, it is found that the positive effect of digital trade is stronger for enterprises with high participation in digital trade and market competition, while it is weakened for enterprises with high proportion of overseas business. Enterprises in China that participate in and benefit from the digital trade are mainly from non-technology-intensive industries and located in regions with better digital innovation environments, where they are more likely to adapt to the development of digital trade. Both state-owned and non-state-owned enterprises are equally affected by digital trade. Through mechanism testing, the study finds that digital trade promotes enterprise competitiveness mainly through three channels: asset expansion, cost reduction, and efficiency improvement. This research analyzes the micro-level impact effects of digital trade development on individual entities, expanding research perspectives into this field. [ABSTRACT FROM AUTHOR]

This study proposes an approach for quantifying two kinds of costs related to the utilisation of regional trade agreements (RTAs). The first, called the "procurement adjustment cost," represents the cost involved in meeting the rules of origin by adjusting procurement sources. The second is the additional fixed cost required to utilise RTAs, including document preparation costs for the certificates of origin. Applying our approach to Thailand's imports from China, our estimates suggest that procurement adjustment costs at the median are equivalent to 4% of the per‐unit production cost. RTA utilisation also requires an additional 27% in fixed costs. In addition, we simulate how much a reduction in these costs would enhance RTA utilisation. [ABSTRACT FROM AUTHOR]

In this study, we empirically test the antecedents and consequences of sustainable manufacturing practices across emerging as well as developed countries such as India, China and OECD. We use data from the sixth edition of International Manufacturing Strategy Survey (IMSS) and partial least squares structural equation modelling (PLS-SEM) to test our conjectures. Our findings suggest that while customer willingness to pay has a significant impact on sustainable manufacturing practices everywhere, stakeholder pressure is able to influence their adoption in OECD and India, but not in China. We also find that firms that are high on sustainable manufacturing practices not only reap sustainability benefits, but also derive cost reduction and quality improvement in many contexts. However, this relationship between sustainability efforts and operational performance is mediated through sustainability performance. [ABSTRACT FROM AUTHOR]

Background: Poverty contributes to the transmission of schistosomiasis via multiple pathways, with the insufficiency of appropriate interventions being a crucial factor. The aim of this article is to provide more economical and feasible intervention measures for endemic areas with varying levels of poverty. Methods: We collected and analyzed the prevalence patterns along with the cost of control measures in 11 counties over the last 20 years in China. Seven machine learning models, including XGBoost, support vector machine, generalized linear model, regression tree, random forest, gradient boosting machine and neural network, were used for developing model and calculate marginal benefits. Results: The XGBoost model had the highest prediction accuracy with an R2 of 0.7308. Results showed that risk surveillance, snail control with molluscicides and treatment were the most effective interventions in controlling schistosomiasis prevalence. The best combination of interventions was interlacing seven interventions, including risk surveillance, treatment, toilet construction, health education, snail control with molluscicides, cattle slaughter and animal chemotherapy. The marginal benefit of risk surveillance is the most effective intervention among nine interventions, which was influenced by the prevalence of schistosomiasis and cost. Conclusions: In the elimination phase of the national schistosomiasis program, emphasizing risk surveillance holds significant importance in terms of cost-saving. [ABSTRACT FROM AUTHOR]

The use of Diagnosis-Related Groups (DRG) is a prevalent payment system employed to control hospitalization costs and improve medical efficiency. China has developed an indigenized DRG payment system including Single Disease Payment (SDP), DRGs, and Big Data Diagnosis-Intervention Packet (DIP). In this study, we took cholecystitis as an example, drawing on both primary and secondary data to verify the effectiveness of China's indigenized DRG system and to introduce the evolution of DRGs in China. Primary data were gathered from Qilu Hospital in 2019–2021. Secondary data were collected from published literature from 2004–2016. Only studies with both pre-SDP/DRG and post-SDP/DRG groups were included. Among the studies included, 92.9% (13/14) reported a significant reduction in hospitalization costs after the implementation of SDP while other studies identified length of stay (LOS) and age as the most significant influential factors in SDP. Furthermore, we elaborated the efficiency of DRGs using data from 2738 inpatients in Qilu hospital. Moreover, 60% (6/10) of the studies from the databases also showed the efficiency of DRGs in different regions. SDP is efficient in saving hospitalization costs, but its implementation is limited. DRGs have a broader scope of application, but their effectiveness remains to be validated. DIP is a brand new concept in China, and more data are needed to assess its efficiency. [ABSTRACT FROM AUTHOR]

