Green development is an effective way to achieve economic growth and social development in a harmonious, sustainable, and efficient manner. Although the Yangtze River Economic Belt (YREB) plays an important strategic role in China, our understanding of its spatiotemporal characteristics, as well as the multiple factors affecting its green development level (GDL), remains limited. This study used the entropy weight method (EWM) to analyze the temporal evolution and spatial differentiation characteristics of the GDL in the YREB from 2011 to 2019. Further, fuzzy-set qualitative comparative analysis (fsQCA) was used to analyze the influence path of GDL. The results showed that the GDL of the YREB increased from 2015 to 2019, but the overall level was still not high, with high GDL mainly concentrated in the lower reaches. The GDL model changed from being environmentally driven and government supported in 2011 to being environmentally and economically driven since 2014. The core conditions for high GDL changed from economic development level (EDL) to scientific technological innovation level (STIL) and environmental regulation (ER). The path for improving GDL is as follows: In regions with high EDL, effective ER, moderate openness level (OL), and high STIL are the basis, supplemented by a reasonable urbanization scale (US). In areas with low EDL, reasonable industrial structure (IS) and STIL are the core conditions for development; further, EDL should be improved and effective ER and OL implemented. Alternatively, without considering changes to EDL, improvement can be achieved through reasonable OL and US or effective ER. This study provides a new method for exploring the path of GDL and a reference for governments to effectively adjust green development policies.

Objectives Repeated presentations to emergency departments (EDs) may indicate a lack of access to other health care resources. Age is an important predictor of frequent ED use; however, age-varying effects are not generally investigated. This study examines the age-specific effects of predictors on ED presentation frequency for children in Alberta and Ontario, Canada. Methods This retrospective study used population-based data during April 2010 to March 2017. Data were extracted from the National Ambulatory Care Reporting System for children aged <18 who were members of the top 10% of ED users in any one of the fiscal years 2011/2012 to 2015/2016 along with a comparison sample from the bottom 90%. A marginal regression model studied the age-varying associations on the frequency of ED presentations with province, sex, access to primary health care provider (for Ontario only), area of residence and lowest neighbourhood income quintile. Results There were 2,481,172 patients who made 9,229,156 ED presentations. The effects of sex, lowest income quintile, rural residence, access to primary health care provider and province on the frequency of presentations varied by age. Notably, boys go from having more frequent presentations than girls when aged ≤5 (i.e. adjusted intensity ratio [IR]=1.04 at age 5, 95% confidence interval [CI] = 1.03,1.06) to less frequent for ages 8–11 years and beyond 14 (i.e. IR = 0.80 at age 15, 95% CI = 0.78,0.81). Adolescents aged ≥15 without access to a primary care provider had more frequent presentations compared to those with a primary care provider. Conclusions When examining the frequency of ED presentations in children, age-varying effects of predictors should be considered. Our more nuanced examination of age provides insights into how health services might better target programmes for different ages to potentially reduce unnecessary ED use by providing other health care alternatives.

Background With the rapid development of telemedicine, has enabled new and various ways to deliver health care services for patients with schizophrenia. However, it is not clear that the newly emerged is better than the standard or not from the perspective of patients with schizophrenia. This study aims to explore their preferences between telemedicine and standard health care services and their associated factors. Methods The cross-sectional study was conducted at the Ningan hospital’s inpatient department in Yinchuan, and collected socio-demographic and clinical information, the preferences regarding telemedicine (WeChat, telephone, and Email), and the standard health care services (community health center and home visit). The socio-demographic and clinical characteristics associated with the five-health care service delivery ways were assessed by descriptive analysis, and the associated impact factors of preferences of patients with schizophrenia were analyzed by multiple logistic regression. Results Among the 300 participants, most of them chose WeChat (46.3%), some of them tended to telephone (35.4%) and community health center (11.3%), and a few of them accepted home visits (4.7%), and Email (2.3%). There are so many associated factors that affected the patients with schizophrenia to choose their favorite health care services, of which age, gender, employment, residence, and duration of illness were the independent impact factors. Conclusions The cross-sectional study surveyed the preferences between telemedicine and standard health care services in patients with schizophrenia’s opinion, disclosed independent impact factors, as well as compared the advantage and disadvantages of these. According to our findings, the best health care services should be based on the preferences of the patients with schizophrenia and adapt to realistic conditions. This provides valuable evidence to improve the health care situation, facilitate the continuity of health care services, and achieve holistic rehabilitative outcomes for the patients with schizophrenia.

The treatment effects of the same therapy observed from multiple clinical trials can be very different. Yet the patient characteristics accounting for the differences may not be identifiable in real practice so that it is necessary to estimate and report the overall treatment effect for the general popoulation during the development and validation of a new therapy. The non-linear structure of the maximum partial likelihood estimates for the (log) hazard ratio defined with a Cox proportional hazard model leads to challenges in the statistical analyses for combining such clinical trials. In this paper, we formulated the expected overall treatment effects using various modeling assumptions. Then we proceeded to propose efficient estimates together with a version of Wald test for the combined hazard ratio using only aggregate data. Interpretation of the methods are provided in the framework of robust data analyses involving misspecified models.