China Institute Research Articles

Promoting education about and for sustainable development: assessing the incorporation of SDGs in Chinese higher education

PurposeThis study aims to examine and assess how sustainable development goal (SDG) Target 4.7 is incorporated in one leading higher education institution (HEI) in China (with a focus on teacher-education programmes) from students’ perspectives.Design/methodology/approachThis study uses document analysis and a semi-structured interview to analyse official and accessible documents of the programmes related to SDG Target 4.7 and recorded interviews with seven students across various Postgraduate Diploma in Education programmes in the field of education at the examined university.FindingsSDG Target 4.7 is absent in the related documents. Challenges and barriers for students include limited opportunity to be informed about SDG Target 4.7, limited topics covered, ineffective pedagogies and students’ diverse needs being neglected and teachers not giving immediate feedback. Given the opportunities in teaching and learning SDG Target 4.7, such as students are keen to learn and implement SDG Target 4.7, future directions could be reducing teachers’ lecturing and increasing student engagement in multiple ways, providing concrete examples that are relevant to students’ lives and giving immediate feedback and designing more related courses to specifically and systematically teach SDG Target 4.7.Originality/valueThis study contributes to the field by identifying and deeply analysing an interesting and representative non-western case that remains underexplored in literature. In this sense, it helps international readers to generate a more comprehensive understanding of Chinese approaches to SDGs in its higher education system, develop a more holistic global discourse on incorporating SDGs into HEIs and compare the similarities and differences between different countries’ approaches.

Introduction of the prompt γ-ray neutron activation analysis system at CARR and the first pilot experiment on boron-containing high-temperature alloys

A prompt γ-ray neutron activation analysis system has recently been developed at China advanced research reactor (CARR), the 60 MW research reactor in China Institute of Atomic Energy (CIAE). The system is set at the cold neutron beam guide with a thermal equivalent neutron flux at the sample position of 1.0 × 109 n·cm−2·s−1 with the power of 30 MW, and it is mainly composed of a neutron beam collimator, a sample chamber, a beam stopper, neutron and γ-ray shieldings and a detection system. The detection system can realize three modes of measurement: single, Compton suppression, and pair modes. The detection efficiency was calibrated up to 11 MeV using a set of radionuclides and the (n, γ) reactions of N and Cl. Boron, one of the most important elements in high-temperature alloy material studies, was analyzed in this work, as the first pilot experiment of the CARR-PGNAA system. The analytical sensitivity of 2000 cps/mg-B was obtained. The results verified the feasibility of the CARR-PGNAA system to measure boron in high-temperature alloys, and laid a foundation for the accurate quantification of boron in the next step.

Conditional generative adversarial network-assisted system for radiation-free evaluation of scoliosis using a single smartphone photograph: a model development and validation study

