Counties In Sichuan Province Research Articles

Research and analysis on the situation of diagnosis and treatment capabilities of breast cancer in China county.

8 Background: 1. In 2016, 306,000 breast cancer cases were newly diagnosed in China, with one-third in rural areas. Breast cancer ranked second in incidence (22.47/105) among female cancers in Sichuan Province. 2. Health resources are unequally distributed in China, especially in Sichuan Province where 43.27% reside rurally. County hospitals play a vital role in rural patients' diagnosis, treatment, and referrals. Methods: This cross-sectional observational study surveyed 124 county-level hospitals that had treated breast cancer in 183 counties in Sichuan Province from December 2023 to January 2024. Outcomes include: 1) hospital level; 2) oncology certification; 3) availability of dedicated breast department and staffing; 4) breast cancer diagnosis and treatment technology; 5) pre-treatment TNM staging rate; 6) anti-neoplastic drugs and support Accessibility of medicines. Results: Out of 124 hospitals surveyed, 6 excluded for zero breast cancer cases in 2023. The remaining 118 hospitals revealed: 1) 78.81% tertiary, 93.22% public; 2) 75.42% with special outpatient qualifications, 57.63% with concurrent special antineoplastic drug designations, 17.80% with one qualification; 3) 57.63% with dedicated breast units, but only 16.1% with specialized breast cancer staff; 4) 31.36% with full breast imaging modalities, 78.23% lacking mammography; PET-CT and bone scan availability: 5.93% and 9.32%; 5) 71.19% with independent pathology, but only 30.65% providing comprehensive services; 6) Surgeries for breast cancer: 86.44% (44.07% breast conservation), radiation therapy availability: 39.83%; 7) AJCC TNM staging rate: 77.12%; 8) Antineoplastic accessibility: conventional chemotherapy (93.22%), anti-HER2 therapy (28.81%), endocrine therapy (47.46%), CDK4/6 inhibitors (26.27%, with 41.53% having only one); 9) Analgesics: 87.90% (morphine 94.92%, tramadol 88.98%, fentanyl patches 34.75%, oxycodone 46.61%); antiemetics (5-HT3 antagonists 69.49%, NK1 antagonists 72.88%, olanzapine 48.31%, metoclopramide 64.41%); medications for hematologic toxicity: 51.61%. Conclusions: Shortages exist in specialized breast care units and trained personnel among county hospitals in Sichuan, China. Special outpatient qualifications and antineoplastic prescription credentials concentrated mainly at tertiary centers. Enhancing imaging and histopathology capacities for breast cancer diagnosis is an urgent need. While conventional chemotherapies demonstrate good accessibility, anti-HER2 targeted therapies, endocrine therapies, and CDK4/6 inhibitors covered by national insurance have limited availability. Enhanced provision of new antiemetics and analgesics is needed. [Table: see text]

Impacts of land-use change on the habitat suitability and connectivity of giant panda

Land-use changes lead to habitat loss and fragmentation, which poses a further threat to the survival of species. Therefore, it is crucial to analyze how land-use change affects its habitat. 37 counties in Sichuan Province, China, where giant pandas are distributed, were selected as the subjects. Through analyzing land-use change, habitat suitability and connectivity characteristics over the past 20 years, and establishing a correlation between them, the impacts of land-use change on the habitat suitability and connectivity of giant pandas were explained. The results showed that from 2000 to 2020, the different land-use areas in the study area showed a pattern of change with an increase in forest area, built-up area and water area, and a decrease in grassland area and cropland area. There were significant differences in the characteristics of land-use dynamics changes among counties. Changes in land-use dynamics have a significant impact on the habitat suitability and connectivity of giant pandas, which is manifested in the fact that the conversion of forestland to grassland and grassland to cultivated land significantly reduces habitat suitability, while the conversion of grassland to forestland and cultivated to forestland significantly increases the connectivity of giant panda habitats. Changes in the habitat suitability index were significantly and positively correlated with the land-use dynamics index and the land-use degree index. Our findings emphasize the importance of balancing socio-economic development, land-use, and conservation efforts to maintain giant panda habitat. Therefore, the development of rational land-use patterns in future management is key to maximizing the comprehensive social, economic and ecological benefits.

