Abstract:With the global trend of population aging, how to integrate the health needs of elderly people into public open space (POS) development while taking into account public interest is a major challenge in the 21st century. Although the issues of elderly people's health and their POS needs are receiving increasing attention, research on continuous improvement strategies for POS for healthy aging societies is still limited. Hence, this study explored continuous improvement strategies thoroughly and systematically by using the DANP-V model. The findings revealed cognitive differences between expert and elderly groups. Moreover, water features, waste management, and co-maintenance spaces were the three criteria with the largest gap value. POS improvement has previously been implemented based on a priority order ranked from the criterion with largest gap value to the criterion with the smallest one. However, an alternative approach based on the cause-effect relationship is proposed in this paper. The study findings have both theoretical and practical implications for POS planners and designers.

Global population is aging, particularly in developed countries and cities. Through the "Friendly Elderly Cities" and "Aging in Place" initiatives, various countries are making great efforts to improve the welfare and quality of life of the elderly, with the aim of catering to the physical and spiritual health as well as social welfare of the elderly. In this regard, the improvement of the housing environment of the elderly is one of the key factors in their quality of life and health. This study aims to effectively assess and improve the housing environment of the elderly in order to enhance their quality of life; it also aims to contribute the knowledge about improving elderly housing by applying an assessment framework using expert interviews and data collected from relevant literature. Using a mixed Multi-Criteria Decision Analysis model, a combination of the DEMATEL (Decision Making Trial and Evaluation Laboratory)-based ANP (Analytic Network Process) (DANP) and the modified VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) methods, and the investigations and assessments in the case study, this study proposes strategies and directions for improving elderly housing. The study results indicate that, as distinct from using traditional methodologies where the hypothesis criteria are mutually independent, the proposed hybrid model (examining real-life problems by considering the mutual influences of factors) identifies a priority sequence wherein emphasis is placed on improving ventilation and air quality rather than adjustment of temperature. The systemic way of thinking shifts the focus from the most apparent problems to the root cause of the problems. Doing so avoids any mismatch of resource allocation in decision-making and thus maximizes the efficiency and sustainability of the improvement.

Climate change-related anomalies have increased public concern regarding environmental protection. This has opened newer rural development avenues. In this regard, livability of villages is crucial; it can be evaluated based on the villagers’ quality of life (QoL). The WHOQOL-BREF, a comprehensive cross-cultural and cross-disciplinary scale proposed by the World Health Organization to assess QoL, has aided in assessing and improving QoL in different regions. However, the factors of this instrument are mutually influential, necessitating an improvement strategy considering the entire system. This problem may be resolved using the DANP-mV model. However, the traditional DANP-mV model includes many items and responding to all of them is difficult for experts. Therefore, by using the case of Xingshisi Village in China, this study proposed a modified DANP-mV model to provide additional suggestions for systematic improvement of the QoL and livability in the village. Xingshisi is a model village built according to an aspirational benchmark; however, different from the traditional definition of a benchmark, this village exhibits room for improvement. Although the modified model reduces the number of questions from 650 to 168, its effect remains similar to that of the traditional model. Moreover, in the modified model, physical capacity (D1) presented the largest dimensional gap. The interaction among the factors indicated that considering the effect of the environment (D4) and developing a systematic improvement strategy are necessary to improve the livability of villages facing limited resources.

With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV) model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP), and Shen-Ji New Village (SJNV), are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP), and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives). Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of resource allocation could be more efficient improvement strategies generated in this proposed model.