Due to the lack of clarity in the strength design of underground tailings reservoirs, it is imperative to investigate the interaction between the tailings deposit body (TDB) and surrounding rock. Taking the TDB as the subject of analysis, a differential equation for vertical stress on the TDB is proposed, considering the stresses from the hanging wall of the surrounding rock and physical and structural parameters of the TDB. Considering the similarity between the underground tailings reservoir and one-step subsequent filling, in situ data of the one-step subsequent filling body from a mine was utilized to compare calculated values of the theoretical model. The resulting theoretical prediction error was less than 10%, thus verifying the reliability of the proposed model. According to the theoretical model analysis, the height of the TDB exerts the most significant influence on vertical stress, while the width and length of the TDB have a negligible impact. Moreover, internal friction angle has a more pronounced effect on vertical stress than cohesion force. A case study for a lead–zinc mine in China is presented in this work. Through uniaxial compressive strength and triaxial shear experiments, the key mechanical parameters of TDB at different ratios of cement to tailings are obtained. According to the theoretical model proposed herein, the distribution law of vertical stress in the height direction of TDB is determined for various ratios of cement to tailings. The original technical scheme of the mine has been optimized by using uniaxial compressive strength greater than vertical stress as the evaluation index, achieving both storage safety and cost reduction goals. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to take a step in this direction and use the high dimensional fixed effects and quantile regression discontinuity design to test the managerial Coase theorem, which provides an institutional perspective for us to gauge the impact of private property rights on firm performance and the effect of management costs on intermediate inputs. Design/methodology/approach: This study first uses high dimensional regression discontinuity designs to examine the impact of privatization on firm performance in China between 1998 and 2013. Findings: Results indicate that privatization effects increase average outputs of the firm by around 10% given lower management costs, and management costs increase intermediate inputs by more than 50% points. Using data from annual surveys to test managerial Coase theorem, the authors show that management costs negatively affect the marginal effect of privatization on the average outputs of the firm. The positive impact on the investment in intermediate goods and services is larger in magnitude under higher management costs. Originality/value: The authors develop the managerial Coase theorem. Today, given lower management costs, private property rights provide an incentive structure for a firm to maximize the value of the assets and expand the boundaries. [ABSTRACT FROM AUTHOR]

The actual situation of carbon-emission reduction in China's power sector has not yet achieved the expected benefits. The rent-seeking behavior of participants in power construction projects (PCPs) hinders the realization of low-carbon benefits. It is necessary to explore the behavioral strategies of the various participants in the low-carbon transition of PCPs. This paper creatively constructs an evolutionary game model of PCPs' participants from the perspective of MRV (monitoring, reporting, and verification) and introduces the influence of the public to provide a comprehensive analysis of strategic equilibrium points. Through numerical simulations with MATLAB R2021a software, this paper explores the strategic choices of participants in different situations and gives relevant inferences and proofs. The results show that the grid company dominates at the initial stage and promotes participants to regulate behaviors. Under the premise of satisfying the system-stability requirements, setting the growth rate of the grid company's punishments to 100% can enhance the willingness for strict supervision, while the growth rate of the supervision costs to 200% significantly decreases the probability of strict supervision. With the integration of MRV and PCPs, participants spontaneously fulfill the carbon-emission-reduction tasks. Reasonable control of input costs can effectively avoid the occurrence of rent-seeking behavior. In addition, this paper sets the public-influence growth rate at 200% and finds that the public plays a greater role in driving participants to fulfill responsibilities. Based on the results, a low-carbon transition mechanism for PCPs under the MRV system is proposed by considering several dimensions, which provides suggestions for participants to fulfill carbon-reduction responsibilities. [ABSTRACT FROM AUTHOR]

