High Level Of Coordination Research Articles

Groupers and moray eels (GME) optimization: a nature-inspired metaheuristic algorithm for solving complex engineering problems

AbstractAs engineering technology advances and the number of complex engineering problems increases, there is a growing need to expand the abundance of swarm intelligence algorithms and enhance their performance. It is crucial to develop, assess, and hybridize new powerful algorithms that can be used to deal with optimization issues in different fields. This paper proposes a novel nature-inspired algorithm, namely the Groupers and Moray Eels (GME) optimization algorithm, for solving various optimization problems. GME mimics the associative hunting between groupers and moray eels. Many species, including chimpanzees and lions, have shown cooperation during hunting. Cooperative hunting among animals of different species, which is called associative hunting, is extremely rare. Groupers and moray eels have complementary hunting approaches. Cooperation is thus mutually beneficial because it increases the likelihood of both species successfully capturing prey. The two predators have complementary hunting methods when they work together, and an associated hunt creates a multi-predator attack that is difficult to evade. This example of hunting differs from that of groups of animals of the same species due to the high level of coordination among the two species. GME consists of four phases: primary search, pair association, encircling or extended search, and attacking and catching. The behavior characteristics are mathematically represented to allow for an adequate balance between GME exploitation and exploration. Experimental results indicate that the GME outperforms competing algorithms in terms of accuracy, execution time, convergence rate, and the ability to locate all or the majority of local or global optima.

Comparison of Multi-Agent Platform Usability for Industrial-Grade Applications

Modern systems often employ decentralised and distributed approaches. This can be attributed, among others, to the increasing complexity of system processes, which go beyond the capabilities of singular components. Additionally, with the growth in demand for system automation and high-level coordination, solutions belonging to the decentralised Artificial Intelligence and collaborative decision-making are often applied. It can be observed that these concerns fall within the domain of multi-agent systems. However, even though MAS concepts emerged more than 40 years ago, despite their obvious advantages and continuous efforts of the scientific community, agents remain rarely used in industrial-grade applications. In this context, the goal of this contribution is to analyse the reasons for the lack of adoption of agent solutions in the real world. During the analysis, all pertinent aspects of the modern software development life cycle are examined and compared to what is currently available in the agent system domain. Specifically, the study focuses on identifying gaps that are often overlooked when it comes to scientific applications of MAS, but are critical in terms of potential for large-scale system development in practice.

Optimization Study on Stakeholder Capability Configuration in Green Construction

Green construction is considered to be a construction model that pursues high resource efficiency and the utilization of reduced environmental impacts through technological innovation and management optimization under the realization of the project’s iron triangle. The realization of its performance relies on the level of stakeholder capability configuration. To reveal the optimal capability configuration and interaction between regulators and executors, this study constructed a utility model based on a post-positivist methodology. By analyzing the optimal capability configuration and coordination levels of regulators and executors according to the practices and constraints of green construction, this study conducted a static analysis to compare the effects of marginal value on regulators’ capability input and coordination coefficients. Finally, a sensitivity analysis uncovers the changes in capability configuration interaction and coordination coefficients at different stages of green construction. The results indicate that high levels of coordination in green construction cannot be maintained in the long term; continuous capability input from regulators is required for sustained support. Only by eliminating external uncertainties, reducing the variable costs for executors in advancing green construction, and controlling their risk aversion can executors be truly motivated to promote green construction. The capability configuration of both regulators and executors adjusts with corresponding marginal values. The capability configuration of executors shows a trend of initially increasing and then decreasing as the progressive coefficient rises. The model proposed in this study ensures that the final coordination level stabilizes at a relatively high level, which is between 0.6 and 0.7. In summary, the breakthrough findings provide critical insights into green construction management, contributing to the achievement of the anticipated green construction objectives.

DILEMMA AND COUNTERMEASURES OF URBAN CHILDCARE SERVICE DEVELOPMENT BASED ON GROUNDED THEORY: A CASE STUDY OF CHANGSHA

This study uses the grounded theory method to conduct in-depth interviews with relevant groups in the development of childcare services in Changsha and explores the difficulties in the development of urban childcare services and their solutions. The study identifies two main categories: "imbalance of internal factors" and "obstruction of external environment», which cover four aspects of institutional operation: professional quality, supply and demand imbalance, and misalignment of management mechanisms. To address these problems, this study proposes countermeasures and suggestions, such as improving the childcare service supply system, strengthening support policies, increasing professional talent training, and building a high-level coordination and planning mechanism to promote the healthy development of urban childcare services.

