Coupling Relationship Among Technological Innovation, Industrial Transformation and Environmental Efficiency: A Case Study of the Huaihai Economic Zone, China

The 14th Five-Year Plan period is a critical period for China to achieve high-quality development. Based on super-efficiency slacks-based measure (SBM) model, grey-related analysis (GRA) and other models, this paper studies the heterogeneity of the coupling relationship among technological innovation, industrial transformation and environmental efficiency in the Huaihai Economic Zone during the period of 2005-2019. In addition, it analyzes the coupling mechanism of single and binary systems to the ternary system, which is of great significance for the collaborative symbiosis among systems. The findings are as follows. 1) The technological innovation, industrial transformation and environmental efficiency (TIE) systems of the Huaihai Economic Zone had significant spatial-temporal heterogeneity. Although their evaluation value fluctuated, the development trends are all positive. Ultimately, technological innovation is characterized by being high in the northeast and low in the southwest around Xuzhou, while other systems are relatively staggered in space. 2) The coupling of TIE systems is in transition, lack of orderly integration and benign interaction. However, the developing trend of interaction is also upward, and a spatial pattern driven by Xuzhou and Linyi as the dual cores has gradually formed. Moreover, the coupling is mostly manifested as outdated technological innovation and industrial transformation. Except for the final coordination of regenerative cities, the other resource types are all in transition. Cities in all traffic locations are still in transition. The overall system interaction of cities on Longhai Line (Lanzhou-Lianyungang Railway) is relatively optimal, and cities on Xinshi Line (Xinxiang-Rizhao Railway) are accelerating toward synergy. 3) The coupling status of TIE systems depends on the development of the single system and the interaction of the binary (2E) system. The coupling is closely related to technological innovation and Technology-Industry system, and is hindered by the inefficient interaction of Technology-Environment system. Specifically, the synergy of regenerative cities is attributed to the advantage of a single system and the effective integration of 2E systems. Beneficial from the advantages of environmental efficiency, the cities on Xinshi Line promote the synergy of the 2E and TIE systems. Therefore, while the Huaihai Economic Zone stimulates the development potential of the single and 2E systems, it is necessary to amplify the superimposition effect of systems in accordance on the basis of resource and location.

Does Corporate Social Responsibility Heterogeneity Affect Corporate Financial Performance Through Technological Innovation? The Moderating Effects of Advertising Intensity

In this study, we examine the effects of firms' corporate social responsibility (CSR), technological innovation, and advertising intensity on corporate financial performance (CFP). Prior research has shown mixed findings for the CSR-CFP relationship. To provide additional evidence and alternative explanations for these mixed findings, we built a moderated mediating model by combining the knowledge-based view with the stakeholder theory. We use this model to examine whether CSR influences CFP by affecting technological innovation, and whether such mediating effects are moderated by advertising intensity. We classify heterogeneous CSR activities into technical and institutional activities. Using data from 2010 to 2018 on Chinese listed firms, we find that superior technical CSR performance can enhance CFP by promoting technological innovation and that it promotes technological innovation to a greater extent when advertising intensity is higher. However, institutional CSR does not affect technological innovation or CFP. The findings suggest that to improve the firm's financial position, its resources should be allocated effectively to technical CSR activities as well as to innovation and advertising.

Governance Quality, Public Health, Education, and Innovation: Study for Novel Implications

Pandemic or worldwide disease is the greatest issue of all time that not only affects human health but also influences the economic, educational, and other activities of the countries, since malaria is among the leading health disease that disrupts the economic system of the country. Therefore, this study aimed to analyze whether educational expenditure and technological innovation influence malarial incidence in emerging economies. This study also examined the role of government effectiveness, government health expenditure, gross domestic growth, human capital, and research and development during the period 2000-2018. Employing panel data approaches, including the slope heterogeneity and cross-sectional dependence, the second-generation unit root test reveals the stationarity of all variables. The study also validated the existence of a long-run relationship between the variables. Based on the asymmetrical distribution properties, this study employed the quantile regression approach. The empirical results asserted that education and technological innovation significantly reduce malarial incidents in the panel economies. Also, government effectiveness, research and development, and human capital adversely affect incidences of malaria. In contrast, gross domestic product is the only factor found that increases malarial incidents during the selected period. Based on the empirical results, this study suggested policy measures that could benefit the governors, policymakers, and scholars.