Adolescent idiopathic scoliosis (AIS) is the most common spinal disorder in children, characterized by insidious onset and rapid progression, which can lead to severe consequences if not detected in a timely manner. Currently, the diagnosis of AIS primarily relies on X-ray imaging. However, due to limitations in healthcare access and concerns over radiation exposure, this diagnostic method cannot be widely adopted. Therefore, we have developed and validated a screening system using deep learning technology, capable of generating virtual X-ray images (VXI) from two-dimensional Red Green Blue (2D-RGB) images captured by a smartphone or camera to assist spine surgeons in the rapid, accurate, and non-invasive assessment of AIS. We included 2397 patients with AIS and 48 potential patients with AIS who visited four medical institutions in mainland China from June 11th 2014 to November 28th 2023. Participants data included standing full-spine X-ray images captured by radiology technicians and 2D-RGB images taken by spine surgeons using a camera. We developed a deep learning model based on conditional generative adversarial networks (cGAN) called Swin-pix2pix to generate VXI on retrospective training (n=1842) and validation (n=100) dataset, then validated the performance of VXI in quantifying the curve type and severity of AIS on retrospective internal (n=100), external (n=135), and prospective test datasets (n=268). The prospective test dataset included 268 participants treated in Nanjing, China, from April 19th, 2023, to November 28th, 2023, comprising 220 patients with AIS and 48 potential patients with AIS. Their data underwent strict quality control to ensure optimal data quality and consistency. Our Swin-pix2pix model generated realistic VXI, with the mean absolute error (MAE) for predicting the main and secondary Cobb angles of AIS significantly lower than other baseline cGAN models, at 3.2° and 3.1° on prospective test dataset. The diagnostic accuracy for scoliosis severity grading exceeded that of two spine surgery experts, with accuracy of 0.93 (95% CI [0.91, 0.95]) in main curve and 0.89 (95% CI [0.87, 0.91]) in secondary curve. For main curve position and curve classification, the predictive accuracy of the Swin-pix2pix model also surpassed that of the baseline cGAN models, with accuracy of 0.93 (95% CI [0.90, 0.95]) for thoracic curve and 0.97 (95% CI [0.96, 0.98]), achieving satisfactory results on three external datasets as well. Our developed Swin-pix2pix model holds promise for using a single photo taken with a smartphone or camera to rapidly assess AIS curve type and severity without radiation, enabling large-scale screening. However, limited data quality and quantity, a homogeneous participant population, and rotational errors during imaging may affect the applicability and accuracy of the system, requiring further improvement in the future. National Key R&D Program of China, Natural Science Foundation of Jiangsu Province, China Postdoctoral Science Foundation, Nanjing Medical Science and Technology Development Foundation, Jiangsu Provincial Key Research and Development Program, and Jiangsu Provincial Medical Innovation Centre of Orthopedic Surgery.

Collectivism-based organizational culture, green empowerment, environmental self-identity and workplace green behavior: the stimulus-organism-response perspective

Drawing on the stimulus-organism-response theory, the present study aims to investigate the mediating role of environmental self-identity on the relationship of collectivism-organizational culture and green empowerment with employee’s workplace green behavior. By adopting procedural remedy and purposive sampling approach, data was collected from 207 administrative employees in higher education institutions of China. Response rate in this study is 41.40%. The authors employed partial least square -structural equation modelling to validate the proposed hypotheses. The current empirical findings confirmed the direct effect of collectivism-organizational culture and green empowerment on employee’s environmental self-identity. It is also proven that environmental self-identity significantly and positively influence employee’s workplace green behavior. This study concludes with significant positive indirect impact of collectivism-organizational culture and green empowerment on the employees WGB through environmental self-identity. This study enriches the literature on sustainable development by examining the integrated relationship of collectivism-organizational culture, green empowerment, self-identity and green behavior. The limitations and implications have been elaborated at the end of research.

Demand Forecasting of Nurse Talents in China Based on the Gray GM (1,1) Model: Model Development Study.

In a global context, the shortage of nursing personnel has emerged as a significant challenge, particularly in countries such as China experiencing population aging. The inadequacy of nursing human resources has become one of the primary threats affecting the quality of health services available to Chinese residents. Therefore, forecasting the demand for nursing personnel has become an important issue. This study presents a Gray GM (1,1) forecasting model for predicting the future 10-year demand for nursing workforce and the number of specialized geriatric nurses, aiming to provide a scientific basis for the development of policies in health care institutions in China. Based on data from the China Statistical Yearbook 2022, the Gray GM (1,1) model was used to predict the demand for nursing jobs and geriatric nurses over the next 10 years (2024-2033). The results indicate that from 2024 to 2033, amidst a continuous growth in the overall population and an increasingly pronounced trend of population aging, the demand for nursing workforce in China, especially for specialized geriatric nurses, is projected to steadily increase. The paper provides a reference basis for the establishment of China's health care workforce system and the involvement of government departments in health care workforce planning.