Communities as Victims of Inter-Cattle Rustling Gangs in the Northern Regions of Kenya and Uganda

Cattle rustling remains a deeply rooted issue in the Northern regions of Kenya and Uganda and encompasses a complex and multi-faceted problem with far-reaching implications for victimized communities. This issue, originating from tribal tensions, territorial disputes, economic incentives, marginalization, and climate change, demands a comprehensive investigation. This study aims to shed light on the intricate dynamics of inter-cattle rustling attacks, delving into the temporal patterns, distinct attack characteristics, and their societal impact. In this context, the research objectives include determining patterns and trends of these attacks, assessing their impacts on affected communities, and proposing measures to enhance the protection and empowerment of these communities. The study employed a mixed methods research approach, which involved a target population of approximately 400,000 individuals from the Pokot and Sebei communities living along the Kenya-Uganda border. Data collection methods included semi-structured interviews with key informants, focus group discussions, and a review of existing reports and records. The study identified distinct temporal patterns of inter-cattle rustling attacks, with attacks occurring most frequently during specific timeframes, such as early morning, late morning, afternoon, and late evening. This temporal pattern offers insights into the strategic considerations of the attackers. In addition, the study revealed that attacks exhibit distinct characteristics depending on the time of day. In the morning, attacks are marked by swiftness, a "grab and run" mentality, and a readiness to eliminate opposition. Afternoons see a shift in focus, with caretakers becoming the primary targets. Evening raids are conducted with stealth and aim to drive stolen animals across the border. Further, the attackers, known as "Morans," were found to be well-prepared and armed, with a high level of coordination, particularly in morning and evening attacks. Their identity adds to the complexity of the confrontations. The impact of inter-cattle rustling attacks goes beyond economic losses, resulting in the loss of life, displacement of communities, closed schools, and the disruption of community centers. Entire sections of communities are forced to relocate, upending livelihoods and contributing to a sense of desolation. The attacks traumatize victim communities, with children, in particular, bearing a heavy psychological burden, especially in the brutal morning confrontations. This psychological impact further erodes the social fabric. Based on these findings, the study recommends implementing community-based resilience programs, establishing psychosocial support services, engaging in conflict resolution and mediation efforts, strengthening security measures, promoting sustainable resource management, providing economic opportunities, and facilitating cross-cultural dialogues. These recommendations are expected to contribute to the development of more effective policies and interventions. In summary, this study contributes valuable insights that can inform evidence-based policy development to address the multi-faceted challenge of cattle rustling and its diverse implications for the affected communities in the Northern regions of Kenya and Uganda.

Combating obesity in Southeast Asia countries: current status and the way forward

Obesity is gaining prominence as a serious public health challenge in the Southeast Asia (SEA) region, with an alarming rate of increase in its prevalence. Countries in the region have shown commitment to curbing the rise of obesity by establishing policies, strategies, and action plans. This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases. Although a range of policies and strategies have been developed, including national nutrition action plans, community intervention programmes, fiscal measures, nutrition labelling to promote healthier choices, countries in the region are struggling to make significant progress toward halting the scourge of obesity. It is imperative to strengthen existing health systems with a paradigm shift from a focus on “sick care” to and enhancing nutrition initiatives to support obesity prevention. A comprehensive and coordinated approach is essential, one that emphasises high-level coordination across all levels of government and multiple sectors, and a unified plan rather than fragmented initiatives. For strategies to be effective and sustainable, they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities. A more holistic approach is clearly needed to improve the entire food environment, which in SEA countries must include the multitude of eating places where large segments of the population “eat out” everyday to meet their energy and nutrient needs. There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits. This paper calls for a whole-of-government, whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.

Simulating Metal-Imidazole Complexes.