Spatial Pattern of Technological Innovation in the Yangtze River Delta Region and Its Impact on Water Pollution

The impact of technological innovation on water pollution is an important parameter to determine and monitor while promoting and furthering a region's economic development. Here, exploratory spatial data analysis was used to analyze: the spatial patterns of technological innovation and water pollution in the Yangtze River, the changes in technical innovation and the resulting changes in water pollution, and the impact of technological innovation on water pollution. The following major inferences were drawn from the obtained results: (1) The spatial pattern of innovation input has a single-center structure that tends to spread. The patent innovation output has evolved, from a single spatial pattern with Shanghai as the core to a diffusion structure with three cores-Hangzhou, Shanghai, and Nanjing. (2) The aggregation mode of water pollution has evolved from the original "Z" mode to a new mode of core agglomeration, and water pollution is constantly being reduced. (3) The trends of change in patent innovation output and innovation input are roughly the same, while the trends of both and that of water pollution are contrary to each other. (4) The correlations between innovation input, patented innovation output, and water pollution are relatively low. From the perspective of spatial distribution, the number of cities with medium and high levels of gray correlation with water pollution is the same.

The Impact of Coordinated Development of Ecological Environment and Technological Innovation on Green Economy: Evidence from China

Promoting the coordinated development of ecological environment and technological innovation is significant to the development of a green economy. In this study, we construct an index system of ecological environment, technological innovation, and green economy based on the panel data of 30 provinces and cities in China from 2005 to 2016, using the entropy weight method, the coupling coordination model, and the panel vector autoregressive model (PVAR) to calculate the comprehensive development levels of ecological environment, technological innovation, and green economy and the coordination degree between ecological environment and technological innovation, and then further explore the impact of the coordinated development level of ecological environment and technological innovation on the development of a green economy. The research results include: First, from 2005 to 2016, the comprehensive development levels of ecological environment, technological innovation, and green economy in China’s 30 provinces and cities achieved different degrees of improvement as a whole. Among them, the comprehensive development level of green economy was the highest, followed by the development level of technological innovation, and the comprehensive development level of ecological environment was the lowest. Second, from 2005 to 2016, the coordination degree between ecological environment and technological innovation in China’s provinces and cities increased year by year, but on the whole, the coordination degree between ecological environment and technological innovation in various regions was in a state of imbalance. Third, there was a long-term equilibrium relationship among the coordinated development levels of ecological environment, technological innovation, and green economy. Fourth, through pulse analysis and Monte Carlo simulation, we found that the coordinated development level of ecological environment and technological innovation had a lagging positive impact on green economy. Finally, we provide a summary of the results of this study.

Innovative Strategies for Talent Cultivation in New Ventures Under Higher Education

This study aims to help enterprises enhance their innovation capabilities in the environment of knowledge economy globalization and stand out in the fierce industry competition. Firstly, data on existing higher education theories and innovation theories are analyzed. Secondly, two companies in the sample data are selected for detailed analysis. Finally, research conclusion and corresponding talent management strategies are presented. The results show that the cumulative contribution value of employees is 87.496%. The cumulative contribution value of human capital is 70.322%. The contribution value of cumulative innovation performance is 61.658%. The cumulative contribution value of R&D investment is 45.306%. The coefficient for the overall sample size is 0.509. The employee quality coefficient is 0.452. The correlation coefficient for educational attainment is 0.598. The high-tech service industry has the highest correlation coefficient at 0.504. The auto industry has the highest coefficient at 0.669. The experimental research has drawn the following conclusion: (1) Talents positively affect enterprise innovation performance; (2) Research and Development (R&D) investment has a positive correlation with enterprise innovation performance; (3) R&D investment has a positive correlation with talents. Through experimental research, the education level of employees is measured by academic qualifications, but the essence of academic qualification measurement is the level of knowledge and skills that employees have. In summary, the study can extend the strategic analysis of the cultivation of innovative talents and play a valuable auxiliary role in cultivating innovative talents.