Understanding the Growth of Artificial Intelligence in Educational Research through Bibliometric Analysis

The purpose of this study was to investigate research trends in artificial intelligence studies related to education that were published in the Web of Science database. This review conducted a bibliometric analysis of 4673 articles published between 1975 and 2023 and explored trends in several areas, including the annual distribution of publications, frequently studied topics, top authors, top countries, top universities/departments, top journals and publishers, and top funders. The findings highlighted that the number of studies increased exponentially after 2010. The most often used terms in artificial intelligence research in education were machine learning, deep learning, and data mining. Studies in higher education have been more prevalent than studies in elementary and secondary education. The USA, mainland China, and Australia were the three most productive nations. Most productive authors were connected to academic institutions in Taiwan, Hong Kong, or mainland China. Furthermore, there was little cooperation among the most productive authors andcountries. In addition to the abundance of journals on educational technology, it is crucial to emphasize the dearth of publications on education across different disciplines. To understand how artificial intelligence can support new practices in educational research, interdisciplinary interest and support are needed.

Emotional journeys: the pathways of African students to a Chinese higher education institution and performances of ‘emotion work’

ABSTRACT This article examines the emotional aspects of international student mobility (ISM) from African countries to a higher education institution in China. While there is increasing scholarly attention to the role of emotional experiences in ISM, most of this work has focused on Western destinations with a long history of education mobilities. Information on newly emerged, non-Western ISM destinations is comparatively limited. Drawing on ethnographic research of 15 months at a Chinese university, this article shows how emotions shape and re-shape pre-arrival aspirations, daily interactions, and post-graduation plans among students from African countries. Specifically, the study shows that many students confront emotional dissonance and perform diverse forms of ‘emotion work’ in attempts to find a sense of familiarity and belonging while studying abroad. This is significant as it speaks to students’ agentive subjectivity in contending with emotional challenges and navigating complex ‘emoscapes’. The paper argues that a focus on emotions contributes to a more nuanced, multifaceted understanding of contemporary educational mobilities. It illuminates how students’ multiple emotions are continuously articulated and circulated with and within these ISM flows apparently driven by economic forces in the global higher education market.

A Data Analytics and Machine Learning Approach to Develop a Technology Roadmap for Next-Generation Logistics Utilizing Underground Systems

The increasing density of urban populations has spurred interest in utilizing underground space. Underground logistics systems (ULS) are gaining traction due to their effective utilization of this space to enhance urban spatial efficiency. However, research on technological advancements in related fields remains limited. To address this gap, we applied a data-driven approach using patent data related to the ULS to develop a technology roadmap for the field. We employed Latent Dirichlet Allocation (LDA), a machine learning-based topic modeling technique, to categorize and identify six specific technology areas within the ULS domain. Subsequently, we conducted portfolio analytics to pinpoint technology areas with high technological value and to identify the major patent applicants in these areas. Finally, we assessed the technology market potential by mapping the technology life cycle for the identified high-value areas. Among the six technology areas identified, Topic 1 (Underground Material Handling System) and Topic 4 (Underground Transportation System) showed significant patent activity from companies and research institutions in China, the United States, South Korea, and Germany compared to other countries. These areas have the top 10 patent applicants, accounting for 20.8% and 13.6% of all patent applications, respectively. Additionally, technology life cycle analytics revealed a growth trajectory for these identified areas, indicating their rapid expansion and high innovation potential. This study provides a data-driven methodology to develop a technology roadmap that offers valuable insights for researchers, engineers, and policymakers in the ULS industry and supports informed decision-making regarding the field’s future direction.

International Development Trends in the Field of Agricultural Resources and the Environment

The development trends and research layout of agricultural resources and the environment (ARE) are the focus of global attention. In this study, we compiled a data set of SCI papers published in the ARE field since the 13th Five-Year Plan. Thereafter, the topic extraction model of Latent Dirichlet Allocation (LDA) was used to mine the text content so as to explore the research layout of global ARE. The results show that, between 2016 and the time of this study, 31,559 articles were published in the ARE field, exhibiting an overall upward trend. During this time, China and the United States were the main forces in paper publishing. The Chinese Academy of Sciences (CAS), Northwest Agriculture and Forestry University, and the US Department of Agriculture were the top three publishing institutions. Research institutes in China, the United States, Russia, Sweden, the Netherlands, Brazil, and Australia cooperated closely, and the CAS was at the center of the cooperation network. The clustering results of text topics based on the LDA model show that three topics—namely, the interaction mechanisms of plants, the rhizosphere, and microorganisms; the mechanisms and predictive evaluation of soil landslides or erosion; and the decomposition and interaction response of organic matter in agroforestry ecosystems—have been the hot research areas in this field since 2016. The management and efficient utilization of farmland nutrients, and the technology and mechanisms of agricultural waste resource utilization have become key research directions since 2019. The research layouts of China and the United States in this field were analyzed, and the similarities and differences were compared. In addition, suggestions for the future development of ARE are proposed. This study is of great significance for the overall development trend of ARE, the timely tracking of scientific research hotspots, outlining key research and development directions, and promoting scientific and technological innovation.