Research on Green Technology Innovation Issues and Paths in the Green Development of Sichuan Counties

With the urgent need for China's economic transformation and sustainable development, the green development of counties in Sichuan Province has become the focus of today's society. This study aims to explore the problems and paths faced by green technology innovation in this context. First, the current status of green technology innovation in Sichuan counties is analyzed, and then the problems of green technology innovation in the green development of Sichuan counties are analyzed. The necessity of research on green technology innovation and policy coordination in Sichuan counties is emphasized, and finally the path to promote green technology innovation in Sichuan counties is proposed. Through the analysis and discussion of this study, it is expected to provide feasible technology innovation paths and policy recommendations for the green development of Sichuan counties, and promote its realization of sustainable development goals.

Has the Establishment of National Key Ecological Function Zones Improved Eco-Environmental Quality?—Evidence from a Quasi-Natural Experiment in 130 Counties in Sichuan Province, China

China’s National Key Ecological Function Zones (NKEFZs) currently represent the largest and most extensive ecological conservation policy in China, with one of the core objectives of this policy being to improve eco-environmental quality (EEQ). This study regards the establishment of NKEFZs as a quasi-natural experiment. Based on panel data from 130 counties in Sichuan Province from 2001 to 2021, a multi-period difference-in-differences (DID) model was employed to evaluate the impact of NKEFZ establishment on EEQ. The findings indicate the following: ① The establishment of NKEFZs can significantly enhance the EEQ of the covered areas, albeit as a gradual long-term process. This conclusion not only meets the parallel-trends assumption but also holds true in a series of robustness tests such as placebo tests. ② Mechanism analysis reveals that NKEFZs can enhance EEQ through the effects of optimizing land spatial allocation and upgrading industrial structure. ③ Heterogeneity analysis demonstrates that the beneficial effect of NKEFZs on EEQ varies across different functional zone types, geographic spaces and ethnic regions. Our study not only contributes to the accumulation of empirical evidence and institutional refinement in the sustainable implementation of ecological policies in China but also offers valuable insights and references for other countries in formulating policies for eco-environmental protection.

Ethnic disparities and temporal trends in health resource allocation: a retrospective decadal analysis in Sichuan, a multi-ethnic Province of Southwest China (2009–2019)

BackgroundResearch on health resource allocation trends in ethnic minority and impoverished areas in China is limited since the 2009 Medical Reform. This study aimed to investigate the variations and inequalities in health resource distribution among ethnic minority, poverty-stricken, and non-minority regions in Sichuan Province, a multi-ethnic province in Southwest China, from 2009 to 2019.MethodsThe numbers of beds, doctors and nurses were retrospectively sourced from the Sichuan Health Statistics Yearbook between 2009 and 2019. All the 181 counties in Sichuan Province were categorized into five groups: Yi, Zang, other ethnic minority, poverty-stricken, and non-minority county. The Theil index, adjusted for population size, was used to evaluate health resource allocation inequalities.ResultsFrom 2009 to 2019, the number of beds (Bedp1000), doctors (Docp1000), and nurses (Nurp1000) per 1000 individuals in ethnic minority and poverty-stricken counties consistently remained lower than non-minority counties. The growth rates of Bedp1000 in Yi (140%) and other ethnic minority counties (127%) were higher than in non-minority counties (121%), while the growth rates of Docp1000 in Yi (20%) and Zang (11%) counties were lower than non-minority counties (61%). Docp1000 in 33% and 50% of Yi and Zang ethnic counties decreased, respectively. Nurp1000 in Yi (240%) and other ethnic minority (316%) counties increased faster than non-minority counties (198%). The Theil index for beds and nurses declined, while the index for doctors increased. Key factors driving increases in bed allocation include preferential policies and economic development levels, while health practitioner income, economic development levels and geographical environment significantly influence doctor and nurse allocation.ConclusionsPreferential policies have been successful in increasing the number of beds in health facilities, but not healthcare workers, in ethnic minority regions. The ethnic disparities in doctor allocation increased in Sichuan Province. To increase the number of doctors and nurses in ethnic minority and poverty-stricken regions, particularly in Yi counties, more preferential policies and resources should be introduced.

The association between perchlorate in drinking water and height and weight of children and adolescents in Southwest China: a retrospective cross-sectional study.

To investigate the association between the concentration of perchlorate in drinking water and the height and weight of children and adolescents in Sichuan Province. Perchlorate in the drinking water of 24 counties in Sichuan Province from 2021 to 2022 was detected and analyzed, 66 drinking water samples were collected, and the content of perchlorate in drinking water during the wet season and dry season was detected by ultra-high performance liquid chromatography in series. The linear mixed effect model was used to estimate the relationship between perchlorate in drinking water and the height and weight of 144,644 children and adolescents, and 33 pieces of local average wage data were used as confounding factors for quality control. After controlling the age, gender, and local economic situation, we found that the concentration of perchlorate in drinking water increased by 10 μg/L is associated with a 1.0 cm decrease in height and a 1.6 kg decrease in weight in children and adolescents (p < 0.05). The concentration of perchlorate in drinking water may be negatively correlated with the height and weight of children.