Creation of an Evidence-Based Implementation Framework for Digital Health Technology in the Intensive Care Unit: Qualitative Study

Background

Digital health technologies such as continuous remote monitoring and artificial intelligence–driven clinical decision support systems could improve clinical outcomes in intensive care medicine. However, comprehensive evidence and guidelines for the successful implementation of digital health technologies into specific clinical settings such as the intensive care unit (ICU) are scarce. We evaluated the implementation of a remote patient monitoring platform and derived a framework proposal for the implementation of digital health technology in an ICU.

Objective

This study aims to investigate barriers and facilitators to the implementation of a remote patient monitoring technology and to develop a proposal for an implementation framework for digital health technology in the ICU.

Methods

This study was conducted from May 2018 to March 2020 during the implementation of a tablet computer–based remote patient monitoring system. The system was installed in the ICU of a large German university hospital as a supplementary monitoring device. Following a hybrid qualitative approach with inductive and deductive elements, we used the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change to analyze the transcripts of 7 semistructured interviews with clinical ICU stakeholders and descriptive questionnaire data. The results of the qualitative analysis, together with the findings from informal meetings, field observations, and previous explorations, provided the basis for the derivation of the proposed framework.

Results

This study revealed an insufficient implementation process due to lack of staff engagement and few perceived benefits from the novel solution. Further implementation barriers were the high staff presence and monitoring coverage in the ICU. The implementation framework includes strategies to be applied before and during implementation, targeting the implementation setting by involving all ICU stakeholders, assessing the intervention’s adaptability, facilitating the implementation process, and maintaining a vital feedback culture. Setting up a unit responsible for implementation, considering the guidance of an implementation advisor, and building on existing institutional capacities could improve the institutional context of implementation projects in the ICU.

Conclusions

Implementation of digital health in the ICU should involve a thorough preimplementation assessment of the ICU’s need for innovation and its readiness to change, as well as an ongoing evaluation of the implementation conditions. Involvement of all stakeholders, transparent communication, and continuous feedback in an equal atmosphere are essential, but leadership roles must be clearly defined and competently filled. Our proposed framework may guide health care providers with concrete, evidence-based, and step-by-step recommendations for implementation practice, facilitating the introduction of digital health in intensive care.

Trial Registration

ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173

Role of Technological Innovation in Achieving Social and Environmental Sustainability: Mediating Roles of Organizational Innovation and Digital Entrepreneurship

Innovation has been a major growing driver of sustainability. The topic addressed in this study is a much-required transition to environmental and social sustainability considering the role of innovation in pacing up those changes. Digital evolution has greatly helped in dealing with climatic changes and promoting sustainability. This has helped the entrepreneurial organizations to adopt innovative approaches to tackle the inflexible challenges. Few developed and developing countries are at the forefront regarding technological innovation that encounter significant challenges in terms of innovation and adoption of new technologies and there is still a study vacuum as to whether the influence of technical innovation on achieving social and environmental sustainability differs depending on the stage of sustainability. This quantitative study has explored these effects collecting data from the SME's (small and medium enterprises). The findings of the study show that attitude toward technological innovation has a strong role to play in organizational innovation, digital entrepreneurship, environmental and social sustainability. Organizational innovation has been found a strong mediator between technological innovation and sustainability while digital entrepreneurship could not find significant results as mediator. This study will be useful for the countries and organizations involved in adopting new technologies considering their organization's role in achieving an overall eco-friendly and social sustainability.

A Remote Patient-Monitoring System for Intensive Care Medicine: Mixed Methods Human-Centered Design and Usability Evaluation

Background

Continuous monitoring of vital signs is critical for ensuring patient safety in intensive care units (ICUs) and is becoming increasingly relevant in general wards. The effectiveness of health information technologies such as patient-monitoring systems is highly determined by usability, the lack of which can ultimately compromise patient safety. Usability problems can be identified and prevented by involving users (ie, clinicians).

Objective

In this study, we aim to apply a human-centered design approach to evaluate the usability of a remote patient-monitoring system user interface (UI) in the ICU context and conceptualize and evaluate design changes.