One commonly observed binding motif in metalloproteins involves the interaction between a metal ion and histidine's imidazole side chains. Although previous imidazole-M(II) parameters established the flexibility and reliability of the 12-6-4 Lennard-Jones (LJ)-type nonbonded model by simply tuning the ligating atom's polarizability, they have not been applied to multiple-imidazole complexes. To fill this gap, we systematically simulate multiple-imidazole complexes (ranging from one to six) for five metal ions (Co(II), Cu(II), Mn(II), Ni(II), and Zn(II)) which commonly appear in metalloproteins. Using extensive (40 ns per PMF window) sampling to assemble free energy association profiles (using OPC water and standard HID imidazole charge models from AMBER) and comparing the equilibrium distances to DFT calculations, a new set of parameters was developed to focus on energetic and geometric features of multiple-imidazole complexes. The obtained free energy profiles agree with the experimental binding free energy and DFT calculated distances. To validate our model, we show that we can close the thermodynamic cycle for metal-imidazole complexes with up to six imidazole molecules in the first solvation shell. Given the success in closing the thermodynamic cycles, we then used the same extended sampling method for six other metal ions (Ag(I), Ca(II), Cd(II), Cu(I), Fe(II), and Mg(II)) to obtain new parameters. Since these new parameters can reproduce the one-imidazole geometry and energy accurately, we hypothesize that they will reasonably predict the binding free energy of higher-level coordination numbers. Hence, we did not extend the analysis of these ions up to six imidazole complexes. Overall, the results shed light on metal-protein interactions by emphasizing the importance of ligand-ligand interaction and metal-π-stacking within metalloproteins.

Defining change: Exploring expert views about the regulatory challenges in adaptive artificial intelligence for healthcare

ObjectiveContinuously learning or adaptive artificial intelligence (AI) applications for screening, diagnostic and other clinical services are yet to be widely deployed. This is partly due to existing device regulation mechanisms that are not fit for purpose regarding the adaptive features of AI. This study aims to identify the challenges in and opportunities for the regulation of adaptive features of AI. Materials and MethodsWe performed in-depth qualitative, semi-structured interviews with a diverse group of 72 experts in high-income countries (Australia, Canada, New Zealand, US, and UK) who are involved in the development, acquisition, deployment and regulation of healthcare AI systems. ResultsOur findings revealed perceived challenges in the regulation of adaptive features of machine learning (ML) systems. These challenges include the complexity of AI applications as products subject to regulation; lack of accepted definitions of adaptive changes; diverse approaches to defining significant adaptive change; and lack of clarity about regulation of adaptive change. Our findings reflect potentially competing interests among different stakeholders and diversity of approaches from regulatory bodies and legislators in different jurisdictions across the globe. In addition, our findings highlight the complex regulatory implications of adaptive AI that differ from traditional medical products, drugs or devices. ConclusionThe perceived regulatory challenges raised by adaptive features of AI applications require high-level coordination within a complex regulatory ecosystem that consists of medical device regulators, professional accreditation agencies, professional medical organisations, and healthcare service providers. Regulatory approaches should complement existing safety protocols with new governance mechanisms that specifically take into account the variety of roles and responsibilities that will be required to monitor, evaluate and oversee adaptive changes.

Can Rural Digitization and the Efficiency of Agricultural Carbon Emissions Be Coupled and Harmonized under the “Dual-Carbon” Goal?

A major driving force behind China’s low-carbon, environmentally friendly development of agriculture and the accomplishment of the “dual-carbon” goal is the digital transformation of rural areas. In this study, on the basis of clarifying the degree of rural digitization and agricultural carbon emissions efficiency in China from 2010 to 2021, the degree of coupled coordination and the spatiotemporal pattern characteristics between the two are examined using the coupled coordination model. Then, the influencing factors are analyzed in depth using the spatial Durbin model. Our findings reveal that, first, in terms of the degree of rural digitization, the index increases overall and the spatial imbalance is obvious, with a spatial distribution pattern of “high in the east and low in the west”. Regarding the efficiency of agricultural carbon emissions, there is an overall “N-shaped” change, which is mainly influenced by technological progress in agricultural production, and the regional annual averages are, in descending order, the Western, Eastern, Northeastern, and Central regions, with obvious regional differences. Second, the coupling coordination index shows a fluctuating upward trend, from “extreme disorder” to “high-level coordination”. Furthermore, there are obvious regional characteristics. The regional growth rates are, in descending order, the Western, Eastern, Central, and Northeastern regions. Third, coupling coordination is jointly influenced by a variety of factors, including government input, educational level, industrial structure, energy use, urbanization rate, living standards, driving temporal patterns, and regional differences. This study not only helps to clarify the relationship between the two, offering a reference for the realization of the “dual-carbon” goal, but also broadens the concepts of the low-carbon and environmentally friendly development of agriculture.