Development of polymorphic microsatellite markers for Fagus pashanica (Fagaceae) using next-generation sequencing.

Fagus pashanica is an endangered and endemic tree species in China. To understand its genetic diversity and structure for effective conservation, we used next-generation sequencing data to develop a set of microsatellite markers. Twenty-three of the 68 designed loci were successfully amplified. Fifteen polymorphic loci with clear peaks were selected for further analyses in three F. pashanica populations sampled from Nanjiang, Wangcang and Pingwu counties in Sichuan Province, China. The number of alleles per locus ranged from two to 11. The levels of observed and expected heterozygosity ranged from 0.033-0.852 and 0.033-0.787, respectively. All 23 loci were also successfully amplified in F. longipetiolata and F. lucida, and 19 were successfully amplified in F. engleriana. These microsatellite markers will be useful for population genetic studies of F. pashanica and other Fagus species.

Association between Yingyangbao cognition and feeding behavior of caregivers in rural areas of Sichuan Province:the mediating effect of self-efficacy

To describe the current situation of Yingyangbao feeding in rural areas of Sichuan, and to explore the mechanism among micronutrient powder cognition, self-efficacy and feeding behavior. The multi-stage cluster sampling method was adopted. In October 2019, in 2 Han counties, 2 Tibetan counties, and 2 Yi counties in Sichuan Province, a total of 108 villages in 36 townships in 6 sample counties were included in the cluster. Caregivers of infants and young children aged 6-24 months were selected as the research subjects, and a face-to-face interview survey was conducted using a self-designed structured questionnaire. A total of 765 caregivers of infants and young children aged 6-24 months were included in this study. The effective feeding rate of the Yingyangbao was 54.43%. The average scores of caregivers Yingyangbao cognition, self-efficacy and feeding behavior were 3.80±1.16, 7.96±1.53 and 0.83±0.38, and there was a significant positive correlation between them. Self-efficacy played a partial mediating effect between caregivers&apos; Yingyangbao cognition and feeding behavior, and the mediating effect accounted for 23.37% of the total effect. Yingyangbao cognition directly affects feeding behavior and indirectly affects feeding behavior through self-efficacy.

Resilience assessment of the nitrogen flow system in food production and consumption for sustainable development on the Qinghai-Tibet Plateau

A robust and resilient nitrogen (N) flow system can effectively ensure consistent food production and consumption activities while preserving environmental quality. In this study, we constructed an indicator system to evaluate N flow system resilience including food production and consumption, at the county scale on the Qinghai-Tibet Plateau (QTP) from 1998 to 2018. The subsystem coupling coordination degree (CCD) and the effect of N losses on N flow system resilience were subsequently explored. The results indicated that despite the overall N flow system resilience remaining low and exhibiting spatiotemporal disparities from 1998 to 2018, over 90 % of the counties experienced improvements. High resilience areas (>0.15) were mainly concentrated in some counties in Sichuan Province, where N losses were positively correlated with system resilience. The level of resilience depended on agricultural and livestock development, and the CCD of subsystems was also high (>0.5) in this region, with the most balanced environmental and socioeconomic development. The low system resilience areas were concentrated in the eastern part of the QTP, where human activities caused substantial disturbances. The fragmentation of the agro-pastoral system coupled with the low system resilience of the food production and driving pressure subsystems led to low CCD between subsystems. In contrast, the western regions, characterized by a stable food production system, high food self-sufficiency, and weak dependence on external systems, showed a higher degree of system resilience and resistance. Our findings provide a reference for N resource management and policy formulation for food production and consumption in the agricultural and pastoral areas of the QTP.

Epidemiological analysis and risk prediction of scrub typhus from 2006 to 2021 in Sichuan, China.

