Uneven Geographical Distribution Research Articles

Examination of the Peaceful Uses of Nuclear Energy in Turkish Legislation

Population growth, industrialization and technological advances increase the demand for energy. Due to problems such as global warming, environmental pollution and destruction, the trend towards alternative energy sources continues on a global scale. For this reason, the use of nuclear energy, one of the secondary energy sources, has tended to increase in recent years. Reasons such as the geographically uneven geographical distribution of resources that are raw materials for energy among countries and their exhaustibility, fluctuations in energy prices and the economical production of nuclear energy are among the reasons why countries in the world turn to nuclear energy. A number of accidents at nuclear power plants have had a negative impact on the perception of nuclear power plants, but for different reasons, nuclear energy is gaining popularity again. Nuclear power plants are the first thing that comes to mind when it comes to nuclear power, but it is also used effectively in medical treatments and applications of various branches of science as well as energy production. In global energy production; the fact that it aims to reduce carbon emissions by providing more energy production within the scope of sustainability, the continuous and uninterrupted continuation of electricity production using nuclear, the production of electricity at more affordable costs in nuclear power plants compared to other power plants (thermal, renewable, etc.), the fact that greenhouse gas emissions are almost negligible, and the use of nuclear technology in many fields such as physics, medicine, transportation, agriculture as well as energy production have made nuclear energy back on the agenda of countries in recent years. In nuclear energy, nuclear waste and their storage processes continue to be discussed as a problem in this process. For these reasons, the possibility of peaceful use of nuclear power has been questioned in academic platforms and various criteria have been determined This article examines Turkey's compliance with the criteria for the peaceful use of nuclear energy and clarifies the development process in this regard. Turkey's legislation on nuclear energy, international conventions, nuclear safety, radiation control criteria and compliance with national legislation will be examined.

Development Strategies for Urban Parks in Chongqing’s Main District: A New Paradigm for Urban Green Spaces

With the advent of the new concept of an “urban park” and the new paradigm of urban development, Chongqing Municipality has actively embraced this vision, integrating it with the city’s unique geographical and demographic conditions. The city has prioritized urban park construction as a key project for public welfare, aiming to address issues such as uneven geographical distribution, limited functionality, and mismatched supply and demand. This initiative seeks to optimize urban parks as vital public resources while protecting the ecological environment. Adhering to principles of functional priority, safety and comfort, shared development, and distinctive features, Chongqing has incorporated parks and other green open spaces into its basic urban planning. This approach aims to create beautiful, comfortable and age-friendly shared urban spaces. This study, grounded in the urban park development concept and the characteristics of a mountainous, multi-center city, constructs a model to measure urban park satisfaction in Chongqing’s main urban area. The model considers supply-demand matching and resident satisfaction. It aims to systematically review relevant policies, plans, and cutting-edge theories, analyze the urban park development in Chongqing, understand residents’ needs, and address issues related to supply-demand matching, multifunctionality, and quality construction. The findings provide insights into the development and conservation of urban parks in Chongqing and beyond, aiming to continually meet the public’s growing desire for a better quality of life and support high-quality development.

The Oral Medicine workforce and impact on access to care in the United States

The objective of this study was to characterize the current oral medicine (OM) workforce by examining the distribution of OM diplomates (OMDs) across the Unites States and to determine the need for expanding access to care. The OMD access was calculated based on the OMDs per 10,000 state population from the 2020 US Census data as well as their distance from state capitals and most populated cities. OMD penetrance in hospitals and cancer centers was assessed at National Cancer Care Network (NCCN) cancer centers, and Best Hospitals as reported in the 2022 US News and World Report (USNWR). OMDs are present in 64% of the states with an uneven geographic distribution. Primary workplaces included dental schools (47%), hospitals (30%), and private practices (19%). Of the OMDs in private practice, 57% limited their practice to OM. OMDs were noted at 28% of NCCN cancer centers, 30% of USNWR Best Hospitals for Cancer, and 20% of USNWR Best Hospitals. There is low density and uneven distribution of OMDs with approximately one-third of the population without access to an OMD in their state, thus limiting access to care. This suggests both vast opportunities for growth and expansion of OM, as well as challenges in developing and training the necessary workforce. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

Prospective life cycle assessment of an electric vehicle equipped with a model magnesium battery

