Alarm Management in Intensive Care: Qualitative Triangulation Study

BACKGROUND

The high number of unnecessary alarms in intensive care settings leads to alarm fatigue among staff and threatens patient safety. To develop and implement effective and sustainable solutions for alarm management in intensive care units (ICUs), an understanding of staff interactions with the patient monitoring system and alarm management practices is essential.

OBJECTIVE

This study investigated the interaction of nurses and physicians with the patient monitoring system, their perceptions of alarm management, and smart alarm management solutions.

METHODS

This explorative qualitative study with an ethnographic, multimethods approach was conducted in an ICU of a German university hospital. Using triangulation in data collection, 102 hours of field observations, 12 semistructured interviews with ICU staff members, and the results of a participatory task were analyzed. The data analysis followed an inductive, grounded theory approach.

RESULTS

Nurses and physicians reported interacting with the continuous vital sign monitoring system for most of their work time and tasks. There were no established standards for alarm management; instead, nurses and physicians stated that alarms were addressed through ad hoc reactions, a practice they viewed as problematic. Staff members' perceptions of intelligent alarm management varied, but they highlighted the importance of understandable and traceable suggestions to increase trust and cognitive ease.

CONCLUSIONS

Staff members' interactions with the omnipresent patient monitoring system and its alarms are essential parts of ICU workflows and clinical decision-making. Alarm management standards and workflows have been shown to be deficient. Our observations, as well as staff feedback, suggest that changes are warranted. Solutions for alarm management should be designed and implemented with users, workflows, and real-world data at the core.

The current state and future perspectives of radiotherapy for cervical cancer

Radiotherapy is an effective treatment method for cervical cancer and is typically administered as external beam radiotherapy followed by intracavitary brachytherapy. In Japan, center shielding is used in external beam radiotherapy to shorten treatment time and reduce the doses delivered to the rectum or bladder. However, it has several challenges, such as uncertainties in calculating the cumulative dose. Recently, external beam radiotherapy has been increasingly performed with intensity-modulated radiotherapy, which reduces doses to the rectum or bladder without center shielding. In highly conformal radiotherapy, uncertainties in treatment delivery, such as inter-fractional anatomical structure movements, affect treatment outcomes; therefore, image-guided radiotherapy is essential for appropriate and safe performance. Regarding intracavitary brachytherapy, the use of magnetic resonance imaging-based image-guided adaptive brachytherapy is becoming increasingly widespread because it allows dose escalation to the tumor and accurately evaluates the dose delivered to the surrounding normal organs. According to current evidence, a minimal dose of D90% of the high-risk clinical target volume is significantly relevant to local control. Further improvements in target coverage have been achieved with combined interstitial and intracavity brachytherapy for massive tumors with extensive parametrical involvement. Introducing artificial intelligence will enable faster and more accurate generation of brachytherapy plans. Charged-particle therapies have biological and dosimetric advantages, and current evidence has proven their effectiveness and safety in cervical cancer treatment. Recently, radiotherapy-related technologies have advanced dramatically. This review provides an overview of technological innovations and future perspectives in radiotherapy for cervical cancer.

Does the digital economy improve comprehensive total factor productivity in China?

Total factor productivity is an important symbol of high-quality economic development. At present, the question of whether the digital economy can infuse fresh impetus into enhancing total factor productivity has emerged as a prominent concern in China. This paper constructs a new undesirable output to measure comprehensive total factor productivity (CTFP) with the slack-based measure (SBM) undesirable Malmquist-Luenberger index by using 2011-2020 Chinese provincial panel data. Then, this paper explores the impact of the digital economy (DIG) on CTFP with a fixed effects (FE) panel model and a mediating effect model. The results show that CTFP increases by an average of 3.9%, technical efficiency contributes -1.1%, and the contribution rate of technological progress is 5.0%. Technological progress is the main source of CTFP growth. The empirical findings show that the DIG has a positive and significant impact on CTFP. This paper conducts various robustness tests, and the results remain consistent with the previous conclusion. Moreover, mechanism tests suggest that the promoting effect of the DIG on CTFP can be attributed to three main effects: technological innovation, the factor endowment structure and the educational level. Furthermore, the results of heterogeneity analysis demonstrate that the promoting effect of the DIG on CTFP exists in China's eastern, central and western regions. The findings of this research can serve as a valuable reference for informing decision-making processes related to environmental governance and high-quality economic development in China.