Background: Physio-psycho-socioeconomical health comprehensively declines during aging, the complexity of which is challenging to measure. Among the complexity, multiple chronic disorders continuously cumulated during aging, further aggravating the challenge. Methods: A population-based survey on Comprehensive Ageing Health Assessment was conducted in older adults (age > = 60) enrolled from hospital settings and community settings in 13 working centers in six subnational regions in China. Cross-sectional datasets of 8,093 older participants with approximately complete assessment results were collected for the present analysis. Individual's multi-disease or multi-symptom was respectively scored by summing coexistent multiple diseases or multiple symptoms by respective weighting efficient for Self-Rated Health (SRH). Individual's age-dependent health decline was further summed of four SRH-weighted scores for daily function (activity of daily life, ADL), physical mobility (an average of three metrics), cognitive function (mini mental state examination, MMSE) and mental being (geriatric depression scale, GDS) plus multi-disease score (MDS) and multi-symptom score (MSS).Multi-disease patten among 18 diseases or multi-symptom pattern among 15 symptoms was latent-clustered in the older adults, the optimal outcome of which was categorized into high, moderate or low aging-associated clusters, respectively. Percentage distribution was compared between overall health decline score and multi-disease pattern cluster or multi-symptom patten cluster. A new variable of difference between MDS and MSS (hereinafter terming DMM) that displayed linear variation with socioeconomic factors was further fitted using multilevel regression analyses by substantial adjustments on individual confounders (level-1) and subnational region variation (level-2). Results: Consistent gradient distribution was shown between health decline and multimorbidity pattern cluster in the older adults. DMM was found linearly varied with personal education attainment and regional socioeconomic status. Using optimally fitted stratification of DMM (DMM interval = 0.02), an independent U-shaped interrelated tendency was shown between health decline, multi-disease and multi-symptom, which could be well explained by regional disparities in socioeconomic status. Conclusion: Newly developed metrics for age-dependent health decline and aging-associated multimorbidity patten were preliminarily validated from within. The new variable of optimally fitted categorization of DMM might function as a practical indicator aiding in improving the cost-effectiveness and reduce inequity of healthcare delivery for older adults in developing countries. [ABSTRACT FROM AUTHOR]

The digital economy uses its own digital information advantages to reduce the intensity of energy consumption brought by economic growth. Intelligent manufacturing achieves cost reduction and efficiency through the integration of manufacturing and intelligence as well as digitalization and information technology. The two have become a new engine for sustainable economic development at present, and they can promote and influence each other. However, there is a lack of research on the relationship between them. In this regard, this study aims to build a coupling coordination model of digital economy and intelligent manufacturing and to make an empirical analysis using the data of Chinese provincial administrative regions in order to provide a theoretical reference for promoting sustainable economic development. The research finds that (1) the digital economy and intelligent manufacturing are mainly cross-coupled from four aspects: infrastructure, technological innovation, product optimization and organizational change. The development level and speed of the former are significantly higher than those of the latter, and the gap does not decrease with time. The two have a strong correlation, but there is no high-quality coupling coordination. (2) The main obstacle factors to the digital economy lie in the imperfect supporting facilities, the short board of technological innovation and the lack of technological application capacity. Intelligent manufacturing lacks intelligent application and technological innovation. (3) Influencing factors such as opening to the outside world, economic development, high-level talent input, industrial structure and innovation emphasis have different effects on their coupling and coordinated development in different regions. (4) The spatial correlation test shows that the coupling coordination degree of each region is spatially positively correlated. This research helps to promote the coupling and coordinated development of the digital economy and intelligent manufacturing. [ABSTRACT FROM AUTHOR]

To clarify the damage losses of invasive insects, the economic cost of global invasive insects were assessed in monetized form. InvaCost database was used to analyze all insecta data, and the conservative economic costs, expenditure costs, management and loss costs, and major invasive insect species from 1970 to 2017 were counted separately, based on which generalized least squares regression, robust regression, and quantile regression 3 models to predict the possible costs from 2010 to 2019. The results showed that the economic cost due to insect invasion from 1970 to 2017 was 500 438 million dollar, with an annual average of 10 426 million dollar. The United States had the highest spending cost in the world, and China ranked second about 50 352 million dollar (340 113 million yuan), and the economic cost of Aedes spp. was the highest among all invasive insect species. The model predicted a possible economic cost of 292.362~709.725 billion dollar in the 21st century 10s, with a maximum confidence value of 367.224 billion dollar. The assessment showed that the global economic costs of invasive insects over the past few decades had been enormous, but proactive management was clearly lacking. [ABSTRACT FROM AUTHOR]

Purpose: Research studies on offshoring and reshoring have predominantly focused on the home company, widely ignoring the offshored company in the host country. The host company's influence and contribution have been unseen. This research explores how the host company responds to the home company's location decisions to maintain the dyadic relationship. Design/methodology/approach: An exploratory case study in China was conducted to examine the host company's response to reshoring. The case company has two Japanese parent companies that acted for the emergence of reshoring drivers. Primary and secondary data were collected and analysed through thematic analysis. The host company's response strategies to the home company's relocation decisions were identified and explored. Findings: The findings reveal that four strategies, identified here as being cost control, market expansion, knowledge seeking and relationship bonding, were implemented by the host company. The importance of Industry 4.0 (I4.0) and knowledge transfer is also emphasised within these strategies. Practical implications: This research identified active and practical strategies conducted by the host company to maintain a cooperative relationship with the home company(ies). Instead of encountering a passive response from the host company, the home company may consider working with the host to overcome difficulties caused by emerging reshoring drivers and create an outcome beneficial to both. Originality/value: To the authors' knowledge, this is the first research to study manufacturing reshoring from the perspective of the host company. It provides a new perspective to understanding this phenomenon. [ABSTRACT FROM AUTHOR]