BackgroundConcerns about the sustainability of commercially available batteries have driven the development of post-lithium systems. While previous studies on Magnesium batteries have explored both the potential environmental footprint of battery production and their possible use in stationary applications, their environmental impact in electromobility remains unexplored. This study provides an initial prospective evaluation of the environmental performance of a theoretical Mg–S battery for potential use in electric vehicles (EVs). Utilizing life cycle assessment (LCA) methodology, various scenarios are analyzed and compared to conventional systems. The analysis focuses on potential environmental impacts, including climate change, resource criticality, acidification of the biosphere, and particulate matter emissions.ResultsIn the battery pack level, the Magnesium anode and its respective supply chain have been identified as main drivers of environmental burdens. Additional concerns arise from the uneven geographical distribution of Mg production, which leads to dependency on few producers. In terms of resource criticality, the Mg–S battery could carry significant advantages over benchmark systems. A look into the use-phase via theoretical implementation in an electric vehicle (EV) also suggests that the Magnesium based EV could perform on a comparable level to an LIB EV, also outperforming conventional ICEVs in several impact categories.ConclusionsThis study is based on optimistic assumptions, acknowledging several remaining technical challenges for the Mg battery. Consequently, the results are indicative and carry a significant degree of uncertainty. Nonetheless, they suggest that the Mg–S system shows promising environmental sustainability performance, comparable to other reference systems.

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.

Electronic cigarettes and subsequent use of cigarettes in young people: An evidence and gap map

AbstractBackground and aimsThe use of e‐cigarettes may influence later smoking uptake in young people. Evidence and gap maps (EGMs) are interactive on‐line tools that display the evidence and gaps in a specific area of policy or research. The aim of this study was to map clusters and gaps in evidence exploring the relationship between e‐cigarette use or availability and subsequent combustible tobacco use in people aged < 30 years.MethodsWe conducted an EGM of primary studies and systematic reviews. A framework and an interactive EGM was developed in consultation with an expert advisory group. A systematic search of five databases retrieved 9057 records, from which 134 studies were included. Systematic reviews were appraised using AMSTAR‐2, and all included studies were coded into the EGM framework resulting in the interactive web‐based EGM. A descriptive analysis of key characteristics of the identified evidence clusters and gaps resulted in this report.ResultsStudies were completed between 2015 and 2023, with the first systematic reviews being published in 2017. Most studies were conducted in western high‐income countries, predominantly the United States. Cohort studies were the most frequently used study design. The evidence is clustered on e‐cigarette use as an exposure, with an absolute gap identified for evidence looking into the availability of e‐cigarettes and subsequent cessation of cigarette smoking. We also found little evidence analysing equity factors, and little exploring characteristics of e‐cigarette devices.ConclusionsThis evidence and gap map (EGM) offers a tool to explore the available evidence regarding the e‐cigarette use/availability and later cigarette smoking in people under the age of 30 years at the time of the search. The majority of the 134 reports is from high‐income countries, with an uneven geographic distribution. Most of the systematic reviews are of lower quality, suggesting the need for higher‐quality reviews. The evidence is clustered around e‐cigarette use as an exposure and subsequent frequency/intensity of current combustible tobacco use. Gaps in evidence focusing on e‐cigarette availability, as well as on the influence of equity factors may warrant further research. This EGM can support funders and researchers in identifying future research priorities, while guiding practitioners and policymakers to the current evidence base.

Cardiac rehabilitation centers in Romania: Where are we now?