In the past decade, the number of reported cases of scrub typhus (ST) has increased dramatically in Sichuan Province. We aimed to overview the epidemiological characteristics of ST, identify the variables contributing to the spatial distribution, and estimate the risk areas of ST occurrence. Daily ST cases reported at the county level from 2006 to 2021 and datasets on environmental and socioeconomic variables were obtained. Joinpoint regression model was utilized to examine the incidence trends and to calculate the annual percentage change. Global spatial autocorrelation analysis was employed to explore the spatial temporal patterns. Then BRT model was employed to identify variables that make sense and predict the risk areas of ST occurrence. It has been reported that there were 6,338 ST cases in Sichuan Province from 2006 to 2021, and the incidence rates continued to rise. Most cases were distributed between June and October each year, peaking in August. During the study period, the cases showed spatial clustering at the county level, mainly in the Panxi area, and then slowly spread to the northwest and northeast. Shrubs, precipitation, farmland and maximum temperature were the primary variables that affected the spatial distribution of this disease. It was estimated that the areas including Liangshan, Panzhihua, Bazhong, and Guangyuan were most at risk of transmission. and there were approximately 32.315 million people living in the areas with potential risk of infection throughout Sichuan. Many counties in Sichuan Province were estimated to be susceptible to ST. Our found in this data-driven study could be used to guide the implementation of targeted prevention and control measures in high-risk areas.

External Factors Facilitating Quality Certification of Agricultural Products in China: Insights from Cooperatives in the Sichuan Province

Promoting quality certification of agricultural products is a matter of the sustainable development of agriculture and the transformation of the global agri-food system, and cooperatives are an important carrier to achieve the above policy goals. However, few scholars have included external resources and cooperative quality certification behavior in an analytical framework from the perspective of resource embedding. This study combines resource dependence theory and embeddedness theory, based on survey data from 230 agricultural cooperatives in six counties of Sichuan Province, China. This paper constructs a theoretical analysis framework of government resources, market resources and cooperative quality certification, and uses binary Logit regression model to empirically study the correlation between external resources and cooperative quality certification. The results show that: (1) Cooperatives do not receive a high proportion of external resource support, with 30% and 47% receiving support from the government and market respectively; the proportion of cooperatives carrying out product quality certification was relatively low, about 29.57%. (2) Government resources and market resources have a significant positive effect on improving the quality certification of cooperatives, and the promotion effect of the market is greater than that of the government. (3) Mechanism analysis shows that government resources promote quality certification in cooperatives mainly through regulations on agricultural inputs, while market resources can jointly play a role on regulations on agricultural inputs and market expectations for certified agricultural products.

Effect of Health Poverty Alleviation Project on the Economic Burden of Disease Among Poor Households: Empirical Evidence from Sichuan Province

To evaluate the effect of Health Poverty Alleviation Project on the economic burden of disease among poor families and to provide references for further improvement of the Health Poverty Alleviation Project. The difference-in-differences with propensity score matching method was used to analyze 48 counties in Sichuan Province. Propensity score matching was first carried out with data from the Sichuan Provincial Information System for Medical Care for Low-Income Population and the New Rural Cooperative Medical Insurance data to identify the non-poor population closest to the poor population. Then, difference-in-difference method was used to determine the effect of the Health Poverty Alleviation Project. Health Poverty Alleviation Project reduced the total annual out-of-pocket (OOP) payments by 13.1% on average, the outpatient OOP payments by an average 2.4%, inpatient OOP payments by an average 19.5%, and the probability of incurring catastrophic health care expenditures by an average of 3.9% for low-income households. In addition, the program had a more significant effect in poverty-stricken counties than it did in non-poverty-stricken counties. Despite the significant effectiveness of the project, 12.1% of the low-income families still incurred catastrophic health expenditures after the program was implemented. Health Poverty Alleviation Project reduces the economic burden of disease for poor households, and it has a better effect on reducing the economic burden of poor households in poverty-stricken counties. However, a certain number of households still incurred catastrophic health expenditures. When consolidating and expanding the effects of Health Poverty Alleviation Project and monitoring medical expenses for poverty prevention, policymakers should focus on the households with catastrophic medical expenditures to prevent them from sinking back into poverty.