Methods

Following institutional review board approval (EA1/031/18), a formative evaluation of the monitoring UI was performed. Simulated use tests with think-aloud protocols were conducted with ICU staff (n=5), and the resulting qualitative data were analyzed using a deductive analytic approach. On the basis of the identified usability problems, we conceptualized informed design changes and applied them to develop an improved prototype of the monitoring UI. Comparing the UIs, we evaluated perceived usability using the System Usability Scale, performance efficiency with the normative path deviation, and effectiveness by measuring the task completion rate (n=5). Measures were tested for statistical significance using a 2-sample t test, Poisson regression with a generalized linear mixed-effects model, and the N-1 chi-square test. P<.05 were considered significant.

Results

We found 37 individual usability problems specific to monitoring UI, which could be assigned to six subcodes: usefulness of the system, response time, responsiveness, meaning of labels, function of UI elements, and navigation. Among user ideas and requirements for the UI were high usability, customizability, and the provision of audible alarm notifications. Changes in graphics and design were proposed to allow for better navigation, information retrieval, and spatial orientation. The UI was revised by creating a prototype with a more responsive design and changes regarding labeling and UI elements. Statistical analysis showed that perceived usability improved significantly (System Usability Scale design A: mean 68.5, SD 11.26, n=5; design B: mean 89, SD 4.87, n=5; P=.003), as did performance efficiency (normative path deviation design A: mean 8.8, SD 5.26, n=5; design B: mean 3.2, SD 3.03, n=5; P=.001), and effectiveness (design A: 18 trials, failed 7, 39% times, passed 11, 61% times; design B: 20 trials, failed 0 times, passed 20 times; P=.002).

Conclusions

Usability testing with think-aloud protocols led to a patient-monitoring UI with significantly improved usability, performance, and effectiveness. In the ICU work environment, difficult-to-use technology may result in detrimental outcomes for staff and patients. Technical devices should be designed to support efficient and effective work processes. Our results suggest that this can be achieved by applying basic human-centered design methods and principles.

Trial Registration

ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173

A Roadmap toward Achieving Sustainable Environment: Evaluating the Impact of Technological Innovation and Globalization on Load Capacity Factor

Technological innovations have been a matter of contention, and their environmental consequences remain unresolved. Moreover, studies have extensively evaluated environmental challenges using metrics such as nitrogen oxide emissions, sulfur dioxide, carbon emissions, and ecological footprint. The environment has the supply and demand aspect, which is not a component of any of these indicators. By measuring biocapacity and ecological footprint, the load capacity factor follows a certain ecological threshold, allowing for a thorough study on environmental deterioration. With the reduction in load capacity factor, the environmental deterioration increases. In the context of the environment, the interaction between technological innovation and load capacity covers the demand and supply side of the environment. In light of this, employing the dataset ranging from 1980 to 2017 for the case of South Africa, the bound cointegration test in conjunction with the critical value of Kripfganz and Schneider showed cointegration in the model. The study also employed the ARDL, whose outcome revealed that nonrenewable energy usage and economic growth contribute to environmental deterioration, whereas technological innovation and globalization improve the quality of the environment. This study validated the hypothesis of the environmental Kuznets curve for South Africa, as the short-term coefficient value was lower than the long-term elasticity. Furthermore, using the frequency-domain causality test revealed that globalization and economic growth predict load capacity in the long term, and nonrenewable energy predicts load capacity factors in the long and medium term. In addition, technological innovation predicts load capacity factors in the short and long term. Based on the findings, we propose that policymakers should focus their efforts on increasing funding for the research and development of green technologies.

Assessing the Antecedents and Consequence of Enterprise Transformation: A Quantitative Approach

With the negative impact of COVID-19, the continuous recession of economic globalization, and the increasing market competition, enterprise transformation gradually becomes the theme of enterprise management. Although more and more scholars and companies have paid attention to the importance of enterprise transformation, most of the research on it is still at the qualitative level of theoretical descriptions and lacks a comprehensive consideration and empirical research on its motivation and performance. In view of this, this study analyzes the overall driving effect of technological innovation and the internal and external environment on enterprise transformation from the perspective of its drivers and analyzes in depth its causes and consequences for different industries (construction and real estate industries). The study also analyzes the antecedents and consequences of enterprise transformation and its differences in different industries (construction and real estate). In this study, a sample of middle and senior management of 10 companies with a valid sample of 401 is collected. Structural equation modeling results indicate that competitive advantage, technological innovation, and market pressure significantly affect enterprise transformation, which is an antecedent of corporate performance. Further, the results of the multiple-group analysis also reveal some significant differences between the theoretical models of the construction and real estate communities. Finally, suggestions are made based on the findings.