Purpose: In 2024, Romania is still facing a critical challenge with high cardiovascular disease mortality rates despite extensive research and policy initiatives. Our study sought to examine the actual state of cardiac rehabilitation in Romania by identifying the healthcare facilities that provide and deliver cardiac rehabilitation services. Methods: The research began with a comprehensive investigation into cardiac rehabilitation centers across Romania. This involved leveraging search engines to identify these facilities. Keywords like “cardiac rehabilitation”, “cardiovascular rehabilitation”, and “cardiac rehabilitation centers” were instrumental in pinpointing relevant information, which included names, geographical locations, and contact details of the centers. Upon identification of potential centers, our research team initiated direct engagement with these facilities via telephonic interviews. Results: The data collected in 2024 was compared to previous findings from a 2017 research report to evaluate the progress and impact of prevention efforts over time. While the number of cardiac rehabilitation centers has grown (69.2% increase in the nationwide count of cardiac rehabilitation centers/facilities), an uneven geographic distribution persists, exacerbated by disruptions during the COVID-19 pandemic. Among the cardiac rehabilitation centers identified, 23% are located in balneoclimatic resorts, but the majority of cardiac rehabilitation centers are located in Bucharest. Overall, 65.3% of all identified centers in Romania belong to the private healthcare sector. Among these private centers, 41.1% offer cardiac rehabilitation programs as continuous inpatient care, with durations ranging from 5 to 16 days. All cardiac rehabilitation centers are equipped with the necessary equipment to perform basic cardiological investigations as well as physio-kinesiological rehabilitative procedures, in addition to aerobic physical training (53.8%). In 33.3% of the identified centers, diabetologists and psychologists/psychotherapists are integral members of the multidisciplinary cardiac rehabilitation team, while only 19.2% of the centers include a dietitian/nutritionist. Regarding costs, there is significant variation depending on the geographical area. In Bucharest, a single rehabilitation session costs between 100 to 400 lei (20 to 80 €), and a rehabilitation program spanning 4-6 weeks can cost up to 3350 lei. Comparing costs identified in 2017, we have observed an increase ranging from 47% to 188% in 2024. Conclusions: Despite an increase in the number of cardiac rehabilitation centers, their prevalence remains inadequate to fulfill the demands of the population. Telerehabilitation emerges as a promising solution, with limited adoption in only one center. Cost variations across regions pose a barrier to patient participation. Our article proposes strategies including decision algorithms for personalized recommendations, expanding cardiac rehabilitation centers, and advocating for comprehensive cost reimbursement. The urgent need for collaborative efforts is emphasized, envisioning innovative solutions like mobile applications to foster a sense of community and optimize cardiac rehabilitation, ultimately improving cardiovascular health outcomes in Romania. Keywords: cardiac rehabilitation, telerehabilitation, cardiac rehabilitation centers, healthcare disparities, cardiovascular health

Epidemiology of systemic sclerosis in Quebec, Canada: a population-based study

Systemic sclerosis (SSc) is a systemic life-threatening autoimmune rheumatic disease. We aimed to assess the incidence, prevalence, mortality and spatiotemporal trends of SSc in Quebec, Canada with stratification by sex and age. SSc cases were identified from Quebec populational databases from 1989 to 2019. Negative Binomial (NB) Generalized Linear Models were used for age-standardized incidence rates (ASIR) analyses and NB random walk for prevalence and mortality. A Poisson Besag-York-Mollié regression model was used for spatial analysis. 8180 incident SSc cases were identified between 1996 and 2019 with an average age of 57.3±16.3 years. The overall ASIR was 4.14/100,000 person-years (95%, Confidence Interval (CI) 4.05-4.24) with a 4:1 female predominance. ASIR increased steadily over time with an Average Annual Percent Change (AAPC) of 3.94% (95% CI 3.49-4.38). While the highest incidence rates were in those aged 60-79 years old among females and >80 years old among males, the highest AAPC (∼10%) was seen in children. Standarized incidence ratios varied geographically between 0.52 to 1.64. The average prevalence was 28.96/100,000 persons (95% CI 28.72-29.20). The Standardized Mortality Ratio (SMR) decreased from 4.18 (95% CI 3.64-4.76) in 1996 to 2.69 (95% CI 2.42-2.98) in 2019. Females had a greater SMR until 2007 and males thereafter. The highest SMR was in children and young adults [31.2 (95% CI 8.39-79.82) in the 0-19-year age group]. We showed an increasing trend in SSc incidence and prevalence and a decline in SMR over a 25-year period in Quebec. An uneven geographic distribution of SSc incidence was demonstrated. National Scleroderma Foundation, Canadian Dermatology Foundation/Canadian Institutes of Health Research.