Coupling Mechanisms of Eco-environmental Quality and Human Activities in China and Their Influencing Factors

In the context of sustainable development, it is important to thoroughly investigate the coupling mechanism between China's eco-environmental quality and human activities, as well as identify the influencing factors, in order to provide scientific references for achieving sustainable development goals in China. This study applied trend analysis, coupling coordination degree, LMDI, and optimal parameter geographic detector models to explore and evaluate the coupling mechanism between China's eco-environmental quality and human activities. The findings of the study were as follows:① During the research period, there was a growth trend in China's coupling coordination degree, human activities, and eco-environmental quality. Human activities and coupling coordination degree exhibited a spatial differentiation pattern with the Hu Line as the boundary, showing an "east high, west low" distribution. The eco-environmental quality demonstrated a "south high, north low" differentiation pattern. ② The overall trend of China's coupling coordination type transformation was shifting from lower-level to higher-level coordination types. ③ Based on the geographic detector and LMDI models, the dominant factors influencing the coupling coordination degree in most provinces east of the Hu Line were social and economic factors, as well as the comprehensive coordination index. In contrast, the dominant factors in most provinces west of the Hu Line were natural environmental factors and coupling degree. ④ The evaluation of the impact of changes in human activities on eco-environmental quality revealed that the regions east of the Hu Line were mainly characterized by favorable development and effective protection, whereas the regions west of the line were mainly characterized by destructive development and ineffective protection. It is suggested that the regions on both sides of the Hu Line should prioritize development based on local prerequisites influencing the coupling coordination degree and the relative relationship between human activities and eco-environmental quality. It is crucial to actively adjust development strategies and pursue a sustainable development path towards the high-level coordination between eco-environmental quality and human activities.

Classic Performing Arts Supply Chain Modeling in Covid 19 Protocol to Support D.I Yogyakarta Cultural Tourism Using Soft System Methodology

The performing arts are a unique and complex industry. To enjoy performing arts products, a customer must come to the rooms where the performance takes place. Performance products can be categorized as service products that do not have a physical form. Every performing arts performance always involves many works of art with a high level of coordination. The flow of materials and information (supply chain) moves very quickly within the limitations of space and time. Because the success of performing arts is influenced by many factors and actors, a performing arts manager must be able to manage the performing arts supply chain well.The Corona Virus Disease 19 (Covid-19) pandemic which has hit almost all corners of the world has formed new patterns of human behavior in working and interacting. Likewise, organizing and enjoying performing arts will look different compared to before the Covid-19 outbreak. The implementation of health protocols is needed to minimize the spread of the virus which has infected more than 13.2 billion people throughout the world.The performing arts supply chain policy model in the Covid-19 protocol to support cultural tourism in D.I Yogyakarta can be implemented by following the Joint Decree Guidelines of the Minister of Education and the Minister of Tourism and Economy dated 02 July 2020. Each actor must pay attention to the technical guidelines for preventing and controlling corona virus disease 2019. Each actor guarantees the hygiene of their respective performing arts equipment. Each actor maintains the form and duration of physical contact and pays attention to health protocols in activities throughout the performing arts supply chain. The performing arts model during the pandemic is realized in regulations that are in accordance with the technical guidelines for preventing and controlling the 2019 corona virus disease.