The Chain-Mediating Effects of Mindfulness and Sense of Control on Corporate Employees' Mental Health Problems.

Based on the chain-mediating role of mindfulness and sense of control, this study examines the mediating role of mindfulness and sense of control on employees' mental health. A total of 720 questionnaires were collected from employees of select enterprises and institutions in China; 53 invalid questionnaires were excluded, with a response rate of 93%, leaving 667 employees as the study sample (average age = 38 years, 71.8% female). The study findings show that: (1) Work-family conflict had a significant positive correlation with mental health problems and a significant negative correlation with mindfulness and sense of control. (2) The influence on the mental health state was due to the mediating effect of mindfulness, sense of control, and the chain-mediating effect of mindfulness and sense of control. The study adopted self-report scales for measuring mindfulness and a sense of control; therefore, further experimental methods must be included in the future to explore these results. This study shows that mindfulness and sense of control can reduce the impact of work-family conflict on mental health problems. Additionally, the chain-mediating effect of mindfulness and sense of control plays an important role in mental health problems.

From a Word to a World: An Innovative Teaching at a Higher Educational Institution in China

China’s higher educational reform created innovative ways to cultivate talents urgently needed for social development during the late 1970s. This paper investigates an enlightening teaching reform of English major on the basis of Tianshui Normal College in Gansu Province. The historical course has three typical examples: enthusiastically fostering talents, seeking more profound cultural exchanges, and moving educational reform forward. Professor Hu Dingyi, as a leading implementer, explored and created a good learning atmosphere for collegiate students beyond the classroom teaching and achieved remarkable results. His innovative thoughts are of great value to promote classroom teaching for students’ gaining the most precious noble ideal, ethnic culture and more subject expertise.

A Career or a Transient Job? The Role and Development of Faculty Members in University-Based Principal Development Institutions in China

Purpose This study examines the role and development of faculty members in university-based principal development institutions in China to elucidate the Chinese experience of educational leadership development and the tensions and challenges faced by the faculty of such institutions. Design/Approach/Methods Interviews with 34 faculty members from five state-authorized university-based principal development institutions were conducted. Findings Faculty members in principal development institutions fulfill a variety of complex, time-consuming, and taxing administrative, professional, and service responsibilities. In China, principal development institutions are affiliated with universities, and their faculty members are subject to university regulations on career sustenance and advancement. However, standards for administrative and academic promotion have no bearing on the sustainable improvement of principal development programs. Originality/Value This study is the first to describe the roles and development of faculty members in university-based principal development institutions in China. Knowledge of the unique structure of such programs and the experiences of faculty members may provide insights into how university-based principal training institutions can better utilize faculty to enhance program quality.

Clinical analysis of adverse reactions in patients with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis treated with delamanid-containing regimen