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The prevention and control of nosocomial infection (NI) are becoming increasingly difficult, and its mechanism is becoming increasingly complex. A globally aging population means that an increasing proportion of patients have a susceptible constitution, and the frequent occurrence of severe infectious diseases has also led to an increase in the cost of prevention and control of NI. Medical buildings’ spatial environment design for the prevention of NI has been a hot subject of considerable research, but few previous studies have summarized the design criteria for a medical building environment to control the risk of NI. Thus, there is no suitable evaluation framework to determine whether the spatial environment of a medical building is capable of inhibiting the spread of NI. In the context of the global spread of COVID-19, it is necessary to evaluate the performance of the existing medical building environment in terms of inhibiting the spread of NI and to verify current environmental improvement strategies for the efficient and rational use of resources. This study determines the key design elements for the spatial environment of medical buildings, constructs an evaluation framework using exploratory factor analysis, verifies the complex dominant influence relationship, and prioritizes criteria in the evaluation framework using the decision-making trial and evaluation laboratory- (DEMATEL-) based analytical network process (ANP) (DANP). Using representative real cases, this study uses the technique for order preference by similarity to ideal solution (TOPSIS) to evaluate and analyze the performance with the aspiration level of reducing the NI risk. A continuous and systematic transformation design strategy for these real cases is proposed. The main contributions of this study include the following: (1) it creates a systematic framework that allows hospital decision-makers to evaluate the spatial environment of medical buildings; (2) it provides a reference for making design decisions to improve the current situation using the results of a performance evaluation; (3) it draws an influential network relation map (INRM) and the training of influence weights (IWs) for criteria. The sources of practical problems can be identified by the proposed evaluation framework, and the corresponding strategy can be proposed to avoid the waste of resources for the prevention of epidemics.

Objective: To develop a big data intelligence platform for secondary use of electronic health records (EHRs) data to facilitate research for nasopharyngeal cancer (NPC). Methods: This project was launched in 2015 and carried out by the cooperation of an academic cancer centre and a technology company. Patients diagnosed with NPC at Sun Yat-sen University Cancer Centre since January 2008 were included in the platform. Standard data elements were established to defined 981 variables for the platform. For each patient, data from 13 EHRs systems were extracted, integrated, structurized and normalized. Eight functional modules were constructed for the platform to facilitate the investigators to identify eligible patients, establish research projects, conduct statistical analysis, track the follow-up, search literature, etc. Results: From January 2008 to December 2018, 54,703 patients diagnosed with NPC were included. Of these patients, 39,058 (71.4%) were male, and 15,645 (28.6%) were female; median age was 47 (interquartile range, 39–55) years. Of 981 variables, 341 were obtained from data structurization and normalization, of which 68 were generated by interacting multiple data sources via well-defined logical rules. The average precision rate, recall rate and F-measure for 341 variables were 0.97 ± 0.024, 0.92 ± 0.030, and 0.94 ± 0.027 respectively. The platform is regularly updated every seven days to include new patients and add new data for existing patients. Up to now, eight big data-driven retrospective studies have been published from the platform. Conclusion: Our big data intelligence platform demonstrates the feasibility of integrating EHRs data of routine healthcare, and offers an important perspective on real-world study of NPC. The continued efforts may be focus on data sharing among multiple hospitals and publicly releasing of data files. Advances in knowledge: Our big data intelligence platform is the first disease-specific data platform for NPC research. It incorporates comprehensive EHRs data from routine healthcare, which can facilitate real-world study of NPC in risk stratification, decision-making and comorbidities management.

Due to the unbalance between Asian and Western countries in terms of higher education development and pressure from global competition, universities in several East Asian countries have striven to become world-class universities (WCUs) by actively assessing themselves using various global ranking systems and subsequently investing in key performance indicators. Numerous scholars have suggested that for these East Asian catch-up universities (EACUs), independently improving the elements related to high-weight indicators could produce short-term increases in ranking performance; however, this approach is not conducive to sustainable development. In addition, little is currently understood regarding sustainable development strategies for developing EACUs into WCUs. This study proposes a systematic evaluation model for self-assessment and the creation of strategies to transform EACUs into sustainable WCUs. The fuzzy Delphi method was used to determine criteria for a new evaluation framework, and the decision-making trial and evaluation laboratory method was employed to construct the influential relationships among the criteria. Two cases were then selected to demonstrate the superiority of the model for creating sustainable development strategies for EACUs. This study provides a systematic perspective and a useful tool for decision-makers at EACUs to achieve sustainable development goals.