Pharmaceutical innovation and advanced biotechnology in the biotech-pharmaceutical industry for antibody-drug conjugate development

Antibody-drug conjugates (ADCs), from prototypes in the 1980s to first- and second-generation products in the 2000s, and now in their multiformats, have progressed tremendously to meet oncological challenges. Currently, 13 ADCs have been approved for medical practice, with over 200 candidates in clinical trials. Moreover, ADCs have evolved into different formats, including bispecific ADCs, probody-drug conjugates, pH-responsive ADCs, target-degrading ADCs, and immunostimulating ADCs. Technologies from biopharmaceutical industries have a crucial role in the clinical transition of these novel biotherapeutics. In this review, we highlight several features contributing to the prosperity of bioindustrial ADC development. Various proprietary technologies from biopharmaceutical companies are discussed. Such advances in biopharmaceutical industries are the backbone for the success of ADCs in development and clinical application.

How does climate change risk affect energy poverty? International evidence

Based on cross-country data from 2002 to 2019, we explore the impact of climate change risk (CCR) on energy poverty (EP), and the moderating role in the CCR-EP nexus is also discussed. The empirical results suggest that CCR can exacerbate EP, especially for rural areas. Moderating effect analysis shows that financial development, technological innovation, and adaptation readiness can modify the negative impacts of CCR on EP to some extent. Moreover, the impact of CCR on EP is heterogeneous, demonstrating that CCR is more likely to exacerbate EP in countries with low economic development, low economic freedom, high carbon intensity, and the Africa region. Our findings emphasize the challenge of balancing EP alleviation with climate change response and provide the policy guidance to promote coordinated development of CCR management and energy supply security.

A new era in the treatment of wide necked bifurcation aneurysms: Intrasaccular flow disruption

Wide-necked bifurcation aneurysms (WNBAs) are challenging lesions to treat via both open surgical and endovascular techniques. Presently, there are 3 intrasaccular devices available to address many of the limitations of prior techniques, all of which are at different phases of approval for human use around the world. These devices include the Woven EndoBridge (WEB®) made by MicroVention, the Artisse™ Embolization Device made by Medtronic, and the Contour Neurovascular System™ made by Cerus Endovascular. Although heterogenous in design, these devices rely on the principle of using fine mesh overlying the aneurysm neck to slow blood inflow, promoting stagnation and thrombosis that ultimately leads to healing across the neck and exclusion from the circulation. While our understanding improves as long-term occlusion rates from these devices continue to be studied, the safety profiles and short-term success rates demonstrated in recent studies provide optimism for these innovative intrasaccular devices for the treatment of WNBAs. In this paper, we review these 3 intra-saccular flow disruption devices for use in WNBAs and summarize recent literature and studies of their effectiveness and safety.

User Requirements in Developing a Novel Dietary Assessment Tool for Children: Mixed Methods Study

BACKGROUND

The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data.

OBJECTIVE

This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years.

METHODS

Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls).

RESULTS

Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product.

CONCLUSIONS

Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.

Understanding the Role of Technology in Asian Economies: The Environmental Impact of Remittances and Economic Complexity

In recent years, scholars have determined various determinants of environmental degradation using the panel and time-series studies. However, technological innovations (TI) and remittances, among the financial system's essential components, are relatively ignored. In addition, nations' economic progress and environmental performance also depend upon the nature of their economic structure. This empirical research investigates the effects of TI, remittances and economic complexity (EC) on CO2 controlling economic growth and trade openness (TR) in the selected 15 Asian nations. The study collected panel data of 15 Asian countries from 1990 to 2019 and employed the panel quantile regression and augmented mean group methods to unveil the impacts of variables on CO2 emissions. The empirical findings established that remittances are negatively linked with CO2 emissions. Similarly, EC reduces CO2 emissions in the context of Asian countries. In addition, EC and remittances Granger cause CO2 emissions. These findings indicate that remittances and EC positively contribute to environmental quality in Asian countries. Conversely, TI, economic growth, and TR intensify CO2 emissions in Asian countries. Finally, the study recommended policies to enhance remittances and EC in Asian countries to curb environmental degradation.