Coupling Coordination between Agricultural Eco-Efficiency and Urbanization in China Considering Food Security

When studying the coupling coordination relationship between agricultural eco-efficiency and urbanization, it is crucial to consider food security, especially in a populous country like China. This paper focuses on 31 provinces in China as the research units, covering the time period from 2000 to 2020. Based on the concept of agricultural eco-efficiency, an evaluation index system was developed to include undesirable outputs (carbon emissions), and agricultural eco-efficiency scores were calculated using the SBM–DEA model. An urbanization evaluation index system, covering six dimensions and twelve indexes, was constructed. A comprehensive index of urbanization is measured using the entropy method. On this basis, a coupling coordination model was applied to quantify the relationship between agricultural eco-efficiency and urbanization at the provincial scale in China. The results showed that the agricultural eco-efficiency of all provincial units in China exhibited an overall trend of improvement. Average efficiency followed a spatial pattern of majority grain-consuming areas > grain production–consumption balance areas > majority grain-producing areas. The level of coupling between agricultural eco-efficiency and urbanization is generally low. Currently, no regions have reached the stage of synergy or high-level coupling. Most regions are currently in an antagonistic stage with a coupling degree of 0.3 < C ≤ 0.5. The classification of coupling coordination levels changed from four levels of “severe imbalance”, “moderate imbalance”, “mild imbalance”, and “primary coordination” to “moderate imbalance”, “mild imbalance”, “primary coordination”, and “intermediate coordination”. The level of “severe imbalance” disappeared, the level of “intermediate coordination” appeared, and the level of “mild imbalance” became the largest scale level. From the perspective of food security, the proportion of grain production in the categories of “primary coordination” and “intermediate coordination” was less than 10%, and these provinces never achieved self-sufficiency in food production. The proportion of grain production at the “mild imbalance” level reached 62.4%, while the per capita grain production at the “moderate imbalance” level reached 846.7 kg. Provinces with lower levels of coupling coordination have stronger food security capabilities. It can be observed that the weaker the coupling coordination between agricultural eco-efficiency and urbanization, the higher the food self-sufficiency. Based on the research results above, we discussed strategies to enhance agricultural eco-efficiency in majority grain-producing regions by focusing on technological progress and technical efficiency. Additionally, we analyzed approaches to achieve grain self-sufficiency in regions characterized by a high level of coordination between agricultural eco-efficiency and urbanization, considering both production and trade dimensions.

Adaptation of national legislation to EU law: experience of member states and candidate states for Ukraine

The article is analyzed the experience of EU member states and candidate states for EU accession in the sphere of adaptation of national legislation to EU law. The relevance of the topic is due to the fact that on June 23, 2022, Ukraine received the status of a candidate state for EU membership, and today it is very close to the beginning of the negotiation process on joining the EU. Negotiations on accession to the EU provide for the screening of the compliance of the national legislation of the candidate state with EU law in order to identify differences between them in each part of the negotiations. After the screening, direct negotiations begin on the conditions under which the candidate state accepts and applies EU law. Each candidate country operates according to a separate schedule and can be accepted into the EU as quickly as it can adapt its national legislation to EU law (a decisive criterion for EU membership). Adaptation of the national legislation of the candidate country to EU law is a long-term process that continues even after the state has acquired full membership in the EU. It is not only about the formal adaptation of legislation, but also about the creation of institutions that ensure its compliance and implementation in practice. Ukraine, which is at the beginning of the negotiation stage, will be helped to speed up its path to the EU by using the positive and taking into account the negative experience of other states in adapting national legislation to the EU acquis. The experience of the EU member states shows that they overcame the process of joining the EU and the related adaptation of national legislation through various legal and institutional mechanisms, but always in one form or another, success depended on the coordination of the actions of the parliament and the government. In particular, it is the development and implementation of programs for the adaptation of national legislation to EU law; establishment of special institutions responsible for European integration; consultative, methodical and financial assistance of the EU and member states; control of projects of normative legal acts for compliance with EU law; a high level of coordination of the activities of state authorities involved in the process of adapting legislation to EU law, etc. At the same time, the main guarantee of successful European integration is the presence of the political will to carry out the necessary reforms in the state, a quick transition from declaring intentions to become a full member of the EU to concrete actions along the way, as well as the support of civil society. The adaptation of national legislation to EU law as a process of bringing the laws of Ukraine and other normative legal acts into compliance with the EU acquis is, first of all, a separate direction of law-making activity that requires proper legal, institutional, methodological, organizational and personnel support. However, the experience of other countries shows that the approximation of the national legal system to the EU law should also include the application and interpretation of the law in the spirit of the EU legal standards.