Mutual Influence of Innovation and Human Capital on Regional Growth in Neighboring Countries: The Case of Russia and Kazakhstan

The aim is to assess the impact on regional growth of spending on R&D, technological innovation, healthcare, education, and socioeconomic conditions, their spillovers between the country regions, and, primarily, from the neighboring country regions. In existing studies, the authors examined other regions’ impact on regional growth. However, this approach does not reveal the effect the neighboring country’s regions had on the regions’ economic growth. Our approach novelty is that we assessed the impact of regional growth factors from the country and the neighboring country separately. The panel data analysis method applied to the endogenous growth model made it possible to assess these effects on regional economic growth and identify regional convergence. Our results are consistent with other studies regarding regional drivers and their spillovers to other regions within each country. Moreover, our results confirmed the technological innovation cost stream hypothesis in the Russian regions from Kazakhstan regions. And they confirmed the hypothesis that R&D costs flow to the Kazakhstan regions from the Russian regions. Thus, the study revealed a synergistic effect from the regional growth in spending on R&D and technological innovation between Russia and Kazakhstan, which is asymmetric. The proposed approach to analyzing interregional mutual influence is also applicable to three or more countries.

The Dynamic Impact of Natural Resource Rents, Financial Development, and Technological Innovations on Environmental Quality: Empirical Evidence from BRI Economies

Until recently, many countries’ policies were motivated by economic growth; however, few strategies were developed to prevent environmental deterioration including reducing the ecological footprint. In this context, the purpose of this study was to analyze the role of natural resource rents, technological innovation, and financial development on the ecological footprint in 90 Belt and Road Initiative (BRI) economies. This research divided the BRI economies into high income, middle-income, and low-income levels to capture income differences. This research used the second-generation panel unit root, cointegration, and augmented mean group estimators to calculate the robust and reliable outcomes. Based on the annual data from 1991 to 2018, the findings show that natural resource rents drastically damage the quality of the environment, whereas technological innovations are helpful in reducing ecological footprint. Moreover, the outcome of the interaction term (natural resource rents and technological innovations) negatively impacts the ecological footprint. Interestingly, these findings were similar in the three income groups. In addition, financial development improved environmental quality in the middle-income BRI economies, but reduced it in high-income, low-income, and full sample countries. Furthermore, the Environmental Kuznets Curve (EKC) concept has been validated across all BRI economies. Policymakers in BRI countries should move resources away from resource-rich sectors of industries/manufacturing sectors to enhance/promote economic growth and use these NRRs efficiently for a progressive, sustainable environment. Based on these findings, several efficient policy suggestions are proposed.

Influence of Financialization of Heavily Polluting Enterprises on Technological Innovation under the Background of Environmental Pollution Control

In the wake of the acceleration of China’s industrialization and rapid economic growth, environmental pollution has also attracted great attention. The technological innovation of heavily polluting enterprises is conducive to reducing pollution emissions and promoting environmental health. The financial investment tendency and behavior of real enterprises have a significant impact on the technological innovation decision-making of enterprises. A panel model is used in this paper in order to empirically test the impact of financialization of Chinese heavily polluting enterprises on technological innovation based on the data of Listed Companies in Chinese heavily polluting industries from 2008 to 2019. The + results show that the financialization of heavily polluting enterprises has a significant crowding out effect on technological innovation. After introducing arbitrage motivation as the regulating variable, further research finds that arbitrage motivation weakens the inhibitory effect of enterprise financialization on technological innovation, that is, the stronger the arbitrage motivation, the smaller the negative effect of financialization on enterprise technological innovation, which weakens this crowding out effect. Finally, the listed enterprises in heavily polluting industries are divided into state-owned enterprises and non-state-owned enterprises according to their corporate attributes. Compared with state-owned enterprises, the financialization of non-state-owned enterprises has a greater squeeze out of technological innovation; and arbitrage motivation has a more significant regulatory effect on the impact of enterprise financialization on technological innovation.