Human-centered design of a smartphone-based self-test for HIV viral load monitoring

Background/Objective

HIV viral load self-testing could enable people living with HIV (PLHIV) to monitor their viral suppression status more easily, potentially facilitating medication adherence and safe behavior decision-making. Smartphone-based viral load testing innovations have the potential to reach resource-limited and vulnerable communities to address inequities in access to HIV care. However, successful development and translation of these tests requires meaningful investigation of end-user contexts and incorporation of those context-specific needs early in the design process. The objective of this study is to engage PLHIV and HIV healthcare providers in human-centered design research to inform key design and implementation considerations for a smartphone-based HIV viral load self-testing device prototype in development.

Methods

Semi-structured in-depth interviews were conducted with PLHIV (n = 10) and HIV providers (n = 4) in Indiana, a state with suboptimal viral suppression rates and marked disparities in access to HIV care. Interview guides were developed based on contextual investigation and human-centered design frameworks and included a demonstration of the device prototype with feedback-gathering questions.

Results

Thematic analysis of interview transcripts revealed important benefits, concerns, and user requirements for smartphone-based HIV VL self-testing within the context of PLHIV lived experience, knowledge, and barriers to care in Indiana.

Conclusion

End-user needs and preferences were identified as key design specifications and implementation considerations to facilitate the acceptability and inform ongoing development and ultimately real-world translation of the HIV VL monitoring device prototype.

Current Status of Korea's Industry-Academia Cooperation in Materials and Future Policy Directions

The current status and policy directions of Republic of Korea's industry-academia cooperation in materials research are introduced. Industry-academia cooperation has various forms, such as contract research, joint research, technology transfer, technology assistance, as well as talent development between universities and industry. The actual characteristics of industry-academia cooperation are differentiated, depending on research models such as curiosity-driven research, market-driven research, and scenario-driven research. In addition, there are diverse forms of cooperation, ranging from attaining one-off cooperation goals, to implementing a series of cooperation, to forging sustainable partnership through sharing of values. The efforts and tasks supporting industry-academia cooperation, and the diverse industry-academia cooperative activities, are considered herein from the perspective of the Korean government's policy. Policy recommendations for the industry-academia cooperation, based on the current state and tasks of materials field, are also suggested.

Analysis of the influence of the COVID-19 outbreak on household solid waste management: An empirical study using PLS-SEM

The global increase in solid waste pollution due to economic growth and population growth has led to severe ecological deterioration. This situation is exacerbated by the ongoing coronavirus disease (COVID-19) pandemic, which has significantly impacted consumer behavior and consumption habits. Proper management of solid waste has thus become critical in mitigating environmental degradation. In this study, we aim to examine the relationship between the outbreak of COVID-19, environmental attitudes (EATT), social norms (SN), environmental knowledge (EK), technological innovation (TI), and solid waste management (SWM) in Ecuadorian households during the pandemic. We collected data from 426 households in Ecuador using an online questionnaire and analyzed it using the Partial Least Squares Structural Equation Model method to test the hypotheses. Likewise, we validated the measurement and structural model. The results are novel about SWM, considering a developing country severely affected during the pandemic. Our findings suggest that COVID-19 has a negative impact on SWM, while EATT, SN, and TI have a positive influence on SWM. However, we found that EK does not significantly affect SWM.

Eyes for Ears: Usage and Efficacy of a Podcast for Ophthalmic Education

Purpose

To characterize listenership and perceived educational impact of the ophthalmic podcast "Eyes for Ears".

Methods

A cross-sectional, internet-distributed, 9-question Qualtrics survey was made available to podcast listeners. Listenership metrics were analyzed from the podcast host platform.

Results

From January 10, 2019 to September 2, 2021, the podcast was downloaded over 422,000 times, averaging about 4442 downloads per episode. 209 Qualtrics survey responses were analyzed from podcast listeners with backgrounds in eye care including medical students, residents, fellows, clinicians and technicians. The majority were residents (60.3%), representative of the target audience of the podcast. Listeners reported using the podcast while commuting (81.3%), felt it increased the time they could spend on self-care (63.2%), and thought it improved their fund of knowledge (99.0%). Respondents recalled feeling better prepared for the OKAP or written boards after using this podcast (before median = 50/100 on Likert Scale, IQR 30-65 vs median = 70/100, IQR 56-81, p <0.001). Respondents identified question banks as the most helpful for OKAP studying, followed by podcasts. Podcasts were preferred over articles and lectures in terms of helpfulness (p < 0.001).