A global multimodal flood event dataset with heterogeneous text and multi-source remote sensing images

ABSTRACT With the increasing frequency of floods, in-depth flood event analyses are essential for effective disaster relief and prevention. Satellite-based flood event datasets have become the primary data source for flood event analyses instead of limited disaster maps due to their enhanced availability. Nevertheless, despite the vast amount of available remote sensing images, existing flood event datasets continue to pose significant challenges in flood event analyses due to the uneven geographical distribution of data, the scarcity of time series data, and the limited availability of flood-related semantic information. There has been a surge in acceptance of deep learning models for flood event analyses, but some existing flood datasets do not align well with model training, and distinguishing flooded areas has proven difficult with limited data modalities and semantic information. Moreover, efficient retrieval and pre-screening of flood-related imagery from vast satellite data impose notable obstacles, particularly within large-scale analyses. To address these issues, we propose a Multimodal Flood Event Dataset (MFED) for deep-learning-based flood event analyses and data retrieval. It consists of 18 years of multi-source remote sensing imagery and heterogeneous textual information covering flood-prone areas worldwide. Incorporating optical and radar imagery can exploit the correlation and complementarity between distinct image modalities to capture the pixel features in flood imagery. It is worth noting that text modality data, including auxiliary hydrological information extracted from the Global Flood Database and text information refined from online news records, can also offer a semantic supplement to the images for flood event retrieval and analysis. To verify the applicability of the MFED in deep learning models, we carried out experiments with different models using a single modality and different combinations of modalities, which fully verified the effectiveness of the dataset. Furthermore, we also verify the efficiency of the MFED in comparative experiments with existing multimodal datasets and diverse neural network structures.

Research Trends and Prospects of Green Economy in Economic Literature: A Bibliometric Analysis

Over the past few decades, the global discourse on environmental sustainability and climate change has catalyzed a profound transformation in economic paradigms, giving rise to the concept of the green economy. This paradigm emphasizes the integration of economic activities with environmental preservation and social equity to achieve sustainable development goals. As scholarly interest and research output in the green economy burgeon, navigating through the vast body of literature becomes increasingly challenging. In response, this study conducts a bibliometric analysis of economic literature related to the green economy, aiming to map out research trends, identify influential authors, seminal works, and thematic clusters. Employing bibliometric techniques such as co-citation analysis, keyword analysis, and citation mapping, this research provides insights into the intellectual landscape of the green economy field. The analysis reveals key research gaps, such as uneven geographical distribution and the need for interdisciplinary studies, while also highlighting emerging areas of inquiry. By delineating future research trajectories, this study aims to inform policymakers, stakeholders, and researchers striving towards sustainable economic development goals.

Sameness across Difference: A Postcolonial Feminist Analysis of Gender-Affirming Health Care in Thailand and the United States.

Joining a growing body of research calling for the integration of social analysis and postcolonial theory, recent work in medical sociology has analyzed health, illness, and medicine from a postcolonial lens. In this article, I argue for a postcolonial feminist approach to medical sociology that builds on this extant work while challenging methodological nationalism and cultural essentialism. Based on an analysis of gender-affirming health care for transgender and gender diverse (TGD) people in Thailand and the United States, I propose "sameness across difference" as a framework to analyze commonalities in the health care experiences of marginalized populations across nations as the products of imperial legacies. Drawing on 83 interviews with health care providers, TGD patients, and TGD activists, I demonstrate the role of imperialism in sustaining barriers to gender-affirming health care through the uneven geographic distribution of care across rural and urban areas and the reinforcement of racial and class hierarchies within cities.

Comprehensive portrait of stroke fellowship training in Brazil: A national survey study

Background and objectivesThe field of vascular neurology has undergone significant advances over the last decade, and care has become more complex. However, vascular neurology training programs remain underdeveloped in many countries, despite stroke impact on health care. There are efforts towards building a nationally regulated curricula in some countries. Still, comprehensive planning and implementation of these programs may be needed on a global scale, especially in countries where stroke treatment is not fully implemented. We aim to comprehensively analyze vascular neurology trainees’ profiles in Brazil to describe training program contents from trainees and program directors’ perspectives. MethodsWe performed an observational, cross-sectional, web-based survey study to describe trainee and program-specific characteristics at vascular neurology fellowship training programs in Brazil. The study was conducted from June to September 2023 using a secure web-based survey sent to active fellows and program directors from all known vascular neurology fellowship programs in the country. All respondents were required to provide informed consent. ResultsWe obtained a 100 % response rate of a total of 12 programs distributed in 7 federal states. Notably, 57 % of the 28 surveyed fellows were women, 60 % were aged 25-30, and 70 % self-identified as White. All fellows had prior neurology training, and 60 % engaged in the program just following residency. Exposure to various training experiences was favorable, except for simulation-based learning and telestroke training. Program directors perceived exposure to be sufficient for most components but similarly found deficiencies in telestroke and simulation-based learning. Scientific productivity was low, with about two-thirds of fellows having no publications or abstracts. Most fellows (92.6 %) reported performing non-fellowship medical activities to supplement their incomes. DiscussionIn conclusion, the number of vascular neurology training programs and trainees in Brazil is currently insufficient and exhibits an uneven geographic distribution. Despite this, the clinical training provided is extensive, and there is generally some funding available for fellows. These insights highlight the need for strategic improvements in Brazil's stroke education and could inform similar developments in other nations.