Modeling the Dynamic Linkage between Tourism Development, Technological Innovation, Urbanization and Environmental Quality: Provincial Data Analysis of China

This study investigates the linkage between tourism development, technological innovation, urbanization and environmental degradation across 30 provinces of China. Based on data from 2001 to 2018, the study used an advanced economic methodology for the long-run estimate, the Augmented Mean Group (AMG) estimator, which accounts for heterogeneity in slope parameters and dependencies across countries. The empirical results show that tourism development degrades environmental quality, while technological innovation mitigates carbon emissions. Further, findings show that urbanization increases carbon emissions, while an inverted U-shaped relationship exists between economic growth and environmental degradation, implying the existence of EKC in China. Further, the Dumitrescu-Hurlin panel causality test shows that any policy aimed at tourism development or technological innovation would substantially contribute to environmental degradation, but not the other way round.

Do Human Capital Investment and Technological Innovation Have a Permanent Effect on Population Health? An Asymmetric Analysis of BRICS Economies

This study examines the asymmetric impact of human capital investment, and technological innovation on population health from the years spanning from 1991 to 2019, by using a panel of the BRICS countries. For this purpose, we have employed the PMG panel NARDL approach, which captures the long-run and short-run dynamics of the concerned variables. The empirical results show that human capital investment and technological innovation indeed happen to exert asymmetric effects on the dynamics of health in BRICS countries. Findings also reveal that increased human capital investment and technological innovation have positive effects on health, while the deceased human capital investment and technological innovation tend to have negative effects on population health in the long run. Based on these revelations, some policy recommendations have been proposed for BRICS economies.

Structure of the Region-Technology Network as a Driver for Technological Innovation

Agglomeration and spillovers are key phenomena of technological innovation, driving regional economic growth. Here, we investigate these phenomena through technological outputs of over 4,000 regions spanning 42 countries, by analyzing more than 30 years of patent data (approximately 2.7 million patents) from the European Patent Office. We construct a bipartite network—based on revealed comparative advantage—linking geographic regions with areas of technology and compare its properties to those of artificial networks using a series of randomization strategies, to uncover the patterns of regional diversity and technological ubiquity. Our results show that the technological outputs of regions create nested patterns similar to those of ecological networks. These patterns suggest that regions need to dominate various technologies first (those allegedly less sophisticated), creating a diverse knowledge base, before subsequently developing less ubiquitous (and perhaps more sophisticated) technologies as a consequence of complementary knowledge that facilitates innovation. Finally, we create a map—the Patent Space Network—showing the interactions between technologies according to their regional presence. This network reveals how technology across industries co-appear to form several explicit clusters, which may aid future works on predicting technological innovation due to agglomeration and spillovers.

Relationship Between Knowledge Base and Innovation-Driven Growth: Moderated by Organizational Character

Purpose: On the background of innovation-driven growth strategy of the Chinese government, this study aims to explore the impact of the knowledge base on innovation-driven growth of a firm, which is moderated by organizational character. Design/methodology/approach: Based on the data of 965 Chinese listed companies, some hypotheses were tested using the method of hierarchical regression analysis. Findings: Organizational growth relies on both technological and business model innovations and their interactive effect. Knowledge base, both breadth and depth, makes a positive impact on the innovation-driven growth of an enterprise. In the impacting mechanism, an explicit organizational character not only has direct positive effects on business model innovation, it also strengthens the effect of knowledge breadth on business model innovation. On the contrary, an implicit organizational character is not significantly related to innovation. Research limitations/implications: In order to achieve growth, enterprises are suggested to adopt such dual innovation strategy, led by technological innovation and supplemented with business model innovation, which is supported by the integrated management of intangible resources, deep and broad knowledge, and explicit organizational character. Originality/value: A new theoretical framework of organizational innovation-driven growth was proposed. The realization paths of innovation-driven growth were explored. The idea of collaborative governance between the knowledge base and organizational character was raised.