Conclusion

The Eyes for Ears podcast has achieved a robust international audience. The surveyed audience felt the podcast was useful for their education and well-being.

Technological Innovations and Data-Driven Support for Older Adults

Entering a new digital era where novel devices and emerging technologies, including artificial intelligence, are playing an incredible role with significant impact on health and health care delivery, JMIR Aging commits to supporting the community of patients and families, clinicians, and scientists to improve the efficiency, equity, and effectiveness of older adult care through the dissemination of cutting-edge evidence.

Political uncertainty and high-quality economic development: Evidence from China

We manually collated data on the turnover of party secretaries and mayors in 285 Chinese cities from 2003 to 2016 and calculated the quality of city economic development represented by environmental total factor productivity growth. We find that the political uncertainty caused by official turnover could significantly promote the improvement of the quality of economic development, and this positive can explained by the progress of production technology and government intervention. Moreover, the political uncertainty caused by the turnover of more educated officials, those with local hukou, promoted officials, and experienced officials could better promote high-quality economic development.

Greening China's Growth: Assessing the Synergistic Impact of Financial Development and Technological Innovation on Environmental Pollution Reduction-A Spatial STIRPAT Analysis

To achieve sustainable economic development in China, it is crucial to balance economic growth and environmental protection. Financial capital and technology can contribute positively to environmental pollution control. This study employs the Cournot model to examine the impact of financial development and technological innovation on environmental pollution at the micro level. It utilizes the spatial STIRPAT model to analyze inter-provincial panel data from China between 2005 and 2020. The results show that China's ecological environment pollution exhibits significant spatial dependence, and heavily polluted areas tend to agglomerate. While improving financial development can increase regional environmental pressure, positive spatial spillover improves environmental quality in neighboring areas. Conversely, technological innovation reduces local ecological pressure, with negative spatial spillover effectively curbing environmental pollution in surrounding regions. The results support the environmental Kuznets curve (EKC) hypothesis, which posits an inverted U-shaped relationship between economic growth and environmental pressure, while population growth increases environmental pressure. The findings are robust and have important policy implications.

The Opening of High-Speed Railways, the Improvement of Factor Allocation Efficiency between Regions, and the City's Environmental Quality Improvement

Based on the panel data of prefecture-level cities in China from 2006 to 2019, this paper uses the PSM-DID method to empirically test the internal impact mechanism among high-speed railway opening, inter-regional factor allocation efficiency, and urban environmental governance. The research results show that: (1) There is a serious factor-misallocation problem among prefecture-level cities in China. From 2006 to 2019, the factor misallocation between prefecture-level cities led to an average annual loss of total factor productivity in China's economy of 52.5%, an average labor misallocation of 23.16%, and an average capital misallocation of 18.69%. Since 2013, capital misallocation has exceeded labor misallocation as the main reason for factor misallocation among prefecture-level cities in China. (2) The opening of high-speed railways can promote the efficiency of urban factor allocation through the technological innovation effect, the foreign investment attraction effect, and the population agglomeration effect. The improvement of urban factor allocation efficiency can promote the improvement of urban environmental quality through the effects of industrial structure optimization, income enhancement, and human capital agglomeration. Therefore, the opening of a high-speed railway can improve urban environmental quality through the intermediary effect of improving the efficiency of urban factor allocation; that is, the opening of a high-speed railway has a dual positive effect of economic efficiency and environmental quality improvement. (3) The optimization effect of factor allocation and the environmental governance effect of the opening of high-speed railways have strong urban scale heterogeneity, urban characteristic heterogeneity, and regional heterogeneity. The research content of this paper has important guiding significance for the construction of China's new development paradigm, accelerating the construction of "a unified national market," and green and low-carbon development.

Modeling the Impact of Fiscal Decentralization on Energy Poverty: Do Energy Efficiency and Technological Innovation Matter?