Spatial–Temporal Differentiation and Trend Prediction of Coupling Coordination Degree of Port Environmental Efficiency and Urban Economy: A Case Study of the Yangtze River Delta

Green development is a primary path for ports and cities to achieve a low-carbon transition under the Sustainable Development Goals and a powerful driving force to elevate regional port–city relations to a high level of coordination. In this paper, twenty port cities in the Yangtze River Delta (YRD) were selected and port environmental efficiency (PEE) was calculated through the window SBM model, while the EW-TOPSIS model was used to evaluate high-quality urban economic development (HED). The coupling coordination degree (CCD) model, the kernel density model, GIS spatial analysis, and the grey prediction model were used to further explore the spatial–temporal dynamic evolution and prediction of the CCD between PEE and HED. The results suggested that: (1) PEE fluctuation in the YRD is increasing, with a trend of seaports achieving higher PEE than river ports; (2) HED in the YRD shows upward trends, and the polarization of individual cities is obvious; (3) Temporally, the CCD in the YRD has risen from 0.438 to 0.518. Shanghai consistently maintains intermediate coordination, and Jiangsu has experienced the most significant increase in CCD. Spatially, CCD is led by Lianyungang, Suzhou, Shanghai, and Ningbo-Zhoushan, displaying a decreasing distribution pattern from east to west. The projection for 2026 suggests that all port cities within the YRD will have transitioned to a phase of orderly development. To enhance the coordination level in the YRD, policymakers should consider the YRD as a whole to position the ports functionally and manage them hierarchically, utilize the ports to break down resource boundaries to promote the synergistic division of labor among cities, and then tilt the resources towards Anhui.

Mitigating the effects of global disruptions on supply chains: gaining insights from the dairy industry during Covid-19

This paper explores the dairy industry during peak Covid-19 disruption. Institutional theory is applied as a lens to investigate resilience factors and capacities at macro (industry), meso (supply chain) and micro (firm) levels. The methodology comprised four stages: in-depth interviews, retrospective literature review, intercoder reliability assessment, and a Delphi panel. Findings demonstrate execution of embedded resilience capacities but also the need for the dairy industry as an institution to dynamically adapt for advanced resilience. At the macro level, technology is highlighted as a critical resilience capacity. At the meso level, findings revealed that both lean and agile were key resilience capacities, exhibited by high levels of coordination, co-dependence, and communication. At the micro level, capacities such as ability to manage risk, skilled workforce, levels of automation, and financial stability were evident. Definition of these capacities and explanation of their adoption through an institutional theoretical lens delivers important contributions for advanced resilience.

Towards strategic agenda for European nuclear education, training, and knowledge management

The key elements of the EU-wide strategic agenda for nuclear education, training, and knowledge management are proposed in this paper. They were developed partly within the ENEN+ and ENEN# projects, to support and consolidate the efforts of the nuclear stakeholders to attract, develop, and retain new talents. The paper considers the projections of needs developed by the European Human Resources Observatory-Nuclear (EHRO-N). It builds on the existing national nuclear education strategies in the EU and beyond and more than two decades of experience with the European Nuclear Education Network (ENEN). The paper outlines and substantiates the most important actions and risks related to human resources, which need to be managed successfully for the EU to contribute to the tripling of the nuclear power generation capacity on the planet by 2050 (as announced in COP28) and to retain its leading role in the nuclear power and non-power applications. The sheer complexity of this challenge calls for high-level strategic support, coordination, and partnership between all nuclear stakeholders, especially those involved in the decision-making. The present situation calls for urgent strategic actions with long-term sustainability.

Improved patient safety with a simplified operating room to pediatric intensive care unit handover tool (PATHQS).