Objective: To explore the characteristics of adverse drug reactions during the 24-week therapy with delamanid-containing regimen for patients with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis (MDR/RR-PTB). Methods: The prospective multicenter study was conducted from June 2020 to June 2023. A total of 608 eligible patients with MDR/RR-PTB were enrolled in 26 tuberculosis medical institutions in China including 364 males and 79 females, aged 39.6(19.0-68.0) years. Patients were treated with chemotherapy regimens containing delamanid. Patients were closely supervised during treatment of medication, and all adverse reactions occurring during treatment were monitored and recorded. The clinical characteristics of adverse reactions were evaluated by descriptive analysis. Chi-square test and multivariate logistic regression were used to analyze the related factors of QTcF interval prolongation (QT corrected with Fridericia's formula). Results: Of the 608 patients enrolled in this study, 325 patients (53.5%) reported 710 adverse events within 24 weeks of treatment. The top 6 most common complications were hematological abnormalities (143 patients, 23.5%), QT prolongation (114 patients, 18.8%), liver toxicity (85 patients, 14.0%), gastrointestinal reaction (41 patients, 6.7%), peripheral neuropathy (25 patients, 4.1%) and mental disorders (21 patients, 3.5%). The prolongation of QT interval mostly occurred in the 12th week after the first dose of medication. Serious adverse reactions occurred in 21 patients (3.5%). There were 7 patients (1.2%) with mental disorders, including 2 patients (0.3%) with severe mental disorders. Conclusions: The safety of dalamanid-based regimen in the staged treatment of MDR/RR-PTB patients was generally good, and the incidence of adverse reactions was similar to that reported in foreign studies. This study found that the incidence of QT interval prolongation in Chinese patients was higher than that reported overseas, suggesting that the monitoring of electrocardiogram should be strengthened when using drugs containing delamanid that may cause QT interval prolongation.

Analysis of Learning Situation and Training Suggestions for Non-traditional Students in Vocational Colleges

With the popularization of higher education in China, the proportion of non-traditional students in higher education will continue to increase. Vocational colleges will be the main institutions in China that accept non-traditional students to attend universities. This student group is still very different from the traditional student group. The analysis of the learning situation of non-traditional student groups is a prerequisite and foundation for vocational colleges to explore the high-quality cultivation of this group. Through investigation and analysis of non-traditional students in vocational colleges, summarizing their learning characteristics strengths, and weaknesses, this article provides corresponding suggestions for high-quality cultivation of this student group in vocational colleges.

Challenges of sustainable public procurement in Chinese higher education institutions: a Delphi study

PurposeThe importance of sustainable public procurement is growing in many countries and industries, including higher education institutions (HEIs) in China. However, in China, the practice of sustainable public procurement is currently limited due to various reasons. This study aims to identify the main challenges faced by Chinese HEIs when it comes to sustainable public procurement. The identification of the challenges encountered by HEIs in sustainable public procurement practices not only has practical significance in terms of improving efficiency, sustainability, competitiveness and guiding policymaking but also has theoretical significance in terms of enriching the knowledge body, facilitating the dissemination of sustainability and supporting international comparative research. To identify these challenges, the study gathered data from a small sample of procurement supervisors, experts and commissioners in HEIs using the Delphi method. The study concludes that Chinese HEIs can address the challenges of sustainable public procurement through measures such as fundraising, technology and equipment upgrading, supply chain optimization, regulatory compliance and raising awareness and providing training.Design/methodology/approachTo pinpoint the challenges of sustainable public procurement faced by HEIs in China, this study began by obtaining data from a small sample of procurement supervisors, experts and commissioners in HEIs who are knowledgeable about the issue through the Delphi method. Secondly, the collected challenge factors were also subjected to a literature review to identify the most common challenges in recent papers published around the world. Thus, it was possible to assess the relationship between the challenges mentioned by researchers in China and other countries.FindingsThe main challenges faced by HEIs in China in implementing sustainable public procurement are the focus on economic efficiency, the experience and awareness of procurement staff, policy ambiguity as well as culture, management mechanisms and leadership attitudes in the organizations. The study concludes that Chinese HEIs can effectively overcome the challenges of implementing sustainable public procurement through a variety of measures, including fundraising, technology and equipment upgrading, supply chain optimization, regulatory compliance and awareness raising and training.Research limitations/implicationsSome limitations should be considered in this study. Judging by the sample size, it is clear that the results of the study are limited. Although the number of experts involved in the study is required, caution should be exercised when generalizing the results, as this may not be representative of the entire population. In future studies, the use of a larger sample size could be considered to overcome this problem. Related to this limitation is the uneven geographical distribution of the sample, and this study only considered the situation of HEIs in Jiangsu Province, China, which is not representative of the national region.Practical implicationsThe practical significance can be seen in two aspects. First, accurately identifying challenges can help HEIs optimize the implementation of their sustainable purchasing policies, leading to more efficient resource allocation and reduced unnecessary resource consumption. Second, by addressing these challenges, HEIs can better fulfill their social role in sustainable development, contributing to the triple bottom line of the economy, environment and society. Implementing sustainable procurement strategies not only enhances the social image of HEIs but also attracts a broader student base and financial support, ultimately improving their competitive position in the education market. A deeper understanding of these challenges provides policymakers with a basis to develop a more operational and targeted policy framework to support sustainable procurement in HEIs.Social implicationsThis study succeeded in answering two research questions that provide practical implications for public procurement practitioners, researchers and policymakers. Although HEIs in China do not practice sustainable public procurement at a high rate, however, with the spread of sustainability and environmental awareness, more and more HEIs are beginning to realize the importance of sustainability and are gradually taking it into account in their procurement.Originality/valueThe findings of the study not only significantly enrich the existing body of knowledge on sustainable public procurement, but also support the selection of challenge variables that must be addressed first to facilitate the application of sustainable procurement in China’s HEIs.