As an important factor affecting economic and social development, energy poverty (EP) has received widespread concern, and many countries have actively proposed policies to eliminate energy poverty. The purpose of this paper is to clarify the current situation of energy poverty in China, explore the factors that affect energy poverty, find sustainable and effective approaches to alleviate energy poverty, and provide empirical evidence for eliminating energy poverty. This research investigates the effect of fiscal decentralization (FD), industrial structure upgrading (ISU), energy efficiency (EE), and technological innovation (TI), as well as urbanization (URB) on energy poverty using a balanced dataset of 30 provinces in China from 2004 to 2017. The empirical outcomes revealed that fiscal decentralization, industrial upgrading, energy efficiency, and technological innovation significantly reduce energy poverty. Moreover, urbanization is positively and significantly correlated with energy poverty. The outcomes further revealed that fiscal decentralization significantly increases the residents' access to clean energy and drives energy management agencies and infrastructure. In addition, the heterogeneity analysis results indicate that the effect of fiscal decentralization in reducing energy poverty is greater in regions with high economic development. Finally, mediation analysis denotes that fiscal decentralization indirectly reduces energy poverty by promoting technological innovation and energy efficiency. Finally, based on the results, policy suggestions for eradicating energy poverty are proposed from the perspective of implementing targeted energy alleviation policies reasonably dividing the rights and responsibilities of local and central governments and encouraging scientific and technological innovation.

The Effect of Energy Use Rights Trading Policy on Environmental Performance: Evidence from Chinese 262 Cities

This study provides empirical evidence and policy inspiration for China to implement the energy use rights trading policy. Using 262 cities in China from 2005 to 2019 as samples, we employed the double difference method and mediation analysis to empirically measure the impact of energy use rights trading policy on environmental performance. First, energy use rights trading policy can improve urban environmental performance. This conclusion is valid as per the endogeneity test, parallel trend test, PSM-DID test, placebo test, and triple difference method. Second, heterogeneity analysis shows that the effect of the energy use rights trading policy on urban environmental performance will be different by the size of population. Energy use rights trading policy has the greatest effect on the environmental performance of resource-based cities. Meanwhile, compared to non-industrial base, the effect of the energy use rights trading policy on environmental performance is more pronounced in cities with older industrial base. Third, the mechanism test using the mediation effect model proved that the impact of energy use rights trading policy on environmental performance is achieved by improving the level of marketization and technological innovation.

Green Finance and Technological Innovation in Heavily Polluting Enterprises: Evidence from China

There is an urgent need for countries worldwide to promote the green transformation of their economies and reduce environmental pollution. Based on China's Green Credit Guidelines policy in 2012 and the data of Chinese listed companies from 2007 to 2021, we conducted an empirical test using the difference-in-differences method. The results showed that green finance policies inhibit technological innovation in heavily polluting enterprises, and the stronger the enterprise's operating capacity, the weaker this inhibiting effect. The study also shows that bank loan, loan term, corporate management motivation, and business confidence have intermediation effects. Therefore, countries should improve green financial policies and promote technological innovation in heavily polluting enterprises in order to reduce environmental pollution and promote green growth.

Asymmetric impact of renewable energy consumption and technological innovation on environmental degradation: designing an SDG framework for developed economy

Many European nations, including Spain, are having difficulties achieving their Sustainable Development Goals (SDGs) objectives. Resultantly, the current research discusses the development of an SDG framework for Spain, which can be utilized as a model for other EU nations. This research examines whether GDP growth, technological innovation, and energy sources (renewable and non-renewable) have any effect on CO₂ emissions utilizing data from 1980 to 2018. The study applied the non-linear ARDL (NARDL) to investigate these interrelations. The outcomes from the NARDL revealed that positive (negative) shocks in renewable energy improve environmental quality in Spain. Furthermore, positive (negative) shocks in technological innovation lead to a decrease (increase) in CO₂. Lastly, positive (negative) shocks in energy consumption lead to an increase (decrease) in CO_2. The results reveal that Spain is on the right path towards decarburization. This research has important policy ramifications for the policymakers and government of Spain as well as neighbouring countries.