Different from the overwhelming evidence in support of the negative effect of economic policy uncertainty on firm value, our findings show that economic policy uncertainty has positive impact on firm value in firms with high managerial ability using the firm-level data from China over the time period 2003 to 2020. Moreover, our mechanism analyses reveal that firms with high managerial ability differ from those with low managerial ability by conducting more acquisitions and innovation activities and improving cost efficiency when faced with high economic policy uncertainty. [ABSTRACT FROM AUTHOR]

Background: In September 2019, the "4 + 7" centralized procurement pilot program was expanded nationwide aiming at reducing drug prices by means of volume-based procurement and using accredited generic drugs for branded drug substitutes. Given the current uncertain effect of the policy outside pilot areas, this study was conducted to evaluate the impact of the National Volume-based Procurement policy on the use of policy-related drugs after expansion. Method: A single-group interrupted time series was applied using drug purchase data, covering 25 months from December 2018 to December 2020. Drugs related to the centralized procurement policy were selected as samples, including 25 first-batch policy-related drugs and 56 alternative drugs. Centralized procured drugs can be divided into bid-winning and non-winning products, where non-winning products were sorted into generic and branded drugs, and alternative products were classified according to different degrees of substitution. Purchase volume, expenditures, and daily costs were measured. Results: After the implementation of the policy, a significant increase was associated with the volume of bid-winning drugs (p < 0.001) and the volume of generic and branded drugs decreased immediately. The DDDc of drugs under the same generic name significantly reduced (an instantaneous drop of bid-winning drugs by approximately 25%, 7.62 CNY for generics and 3.07 CNY for branded drugs), saving 48.2 million CNY of drug expenditures. The policy has a significant effect on the drug for the treatment of cardiovascular diseases and exerted little influence on the drug for the treatment of nervous diseases, and the substitution of generics for antitumor-branded drugs was not obvious. In addition, the procurement volume of alternative drugs appeared to be a "carry-over". Conclusions: These findings indicated that the policy demonstrated positive effects in terms of price reductions and cost savings and accelerated the substitution of generics against branded drugs. The "patent cliff" for branded drugs has gradually emerged. Besides, a short-term "spillover effect" of the volume of alternative drugs was observed, requiring special attention and vigilance. [ABSTRACT FROM AUTHOR]

Aim: To understand the work status of nurses in long‐term care institutions in China for elderly care to provide a reference for further formulating management strategies and promoting the development of long‐term care teams. Methods: Using qualitative descriptive research methods, 31 nurses from three long‐term care institutions were selected through purposive sampling for in‐depth interviews, and a three‐week participatory observation was conducted on the daily work of nurses in the above three long‐term care institutions. Content analysis was used to analyse data. Results: In our sample, nurses in long‐term care institutions had insufficient manpower, generally had low academic qualifications, and lacked professional ability. Their work enthusiasm and initiative need to be further improved. Long‐term care nurses were moderately paid, and their salary satisfaction was lower than in other trades. At the same time, the social understanding of the long‐term care industry was insufficient, and the social identity of nurses in long‐term care institutions was low. Conclusion: The development of long‐term care requires the joint efforts of nurses, medical institutions, and society. By improving the system, cultivating talents and building a harmonious atmosphere, we aim to enhance the work enthusiasm of long‐term care nurses and promote the stable and orderly development of the long‐term care team. Implications for nursing management: Nurses in long‐term care institutions are at the core of the ageing age and play a vital role in coping with the ageing problem, meeting long‐term care needs, improving the quality of life of old people and reducing the cost of long‐term care. The training and management of nurses in long‐term care institutions and the construction of the entire long‐term care system should be based on China's national conditions and actual needs. [ABSTRACT FROM AUTHOR]