Micronutrient Powders Feeding Behaviors of Baby Caregivers in Remote Rural Areas of Sichuan Province: A Study Based on the Theory of Reasoned Action

To explore the status quo and influencing factors of feeding behaviors of micronutrient powders (MNP), or yingyangbao in Pinyin, the Chinese Romanization system, of baby caregivers in remote rural areas of Sichuan Province. In 2019, caregivers of babies aged 6 to 24 months from 6 counties of Sichuan Province were selected as the respondents of the survey through a multistage cluster random sampling method. Data concerning the baby caregivers' attitude of behavior, subjective norms, behavioral intention, and feeding behaviors about MNP feeding were collected with a questionnaire through a structured interview. Based on the theory of reasoned action, a structural equation model was constructed to explore the influencing factors of feeding behaviors. A total of 1002 valid samples were included in the study. The effective feeding rate of MNP among the baby caregivers was 55.49%. The results of model analysis suggested that attitude of behavior ( β direct=0.212, 95% CI: 0.105-0.327), subjective norm ( β direct=0.123, 95% CI: 0.016-0.228), and behavioral intention ( β direct=0.162, 95% CI: 0.093-0.224) could have a significant direct impact on MNP feeding behaviors. Behavior attitude ( β indirect=0.044, 95% CI: 0.023-0.073) and subjective norms ( β indirect=0.018, 95% CI: 0.001-0.040) could have a significant indirect impact on MNP feeding behaviors through the intermediary of behavioral intention. Among the three theoretical elements, attitude of behavior had the largest total effect on the feeding behavior ( β total=0.256, 95% CI: 0.148-0.366). The effective feeding rate of MNP among baby caregivers in remote rural areas of Sichuan Province is low. The attitude of behavior and subjective norms of caregivers may have a direct impact on their feeding behavior, and both attitude of behavior and subjective norms can have an indirect impact on the feeding behavior through the intermediary of behavioral intention. The influence of attitude of behavior attitude on feeding behavior is greater than that of subjective norms. Future intervention plans for promoting effective MNP feeding should incorporate health education for baby caregivers and their important social relations. Thus, baby caregivers' attitude and willingness for MNP feeding will be strengthened and the effective feeding rate of MNP will be improved accordingly.

Does forest farm carbon sink projects affect agricultural development? Evidence from a Quasi-experiment in China

Forest Farm Carbon Sink (FFCS) projects are one of the effective ways to achieve carbon neutrality and mitigate global warming. Though the existing literature has widely discussed the effect of FFCS on the allocation of agricultural factors, such as land, labor employment structure and income structure, little is known about whether FFCS projects could have an effect on agricultural development. Based on the panel data of 140 counties in Sichuan province, China, from 2002 to 2018, we examined the causal effect on agricultural total factor productivity (TFP), and revealed their dynamic effect and underlying mechanisms. Propensity score matching and the difference in difference (PSM-DID) method were used to address the endogeneity problem of FFCS implementation. Results showed that FFCS projects increased agricultural TFP by 1.7%–2.4%. Health, saving and industrial structure were the important channels through which FFCS projects affect agricultural TFP. Our findings suggest that policies promoting FFCS projects can increase agricultural TFP while achieving environmental goals—a win-win situation.

Impact of “expanding powers and strengthening counties” reform on basic public education services: Empirical evidence from Sichuan, China

The quality of a country's education system is both an indicator of its present level of development and a predictor of future economic advancement. This study intended to explore the impact of the “expanding power and strengthening counties” reform on the supply of basic public education resources. A combination of qualitative and quantitative methods was used to analyze the panel data of 114 counties in Sichuan Province from 2005 to 2017, including 78 counties with expanded powers. The study found that the “expanded power strong counties (EPSC)" had a significant positive impact on the supply level of funding resources measured by per capita public education expenditure. The time effect of the EPSC on the supply of teacher resources for county public education was manifested as a sharp increase in the supply level in the three years before the reform. The supply level tended to be stable after four years of reform. The economic resources supply level was relatively stable in the first three years and rose sharply after four years. There was a downward trend after the reform for 8 years. The structural effect has shown a more significant incentive effect on the supply of public education resources to strong and weak counties. But compared with the weak counties with lower economic development levels, the strong counties with higher economic development levels have a more noticeable effect of their decentralization reform on improving the supply level of public education resources.

Does Rural Operation System Reform Enhance Agricultural Output? Evidence from Sichuan Province

Rural operation system reform is vital in promoting rural revitalisation and agricultural and rural modernisation in China. Based on the sample data of 153 counties in Sichuan Province from 2012 to 2020, this paper constructs a PSM-DID evaluation model to analyse the effectiveness of rural operation system reform on agricultural development from the perspective of policy action mechanism, variable differentiation and other aspects. The results show that: (1) rural operation system reform has significantly boosted the economic development of the counties implementing the pilot reform of the rural operation system; (2) rural operation system reform mainly has two components: rural land system reform and agriculture organisation innovation; both have an impact on county economic and social development, but the degrees of impact are different; (3) the effectiveness of the rural operation system reform policy has a specific time lag. The results of this paper enrich the effectiveness evaluation of the reform policy on economic development and have policy implications for further promotion of agricultural and rural reform in China.