The Effects of Population Aging on Sports Industry Development: The Mediating Effect of Technological Innovation

It is of great practical significance to rationally formulate a development strategy for the sports industry to deeply understand and comprehensively grasp the impact of population aging on the development of the sports industry. To study the impact of population aging on the development of the sports industry, panel data at the provincial level in China from 2014 to 2020 are selected, and a mediation effect model is established to test how the aging of the population affects the development of the sports industry through technological innovation. The results show that technological innovation can explain 59.87% of the impact of population aging on the development of the sports industry without considering the control variables, and the impact of population aging on labor productivity through technological innovation is positive. Under the condition of considering the control variables, technological innovation can explain 56.74% of the impact of population aging on the development of the sports industry, and the impact of population aging on the development of the sports industry through technological innovation is positive. The proportion of the population aged 65 and above in the total population was used as a proxy variable for population aging to test the robustness test, and the impact of technological innovation on the development of the sports industry was positive without considering the control variables. In the robustness test considering the control variables, the impact of technological innovation on the development of the sports industry is positive.

Environmental Governance Goals of Local Governments and Technological Innovation of Enterprises under Green Performance Assessment

The current study empirically estimates the impact of local government environmental governance on enterprise technological innovation from the perspective of a green political performance assessment of local governments with Chinese characteristics. Fourteen years of data (from 2006 to 2019) on pollutant emissions, and the patents of A-share listed companies were collected from 230 cities in China. A fixed effect model and tool variable method were applied to empirically analyze the objectives of the study. The results show that the environmental governance formulated by the local government has regional differences, which are shown as lower governance indicators for underdeveloped areas and higher governance indicators for developed areas. Environmental governance has a greater promotion effect on technological innovation in enterprises in developed regions, as well as in large and private enterprises. Moreover, mechanism analysis showed that the local governments preferred the path of financial subsidies to promote the level of technological innovation in enterprises. This study provides a foundation for attaining the "win-win" scenario of local government environmental stewardship and high-quality green economic growth.

Research on the efficiency evaluation of the integration of technology and finance in China's strategic emerging industries

The combination of technology and finance has a great potential impact on regional social and economic development, and strategic emerging industries are the convergence of technological innovation and financial support, the development of which have great significance for industrial structure adjustment and industrial quality improvement. The geographical distribution of emerging strategic industries in China is uneven. We selected 18 provinces with relatively concentrated emerging industries. 206 STI board enterprises in 2020 were collected. A three-stage DEA model was used to measure the input-output efficiency of the integrated development of science and technology finance. Also, we used a regression model to examine the path of integrated development of science and technology innovation and financial support. The research finds that the development of strategic emerging industries has a large demand for financial support and obvious regional differences, and the government plays a strong guiding role in their development as well. At the end of the research, countermeasures and suggestions for the development of strategic emerging industries are given.

The association between information technology sophistication and patient portal use: A cross sectional study in Eastern North Carolina

Even with the extolled benefits of patient portals, there has been some challenges to ensuring patient portal use. This study examines if a patient's level of information technology (IT) sophistication, defined as the degree of use of diverse information technologies by an individual, is associated with their use of a patient portal. Patients previous experience and exposure to other similar technologies like desktop computer, laptop, internet, smart phone, or social media explains their willingness to use information technology for their health. Data on a cross-sectional survey of 565 individuals in Eastern NC was available for analysis. Multinomial regression analyses revealed that IT sophistication is important in determining whether patients will use a patient portal. It specifies that patients with low IT sophistication compared to those with high IT sophistication were more likely to have never activated their patient portals (RRR = 2.2155, p < 0.009), or to have activated but never used a patient portal (RRR = 3.5869, p < 0.010). The findings of this study should aid healthcare leaders as they strive to improve patient engagement. They should continue to promote the benefits of the patient portal and consider offering personalized support programs for patients with low IT sophistication.

Insurers' intervention, separation of two rights and firm's technology innovation

This paper takes insurers' intervention as the entry point, and sets insurers' intervention, separation of two rights and firms' technological innovation in a specific context to study the transmission mechanism and economic consequences using panal model. The results show that there is a positive relationship between insurers' intervention and firm's technological innovation, and the degree of separation of two rights has a negative moderating effect on the relationship between insurers' intervention and technological innovation, and this effect is more obvious in the sample of state-owned enterprises. Therefore, the state should formulate relevant policies to guide the equity investment behavior of insurance companies so as to improve the operational efficiency of market resources.