Does Technological Innovation Promote Green Development? A Case Study of the Yangtze River Economic Belt in China

The role of technological innovation (TI) in green development is controversial. Based on 2003-2017 panel data of 108 cities in the Yangtze River Economic Belt (YREB), this study constructed an index system to evaluate urban green development and analyzed the role of TI on urban green development with the help of a panel econometric model. The results show that: (1) From 2003 to 2017, the levels of TI and green development of cities in the YREB have gradually improved, but the core-periphery structure is obvious, and the levels of TI and green development in the lower reaches are significantly higher than those in the middle and upper reaches. (2) TI has a significant positive role in promoting green development, showing a U-shaped nonlinear relationship, and this relationship varies from region to region. (3) TI has a significant impact on green development with direct and indirect effects. In the economic and social dimensions, TI has a positive impact on green development, while in the ecological dimension, the direct effect and indirect effect have opposite relationships. (4) TI has a significant threshold effect on green development, and there are differences in threshold characteristics between the three dimensions. These findings provide a scientific basis for policymaking about innovation-driven regional green development, and it can enrich the related theories of environmental economic geography.

Patient Monitoring Alarms in an Intensive Care Unit: Observational Study With Do-It-Yourself Instructions

BACKGROUND

As one of the most essential technical components of the intensive care unit (ICU), continuous monitoring of patients' vital parameters has significantly improved patient safety by alerting staff through an alarm when a parameter deviates from the normal range. However, the vast number of alarms regularly overwhelms staff and may induce alarm fatigue, a condition recently exacerbated by COVID-19 and potentially endangering patients.

OBJECTIVE

This study focused on providing a complete and repeatable analysis of the alarm data of an ICU's patient monitoring system. We aimed to develop do-it-yourself (DIY) instructions for technically versed ICU staff to analyze their monitoring data themselves, which is an essential element for developing efficient and effective alarm optimization strategies.

METHODS

This observational study was conducted using alarm log data extracted from the patient monitoring system of a 21-bed surgical ICU in 2019. DIY instructions were iteratively developed in informal interdisciplinary team meetings. The data analysis was grounded in a framework consisting of 5 dimensions, each with specific metrics: alarm load (eg, alarms per bed per day, alarm flood conditions, alarm per device and per criticality), avoidable alarms, (eg, the number of technical alarms), responsiveness and alarm handling (eg alarm duration), sensing (eg, usage of the alarm pause function), and exposure (eg, alarms per room type). Results were visualized using the R package ggplot2 to provide detailed insights into the ICU's alarm situation.

RESULTS

We developed 6 DIY instructions that should be followed iteratively step by step. Alarm load metrics should be (re)defined before alarm log data are collected and analyzed. Intuitive visualizations of the alarm metrics should be created next and presented to staff in order to help identify patterns in the alarm data for designing and implementing effective alarm management interventions. We provide the script we used for the data preparation and an R-Markdown file to create comprehensive alarm reports. The alarm load in the respective ICU was quantified by 152.5 (SD 42.2) alarms per bed per day on average and alarm flood conditions with, on average, 69.55 (SD 31.12) per day that both occurred mostly in the morning shifts. Most alarms were issued by the ventilator, invasive blood pressure device, and electrocardiogram (ie, high and low blood pressure, high respiratory rate, low heart rate). The exposure to alarms per bed per day was higher in single rooms (26%, mean 172.9/137.2 alarms per day per bed).

CONCLUSIONS

Analyzing ICU alarm log data provides valuable insights into the current alarm situation. Our results call for alarm management interventions that effectively reduce the number of alarms in order to ensure patient safety and ICU staff's work satisfaction. We hope our DIY instructions encourage others to follow suit in analyzing and publishing their ICU alarm data.