Перспективи використання телемедицини в стоматології

Telemedicine is one of the innovative directions that has been actively developing for many years and is able, at least partially, to meet the needs of the medical and educational spheres. This is a relatively new direction in the health care system, based on the possibilities of rapid exchange of medical information between medical workers and patients, specialists of different medical institutions who may be at different distances to provide qualified medical care, as well as application in the field of medical education. The aim is to analyse the possible prospects for using telemedicine resources in various areas of dentistry. The introduction of telemedicine in the field of practical health care, including in such a specific field as dentistry, was facilitated by the lack of specialized medical care and specialists, the uneven geographical distribution of primary and specialized care, high national costs for health care, as well as the COVID-19 pandemic, emergencies and military operations. Telemedicine is designed to improve the quality of medical care by minimizing the time between the diagnosis of a disease, the selection of a personalized scheme and the start of its effective treatment, and also provides and expands access to specialized and high-quality medical services in regions where they are not available. Telemedicine is developing at the intersection of several fields - medicine, telecommunications, and information technologies. Today, telemedicine includes various forms, projects and procedures, among which the main ones are: telemedical consultation (remote discussion of a clinical case) - deferred and in-person remote consultation; biotelemetry (telemonitoring); home (individual) telemedicine; telescreening; telepresence; teleassistance; Distance Learning. No conflict of interests was declared by the authors.

Global climate change mitigation technology diffusion: A network perspective

There is a rapidly growing number of studies on transnational climate change mitigation technology (CCMT) diffusion. Most of these studies have adopted a bilateral perspective, treating countries as primary agents driving the diffusion process. However, CCMT diffusion typically arises from the interactions between firms and involves strong network effects. In this paper, we explore the global CCMT diffusion from a network perspective, with multinational corporations (MNCs) as network makers. We first propose a methodology to construct the global CCMT diffusion networks, leveraging CCMT-related patent data, intra-firm relationships, and business scales of the selected MNCs. We then calculate the network capital for each country, utilizing it as the input for the econometric analysis to investigate the network effects on CCMT development. The network statistical analysis reveals an uneven geographical distribution of network capital, underscoring the presence of global disparities in CCMT development. Moreover, the econometric analysis identifies significant network effects originating from linkage volumes and structural positionalities within the CCMT diffusion networks.

The use of environmental data in descriptive and predictive models of vector-borne disease in North America.

Vector-borne disease incidence and burden are on the rise. Weather events and climate patterns are known to influence vector populations and disease distribution and incidence. Changes in weather trends and climatic factors can shift seasonal vector activity and host behavior, thus altering pathogen distribution and introducing diseases to new geographic regions. With the upward trend in global temperature, changes in the incidence and distribution of disease vectors possibly linked to climate change have been documented. Forecasting and modeling efforts are valuable for incorporating climate into predicting changes in vector and vector-borne disease distribution. These predictions serve to optimize disease outbreak preparedness and response. The purpose of this scoping review was to describe the use of climate data in vector-borne disease prediction in North America between 2000 and 2022. The most investigated diseases were West Nile virus infection, Lyme disease, and dengue. The uneven geographical distribution of publications could suggest regional differences in the availability of surveillance data required for vector-borne disease predictions and forecasts across the United States, Canada, and Mexico. Studies incorporated environmental data from ground-based sources, satellite data, previously existing data, and field-collected data. While environmental data such as meteorological and topographic factors were well-represented, further research is warranted to ascertain if relationships with less common variables, such as oceanographic characteristics and drought, hold among various vector populations and throughout wider geographical areas. This review provides a catalogue of recently used climatic data that can inform future assessments of the value of such data in vector-borne disease models.