Pathways to master’s education: insights from students in transnational higher education in China

AbstractPrevious studies have identified the tendency among transnational higher education (TNHE) graduates to pursue master’s programmes, especially overseas degrees. Nonetheless, there is a lack of exploratory research on this ‘transnational’ group to understand the logic of practice behind this phenomenon. This article draws on interviews with 23 students at a Sino-US university to understand their perceptions of master’s study and explore the effect of TNHE experience on their decision-making about further study. Using Bourdieu’s theory of practice, we find students perceive pursuing master’s study as a natural progression and a remedy for failures in their educational backgrounds. This paper also argues that the ‘fit’ or ‘split’ between TNHE students’ habitus and the embedded field generates two distinct groups regarding choices of post-graduate study, international aspirants and returnees. While the acquisition of new habitus and capital through TNHE experiences steers most students towards international master’s study, the durability of old habitus and personal reflexivity lead a few to pursue domestic education. Our findings provide implications for TNHE administrators in supporting students’ post-graduate educational aspirations and further development of TNHE institutions in China.

The value of intervention with radiotherapy after first-line chemo-immunotherapy in locally advanced or metastatic esophageal squamous cell carcinoma: A multi-center retrospective study

BackgroundChemotherapy plus immunotherapy has become the standard first-line treatment of advanced or metastatic esophageal squamous cell carcinoma (ESCC), but median duration of response is only 7.0–8.3 months and progression-free survival (PFS, ∼6 months) is still far from satisfactory. We aim to evaluate whether early involvement of radiotherapy might improve the treatment outcome if objective response to first-line chemo-immunotherapy was observed in locally advanced or metastatic ESCC. MethodsPatients were retrospectively collected from 3 institutions in China. Patients with histopathologically confirmed diagnoses of locally advanced or metastatic ESCC were identified, who objectively responded to first-line chemo-immunotherapy (complete or partial response, or stable disease) and also received radiotherapy of primary lesions with radiation dose of over 40 Gy, with or without radiotherapy of metastatic lesions before the first disease progression. ResultsA total of 72 eligible patients were identified. With median follow-up duration of 14.6 (range, 7.1–34.8) months, median progression-free survival (PFS) and overall survival (OS) were 13.5 (95 % CI,10.4-NA) months and 31.8 (95 % CI, 23.0-NA) months, respectively. Median duration from initiation of chemo-immunotherapy to radiotherapy was 2.9 (range, 0–15.1) months. Besides lower tumor burden as a significant factor of better treatment outcome, radiation dose ≥ 50 Gy was associated with superior PFS, while OS might be mainly related to tumor response to the induction chemo-immunotherapy. A low incidence of Grade 3 or above treatment-related adverse events were observed (19 %), and no treatment-related death occurred. ConclusionOur multi-center retrospective study showed survival benefit brought by early involvement of radiotherapy after first-line chemo-immunotherapy for patients with locally advanced or metastatic ESCC. However, further investigation is warranted in future prospective, controlled trials to assess the value of radio-immunotherapy in advanced or metastatic ESCC.