Policy Evaluation of Demonstration Cooperative Construction: Evidence from Sichuan Province, China.

Agricultural cooperatives are professional organizations that increase farmers’ incomes through market failure corrections, livelihood resilience, and sustainable rural development. The main purpose of this paper was to evaluate the policy effects of the construction of demonstration cooperatives for farmers in China. The authors of this paper used the propensity score matching (PSM) method to evaluate the policy effect of the construction of demonstration cooperatives based on questionnaire survey data on 509 farmer cooperatives in 10 counties in Sichuan Province of China. On this basis, the inverse probability weighting-regression adjustment (IPWRA) method was used as a robustness test. The authors of this study were the first to systematically and comprehensively assess the policy effects of demonstration cooperatives while considering selectivity effects. The empirical results show that the Chinese government’s construction of demonstration cooperatives has significant policy effects, especially regarding policy support in improving the economic strength, service capacity, product quality, and social response of demonstration cooperatives. However, the policy effect of improving the democratic management of cooperatives is not significant. It is recommended that the government continue to strengthen policy support in improving the economic strength, service capacity, product quality, and social response of demonstration cooperatives. Simultaneously, more effective measures should be taken to promote the democratic management of model cooperatives.

Towards comprehensive regional resilience evaluation, resistance, recovery, and creativity: From the perspective of the 2008 Wenchuan Earthquake

Regional resilience is the ability to resist, recover, and redevelop (creativity) after a disaster. However, few comprehensive pre-and post-disaster analyses based on resilience indicators have been conducted. This research used ordination and clustering analyses to develop a comprehensive framework that included a multi-indicator horizontal analysis and an uni-indicator longitudinal recovery trend analysis. Novel resilience evaluation criteria and a resilience score that accounted for both short-term resistance and long-term recovery and creativity are also proposed. The framework was then applied to data from 55 counties in Sichuan Province, China, before and after the 2008 Wenchuan Earthquake (2005–2016). It was found that: (i) after the Wenchuan Earthquake, the economic and public facility-related indicators first underwent a one to three-year recovery process after which there was a period of steady redevelopment; (ii) the more economically developed regions had higher resilience; and (iii) compared with the average for the more developed regions, the underdeveloped regions appeared to have better catastrophic earthquake resistance and recovery capabilities. This research provides a comprehensive quantitative regional resilience evaluation, which could assist emergency managers and decision-makers in improving disaster resilience.

County Ecosystem Health Assessment Based on the VORS Model: A Case Study of 183 Counties in Sichuan Province, China

The scientific assessment of the health level of county ecosystems is the basis for formulating county-based sustainable development strategies. In this paper, we take the county areas of Sichuan Province as the evaluation objects and combine the SDGs (the Sustainable Development Goals) to establish a county ecosystem health evaluation index system based on the VORS (Vigor–Organization–Resilience–Service) model. On this basis, we used the entropy weight method, the Moran index method, and the obstacle degree model to analyze the ecosystem health level, spatial distribution characteristics, and obstacles of 183 counties in Sichuan Province. The main results were as follows: (1) A total of 80.87% of the counties in Sichuan Province were at sub-healthy and healthy levels, concentrated in the southeastern part of Sichuan, and 19.13% of the counties were at an unhealthy level, mainly in the Aba, Ganzi, and Liangshan areas. (2) The health levels of county ecosystems in Sichuan Province had high spatial autocorrelation characteristics. The H–H (High–High) agglomeration area and the L–L (Low–Low) agglomeration area had significant agglomeration characteristics, which were distributed in the Cheng-Mian area and the northwestern Sichuan area, respectively. (3) The key indicators restricting the healthy development of urban ecosystems in Sichuan counties are economic vitality, economic resilience, and quality of life, all of which belong to the economic subsystems, with obstacles reaching 17.25%, 16.68%, and 13.52%, respectively. This study can provide theoretical and methodological support for research into ecosystem health evaluations at the county level, and provide a decision-making basis for promoting the health of county ecosystems and coordinating regional development in Sichuan Province.

Long-term effectiveness of rehabilitation services delivery for Wenchuan earthquake survivors with impairments over a 4-year period: a prospective cohort study

ObjectiveTo examine long-term effectiveness of rehabilitation services on physical function, pain severity and post-traumatic stress disorder (PTSD) in earthquake survivors over a 4-year period.DesignProspective cohort study with early and late...