Curcumin-Loaded Micelles Dispersed in Ureasil-Polyether Materials for a Novel Sustained-Release Formulation

Vulvovaginal candidiasis (VVC) is a vulvar/vaginal infection that affects approximately 75% of women worldwide. The current treatment consists of antimicrobials with hepatotoxic properties and high drug interaction probabilities. Therefore, this study aimed to develop a new treatment to VVC based on micelles containing curcumin (CUR) dispersed in a ureasil-polyether (U-PEO) hybrid. The physical-chemical characterization was carried out in order to observe size, shape, crystallinity degree and particle dispersion in the formulation and was performed by dynamic light scattering (DLS), scanning electron microscopy (SEM), X-ray diffraction (XRD) and through in vitro release study. The results of DLS and SEM exhibited micelles with 35 nm, and encapsulation efficiency (EE) results demonstrated 100% of EE to CUR dispersed in the U-PEO, which was confirmed by the DRX. The release results showed that CUR loaded in U-PEO is 70% released after 10 days, which demonstrates the potential application of this material in different pharmaceutical forms (ovules and rings), and the possibility of multidose based on a single application, suggesting a higher rate of adherence.

Driving Mechanism of Power Battery Recycling Systems in Companies

In recent years, international environmental and public health research has become a hot topic, and battery recycling, which is often mentioned separately from waste disposal, has likewise become an academic topic. Battery recycling research is beneficial not only for controlling toxic and harmful substances, but also for public health. In addition, battery recycling brings value-added benefits to company management. As the most important link in the battery supply chain, the driving mechanism of battery recycling in the new electric vehicle industry will become particularly important. The subject of battery recycling is diverse, and the relationships among influencing factors are complex, thereby presenting a fluctuating state. Against this background, this study constructs a system dynamics model from the perspective of a main sorting and recycling system, a technological innovation subsystem and a replacement subsystem. Moreover, this study examines the driving mechanism of the power battery recycling system of a microlevel company. Focusing on the systematic impact of technological innovation capability and substitution, we find that the technological innovation drive of companies increases the total effect of required costs and product demands. It is embodied in two aspects, that is, the increase in the recovery rate leads to an increase in demand, whereas the increase in actual expenditures is less than the increase in technology-driven benefits. After technological innovation capability is improved, the effect of the technological innovation multiplier on the driving mechanism of companies is shown as rapid response time changes. In the substitution component of a company recycling system, we find that the maximum substitution rate limiting expectations has no significant impact on product differentiation. The leading effect of technological innovation capability is more obvious than that of substitution activity. Based on these findings, several suggestions for company operation and environmental governance are presented.

Ex novo development of lead glassmaking in early Umayyad Spain

The Islamic conquest of the Mediterranean has long been associated with fundamental geopolitical and economic transformations that sundered the medieval world from antiquity. An eighth- to ninth-century glass assemblage from Cordoba provides new insights into the processes of technological innovation, adaptation, and dissemination contingent on the specific historical environment. Its compositional characteristics reveal the mechanisms underlying the development of a new glassmaking tradition that, based on lead isotope analyses, can be attributed to a local production, using raw materials from nearby ore deposits. Our study illustrates that the second half of the eighth century and the ninth century was a period of considerable technological development in al-Andalus, triggered by a rupture in glass supplies from the eastern Mediterranean.

This study investigates glass finds from the Iberian Peninsula as a proxy for identifying the mechanisms underlying technological transformations and innovation in the wake of the Arab conquest in the seventh and eighth centuries CE. High-resolution laser ablation inductively coupled plasma mass spectrometry data combined with lead isotope analyses of a precisely dated (mid-eighth century to 818 CE) glass assemblage from the Rabad of Šaqunda in Cordoba, capital of Umayyad Spain, enabled us to trace the origins of an Iberian glassmaking industry and to unambiguously link it to the exploitation of local raw materials. The analytical data reveal increased recycling, some isolated imports of Islamic plant ash glasses from Mesopotamia, and, most notably, the development of a new type of glassmaking technology that resorted to the use of lead slag from silver and lead mining and processing in the region around Cordoba. The production of this type of lead glass from Šaqunda was short-lived and was subsequently refined by introducing additional fluxing agents. The technological innovation of Islamic glassmaking in Spain evidently drew inspiration from adjacent high-temperature technologies. The revival of glass and the development of a local glassmaking tradition was indirectly related to the wider processes of Islamization, such as the introduction of glazed ceramics that are compositionally related to the lead glasses from Šaqunda.