Recent landscape and trends for industry-sponsored pediatric clinical trials in China from 2013 to 2022.

Pediatric medication is a challenging issue globally. Promoting trials of medications for children and implementing measures to encourage innovation for addressing unmet medical and health needs are important. To explore the recent landscape of pediatric clinical trials of new investigational drugs conducted by pharmaceutical enterprises in China from 2013 to 2022 to provide insight into pediatric drug development in the pharmaceutical industry and regulatory policy formulation. We performed a cross-sectional observational investigation of pediatric clinical trials registered from January 1, 2013, to December 31, 2022, on the Registration and Information Disclosure Platform for Drug Clinical Trials, the official registration platform established in 2013 for trials of new investigational drugs initiated by biopharmaceutical enterprises. Trials that included pediatric participants (under 18 years old) were retrieved, and their relevant characteristics were extracted and analyzed. In total, 895 pediatric clinical trials were collected, accounting for 5.1% of the total registered clinical trials initiated prior to January 1, 2023. The overall average annual growth rate for the number of pediatric clinical trials was 12% (P < 0.001). Phase III trials accounted for the highest proportion (49.1%, 439). Of the 895 trials included, 736 (82.2%) were domestic trials, and 159 (17.8%) were international multicenter trials. In terms of tested drugs, investigations of biological products accounted for the largest proportion of trials (67.4%, 603). Among pediatric clinical trials, studies of vaccines accounted for the largest proportion of trials (41.0%, 367), followed by trials for rare diseases (17.2%, 154). Furthermore, geographical distribution analysis revealed that the largest and smallest numbers of trials were conducted in North China (35.7%, 320) and Northeast China (0.8%, 7), respectively. The growth trends for industry-sponsored clinical trials involving children illustrate the progress and increasing capability of pediatric drug development achieved in China since 2013. Current challenges and potential areas of focus for policymakers and stakeholders include investigating orphan drugs for rare diseases according to the unique epidemiological characteristics of Chinese children, expanding the scope of pediatric clinical trials, and improving the uneven geographical distribution of leading research centers.

Uneven geographical distribution of R&amp;D-related foreign direct investment in Latin America: Uncovering the paradox of national development

Uneven geographical distribution of R&amp;D-related foreign direct investment in Latin America: Uncovering the paradox of national development