Patient handover is a crucial transition requiring a high level of coordination and communication. In the BC Children's Hospital (BCCH) pediatric intensive care unit (PICU), 10 adverse events stemming from issues that should have been addressed at the operating room (OR) to PICU handover were reported into the patient safety learning system (PSLS) within 1 year. We aimed to undertake a quality improvement project to increase adherence to a standardized OR to PICU handover process to 100% within a 6-month time frame. In doing so, the secondary aim was to reduce adverse events by 50% within the same 6-month period. The model for improvement and a Plan, Do, Study, Act method of quality improvement was used in this project. The adverse events were reviewed to identify root causes. The findings were reviewed by a multidisciplinary inter-departmental group comprised of members from surgery, anesthesia, and intensive care. Issues were batched into themes to address the most problematic parts of handover that were contributing to risk. A bedside education campaign was initiated to familiarize the team with an existing handover standard. The project team then formulated a new simplified visual handover tool with the mnemonic "PATHQS" where each letter denoted a step addressing a theme that had been noted in the pre-intervention work as contributing to adverse events. Adherence to standardized handover at 6 months improved from 69% to 92%. This improvement was sustained at 12 months and 3 years after the introduction of PATHQS. In addition, there were zero PSLS events relating to handover at 6 and 12 months, with only one filed by 36 months. Notably, staff self-reporting of safety concerns during handover reduced from 69% to 13% at 6 months and 0% at 3 years. The PATHQS tool created in this work also spread to six other units within the hospital as well as to one adult teaching hospital. A simplified handover tool built collaboratively between departments can improve the quality and adherence of OR to PICU handover and improve patient safety. Simplification makes it adaptable and applicable in many different healthcare settings.

Reliability and Validity of the Star Excursion Balance Test for Evaluating Dynamic Balance of Upper Extremities.

Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity. The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs. Observational study. Level 4. This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured. Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (r = 0.315-0.755, P < 0.01) and a strong correlation with CKCUEST (r = 0.4-0.67, P < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (r = 0.26-0.43, P < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees. UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests. UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.

Coupling coordination of the provision of medical services and high-quality economic development in the Yangtze River Economic Belt.

Promoting high-level coupling coordination between the provision of medical services (PMS) and high-quality economic development (HED) has emerged as a critical issue in China's pursuit of high-quality development and is now a significant subject of concern in the area of welfare economics. Based on panel data from 11 provinces and municipalities in the Yangtze River Economic Belt, covering the period from 2010 to 2020, this study conducted an empirical analysis of the coupling coordination between PMS and HED and its influencing factors. Methods combined a comprehensive evaluation model, a coupling coordination model, and a panel Tobit model. The study found that: (1) Regarding the overall situation in the Yangtze River Economic Belt, the overall PMS demonstrates a fluctuating upward trend, while HED fluctuates within the lower range of 0.3 to 0.4. The coupling coordination degree between PMS and HED fluctuates within the moderate range of 0.5 to 0.6. (2) In terms of the spatiotemporal evolution trends, there still exists substantial spatial disparity among provinces and municipalities within the Yangtze River Economic Belt regarding PMS; nonetheless, this gap is gradually narrowing. Significant regional disparities are also observed in HED, with Shanghai, Jiangsu, and Zhejiang leading among the provinces and municipalities in the Yangtze River Economic Belt. The coupling coordination degree between PMS and HED displays notable spatial discrepancies, where downstream areas of the Yangtze River Economic Belt such as Shanghai, Jiangsu, and Zhejiang exhibit a higher coupling coordination degree compared to other provinces and municipalities. However, most provinces and municipalities outside this group remain at a moderately coordinated stage concerning the degree of coupling coordination between PMS and HED. (3) Economic development level and local government competition had a significant negative impact on coupling coordination between PMS and HED, whereas there was a significantly positive impact on the degree of fiscal autonomy and urbanization. This study contributes to comprehensively understanding the coupling and coordination relationship between the PMS and HED across provinces and municipalities in the Yangtze River Economic Belt. It provides empirical evidence for the collaborative evolution of PMS and HED.

Determination of the parameters of the general contractor selection model for the successful implementation of the construction project

The authors examined the organization of interaction between the technical customer and the general contracting organization and revealed that it is at the stage of construction of facilities that difficulties arise in the interaction of construction participants, which were not initially taken into account when signing the construction contract. The implementation of the construction project depends on the effective organization of construction. The construction is characterized by dynamism and a high level of coordination of construction participants, which indicates the appearance of additional costs for both the technical customer and the contractor. To reduce the level of possible risks, the authors proposed at the initial stage of construction to exclude or reduce the impact of risk factors associated with the choice of an inefficient sub-row organization. 6 most important and relevant risk factors in the field of interaction between the technical customer and the contractor have been identified and analyzed. Expert surveys were conducted to determine the weight coefficients of damage and the probability of occurrence of risk factors. The reliability of the results was confirmed by calculating the multiple correlation coefficient.