Purpose: The five-year update data from the KEYNOTE-407 study have unveiled noteworthy improvements in survival outcomes achieved with pembrolizumab plus chemotherapy (Pembro+Chemo) compared to placebo plus chemotherapy (Placebo+Chemo) for patients with previously untreated metastatic squamous non-small cell lung cancer (NSCLC). Building upon this finding, our study sought to evaluate the cost-effectiveness of Pembro+Chemo, utilizing the latest available data, from the perspective of the Chinese health care system.Patients and Methods: A Markov model was employed to compare the quality-adjusted life-year (QALY), life-year (LY), total cost, and incremental cost-effectiveness ratio (ICER) between Pembro+Chemo and Placebo+Chemo. The clinical and safety data were derived from the five-year update date of the KEYNOTE-407 study. Sensitivity analyses were conducted to assess the uncertainty of the model, and additional subgroup analyses were performed to explore specific subpopulations.Results: For patients with previously untreated metastatic squamous NSCLC, the utilization of Pembro+Chemo resulted in a improvement of 0.61 quality-adjusted life years (QALYs) along with a cost reduction of $17,491.52 when compared to Placebo+Chemo. Notably, across various subgroups with different tumor proportion scores (TPS), Pembro+Chemo demonstrated enhanced QALYs and lower total costs.Conclusion: From the perspective of the Chinese health care system, first-line Pembro+Chemo emerges as a dominant treatment option over Placebo+Chemo for the treatment of metastatic squamous NSCLC. [ABSTRACT FROM AUTHOR]

Simple Summary: Boron neutron capture therapy (BNCT) is an innovative radiation therapy that shows promise in treating certain types of cancer. Recent advancements in BNCT have focused on developing compact neutron source devices and more effective boron agents in mainland China. This paper highlights the successful transition of two compact neutron source devices from research to clinical trials, with plans underway for their registration as medical devices. Moreover, accelerator-based neutron source devices in construction and the development of boron agents are introduced. The challenges facing BNCT in practice in mainland China as a widely accepted and implemented cancer treatment are analyzed. Boron neutron capture therapy (BNCT) is a promising cancer treatment modality that combines targeted boron agents and neutron irradiation to selectively destroy tumor cells. In mainland China, the clinical implementation of BNCT has made certain progress, primarily driven by the development of compact neutron source devices. The availability, ease of operation, and cost-effectiveness offered by these compact neutron sources make BNCT more accessible to cancer treatment centers. Two compact neutron sources, one being miniature reactor-based (IHNI-1) and the other one being accelerator-based (NeuPex), have entered the clinical research phase and are planned for medical device registration. Moreover, several accelerator-based neutron source devices employing different technical routes are currently under construction, further expanding the options for BNCT implementation. In addition, the development of compact neutron sources serves as an experimental platform for advancing the development of new boron agents. Several research teams are actively involved in the development of boron agents. Various types of third-generation boron agents have been tested and studied in vitro and in vivo. Compared to other radiotherapy therapies, BNCT in mainland China still faces specific challenges due to its limited clinical trial data and its technical support in a wide range of professional fields. To facilitate the widespread adoption of BNCT, it is crucial to establish relevant technical standards for neutron devices, boron agents, and treatment protocols. [ABSTRACT FROM AUTHOR]

Background: Non-pharmacological interventions (NPIs) could be considered in the early management of prehypertensive population. This study aimed to evaluate the potential cost-effectiveness of NPIs and the budget impact of implementing NPIs on prehypertensive population in China and provide evidence of chronic disease management innovation for decision-makers. Methods: Five NPIs including usual care, lifestyle, strengthen exercise, relaxation, and diet therapy were selected based on the practice of hypertension management in China. A nine-state Markov model was constructed to evaluate the lifetime costs and health outcomes of five NPIs and a non-intervention group from the perspective of Chinese healthcare system. The effectiveness of NPIs was obtained from a published study. Parameters including transition probabilities, costs and utilities were extracted or calculated from published literature and open-access databases. Sensitivity analyses were conducted to test the uncertainty of all parameters. The impact of duration of intervention was considered in scenario analyses. A budget impact analysis (BIA) was conducted to evaluate the total cost and the medical cost saving of a hypothetical nationwide implementation of potential cost-effective NPI in prehypertensive people. Management strategies including focusing on patients with specific ages or different CVE risk levels, and different duration of implementation were taken into consideration. Results: Strengthen exercise was the most cost-effective intervention with a probability of 78.1% under the given WTP threshold. Our results were sensitive to the cost of interventions, and the utility of prehypertension and hypertension. The duration of implementation had limited impact on the results. BIA results showed that the program cost was hefty and far more than the medical cost saving with the course of simulation time. Applying management strategies which focused on individual characteristics could largely reduce the program cost despite it remained higher than medical cost saving. Conclusions: Strengthen exercise was a potential NPI that can be considered in priority for early management in prehypertensive population. Although early management can acquire medical cost saving, the related program cost can be quite hefty. Precise strategies which may help reduce the cost of early management should be taken into consideration in program design. [ABSTRACT FROM AUTHOR]