Current State and Features of Tourism Development in Czechia

Tourism is a significant contributor to the social and economic growth of countries and regions. As such, developing tourism is a crucial element in enhancing a country's economic efficiency. In Europe, the Czech Republic stands as one of the most alluring and well-established countries. Thanks to its abundant natural, recreational, historical, and cultural resources, it has fostered a fiercely competitive tourism industry. The commonness of historical, natural, social, and economic developmental conditions between Czechia and Ukraine establishes similar prerequisites for tourism development. An analysis of Czech tourism development, including identification of the country's tourism traits and trends, enables the adoption of Czech tourism organization experience and practical application in Ukraine. The present article examines the current state of tourism development in Czechia. The analyses the development of the tourist infrastructure in the country. It examines the dynamics of the collective means of tourist accommodation in the Czech Republic. The analysis focuses on the dynamics of tourist arrivals to the Czech Republic, characterizing the structure of tourist flows. The geospatial features of tourist flows are considered, and the dynamics of the volume of income from foreign tourism are analysed. Tourism plays a significant role in the economics of the Czech Republic. The contribution of tourism to the country's GDP remains below its pre-COVID-19 levels. However, in 2022, the tourism industry of the country started to recuperate from the pandemic. As compared to 2021, the number of tourists escalated by 8 million in 2022. Majority of the tourists arrived in the Czech Republic for recreational and cultural purposes, as well as to meet their relatives and for business agendas. The Czech Republic received the majority of its foreign tourists from Germany, Slovakia, and Poland. The domestic tourist share in the country's overall tourist flow is 62,3 %, while the foreign tourist share is 37,7 %. The country is currently investing significantly in transport infrastructure by modernizing its railway network and expanding the capacity of its airports. The provision and standard of accommodation play a vital role in the appeal of tourist destinations, and the Czech Republic has seen a consistent rise in the quantity of lodging options. An appreciable increase in the number of shared lodging facilities was observed in the Czech Republic over the period of 2020–2022. South Bohemian, Hradec Královе and South Moravian regions boast the highest number of accommodation facilities, while Pardubice and Vysočina regions have the lowest. The city of Prague, along with South Bohemian and South Moravian regions, is home to the largest number of rooms in collective accommodation facilities. The Czech Republic boasts a thriving restaurant industry that has seen a steady increase in the number of establishments. The country's tourism is characterized by uneven geographic distribution. Notably, the largest number of tourist arrivals are recorded in Prague, South Moravian, Hradec Královе, and South Bohemian regions. According to the analysis, the regions adjacent to Prague also exhibited a significant appeal to tourists. This trend might be clarified by tourists who visit Prague tend to extend their routes to neighbouring regions, particularly in Central Bohemian, Liberec, and Hradec Královе regions. Conversely, regions situated far from the capital draw a substantial number of visitors. This could suggest the existence of exceptional tourism services that entice travellers. The Czech Republic has high tourism densities, with Prague having the highest observed density due to the influx of tourists into a relatively small area. Karlovy Vary, Liberec, and Hradec Královе regions also have high tourism densities. In 2022, foreign tourism generated revenues of 1 billion USD for the country. However, due to the coronavirus pandemic, foreign tourism revenues decreased by 62,5 % in 2020. The Czech Republic is known for its conventional health and wellness, cultural and educational tourism. Keywords: tourism, tourist arrivals, collective accommodation, tourists, Czechia.

The relationship between graduation school background and geographical distribution of dentists in Taiwan

Background/purposeTaiwan’s eight dental schools are all located in the western region. This study attempted to analyze the relationship between the geographical distribution of dentists in Taiwan and their graduation school background and to develop several statistical indicators to analyze the geographical distribution of dentists. Materials and methodsThe method of the secondary data analysis was adopted to collect the open information related to the number of the practicing dentists based on their graduation schools and practice locations by cities and counties in Taiwan in January 2023. The data were used to develop several statistical indicators to analyze the geographical distribution of dentists. ResultsThere were 16,533 practicing dentists in Taiwan in January 2023. Of the 16,533 dentists, 15,687 (94.88 %) graduated from domestic dental schools and 846 (5.12 %) graduated from foreign dental schools. For the school location, the coefficient of variation, Gini coefficient, population proportion index, and population density index were the largest (168.57 %, 0.47, 10.76 %, and 3927.01 people/square kilometer) in the dentists graduating from the northern dental schools. In overall, the dentists were concentrated in municipalities, cities, and the northern region of Taiwan, especially those graduating from the northern dental schools. ConclusionIn Taiwan, the geographical distribution of dentists is highly related to their graduation school background. Promoting a balanced distribution of dental enrollment quotas and dental student sources from different geographical locations and inducing the movement of dentists to the dentist-shortage areas may be the more feasible ways to solve the uneven geographical distribution of dentists in Taiwan.

Turkish Nationalism, Egalitarianism, and Social Policy: The Compulsory Public Service of Physicians

Abstract This article examines how the Turkish political elites have responded to the uneven geographical distribution of physicians. This has been a chronic problem in health care provision, with physicians concentrated in the urban areas of western Anatolia at the cost of rural areas and the east, especially the Kurdish southeast. Successive Turkish governments have employed compulsory service laws as major policy tools to tackle this distribution problem. Legislative discussions about these laws have revolved around the idea of a unitary Turkey, the Turkish nation, and how to close the gap between the idealized imaginary of these and the defective reality. Drawing on Kojin Karatani’s mode-of-exchange framework, this study examines the legislative process on the distribution problem through the history of the post-Ottoman republic to the present. It identifies Turkish nationalism centered on state and on commodity exchange as two variants giving shape to the response to the problem. This analysis also contributes to our understanding of the weakness of social citizenship in Turkey. It is argued that Turkish nationalism—specifically, its state-centered version—operates by interpellating Turkish citizens as indebted to the nation-state, thereby hindering the development of the notion of the rights-bearing citizen.