Education for sustainability as a way-out to nurture citizens: a reframing in policy practices of Chinese higher education

PurposeThis study examines education for sustainability (EfS) within the Chinese context, to specifically enrich the understanding on how EfS is structured and implemented to nurture citizenship in the policy practices of universities in Mainland China and Hong Kong.Design/methodology/approachA cross-case analysis is recruited to examine the commonalities and differences between two universities and identify patterns in cultivating sustainability citizenship within higher education institutions (HEIs) in China. Data were collected through reviewing documents, including two universities’ strategic plans, action plans, department meeting memos, program introductions, course outlines and publicity coverage. Observation was also adopted to enrich the data for analysis, covering meetings, speeches by senior management, university events and informal conversations about university operations.FindingsCitizenship and sustainability in university strategic planning, curriculum and instruction, carriers of EfS institutionalization, and resources and impacts of EfS beyond the institutes were analyzed in a comparative manner, offering valuable insights into how EfS can be institutionalized in different universities based on their unique appeals, existing curriculum and management systems.Originality/valueBy exploring these intra-national distinctions in EfS, the study sheds light on the variation within China's citizenship education, which is traditionally seen as highly unified with limited room for differences. The detailed exploration of university strategies and program/course content enriches the literature of sustainability as an educational phenomenon on an international scale and modernized citizenship education in China.

Evaluation of appropriateness of antibiotic prescribing in primary healthcare institutions in China using proxy indicator

Our objectives were to develop a set of proxy indicators (PIs) suited for assessing antibiotic use appropriateness in China's primary healthcare institutions (PHIs), and assess performance scores of these PIs while exploring factors that influence the antibiotic appropriateness. We selected potential PIs for the PHIs through a RAND-modified Delphi procedure, and assessed clinimetric properties, focusing on measurability, applicability, and potential for improvement. PIs with favorable clinimetric properties were used to evaluate antibiotic prescription appropriateness by calculating performance scores of each PI. Institutions were categorized into three clusters representing different levels of appropriateness. We used the chi-square test and an ordinal logistic regression model at PHI level to explore factors influencing antibiotic appropriateness. Eighteen PIs were developed through two rounds of online surveys and one face-to-face meeting involving 20 stakeholders. All PIs met the clinimetric properties criteria and were used to analyze 209,662 antibiotic prescriptions across 269 PHIs. The percentage of PHIs meeting the target ranged from 3.1% to 69.3%, with 6 PIs below 10%. The appropriateness of antibiotic prescriptions was significantly associated with percentages of patients' gender of the PHIs. The varied and suboptimal performance of the PIs indicated the need for diverse efforts to enhance the rational antibiotic use at PHI level. It was necessary to devise distinct sets of PIs for diverse settings in future endeavors. This work was supported by the National Natural Science Foundation of China (grant numbers 72374009, 81973294).

Two Decades of Audiovisual Translation Studies: A Bibliometric Literature Review

Audiovisual Translation (AVT) studies have been among the burgeoning disciplines in translation studies. Although much progress has been made in AVT, there has been little scholarship heretofore to sketch a comprehensive understanding of the domain mapping using bibliometric analysis. Based on a total of 1,424 journal articles collected from the Web of Science Core Collection (SSCI, A&HCI, and ESCI) and Scopus from 2002 to 2022, the publication trends, research progress, research hotspots, and research frontiers were analyzed and visualized using CiteSpace and VOSviewer. The results of this study show that research on AVT has experienced exponential growth in the last two decades and is likely to follow an upward trend in the future. Topics including subtitling, dubbing, audio description, reception, and media accessibility have been frequently explored; and active researchers from Europe and Iran, as well as productive institutes in Europe, the USA, and China, with publications in influential journals, have contributed greatly to AVT studies. The historical development of AVT studies also implies an interdisciplinary trend. These findings provide insights into AVT studies, with a comprehensive overview, which is of great reference significance for researchers in understanding the past achievements of the discipline and carrying out their future research.