Search Results (38)

COVID-19 still poses a global public health challenge, exerting pressure on radiology services. Chest X-ray (CXR) imaging is widely used for respiratory assessment due to its accessibility and cost-effectiveness. However, its interpretation is often challenging because of subtle radiographic features and inter-observer variability. Although recent deep learning (DL) approaches have shown strong performance in automated CXR classification, their black-box nature limits interpretability. This study proposes an explainable deep learning framework for COVID-19 detection from chest X-ray images. The framework incorporates anatomically guided preprocessing, including lung-region isolation, contrast-limited adaptive histogram equalization (CLAHE), bone suppression, and feature enhancement. A novel four-channel input representation was constructed by combining lung-isolated soft-tissue images with frequency-domain opacity maps, vessel enhancement maps, and texture-based features. Classification was performed using a modified Xception-based convolutional neural network, while Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to provide visual explanations and enhance interpretability. The framework was evaluated on the publicly available COVID-19 Radiography Database, achieving an accuracy of 95.3%, an AUC of 0.983, and a Matthews Correlation Coefficient of approximately 0.83. Threshold optimisation improved sensitivity, reducing missed COVID-19 cases while maintaining high overall performance. Explainability analysis showed that model attention was primarily focused on clinically relevant lung regions. Full article

This research examines the structural evolution and functional performance of urban spatial expansion in Changchun, Northeast China. Utilizing an integrated framework of the Adjusted Sprawl Index, Gaussian two-step floating catchment area (Gaussian 2SFCA) accessibility modeling, and XGBoost-SHAP machine learning, the study identifies a decoupled growth pattern where land development and infrastructure construction proceed without a corresponding increase in population density, reflecting a structural-demographic divergence. Empirical results demonstrate that land expansion reached a significant peak between 2015 and 2020, followed by a transition toward morphological equalization and stabilization after 2020. This process manifests as asynchronous urbanism, where the strategic deployment of physical infrastructure frameworks systematically precedes the functional integration of essential social services. The analysis reveals the emergence of localized service-value misalignment clusters in peripheral zones. The phenomenon represents a deviation from the traditional monocentric paradigm toward McCann’s framework of modern urban economics, as high residential valuations are sustained by social capital and institutional expectations despite physical service gaps. Within these clusters, the club realm and private enclosure function as critical forward-looking mechanisms, where the presence of influential groups signals future social and infrastructural investment. A negative interaction effect between property management levels and regional accessibility confirms that these private governance structures effectively substitute for maturing public resources. These findings suggest that future development should prioritize the functional integration of social systems over mere material expansion. Full article

Promoting the coupled and coordinated development of new-type urbanization and rural revitalization is important for achieving high-quality and sustainable growth in China. This study follows a people-centered and coordinated development approach and is aligned with the Sustainable Development Goals (SDGs). It builds a comprehensive evaluation framework for the two systems and measures and interprets their coupling and coordination. On this basis, and under the background of China’s territorial spatial planning, the study draws implications for land and spatial governance. The core of the study is to answer the following questions: What are the spatiotemporal patterns of the coupling coordination level between new-type urbanization and rural revitalization in China from 2014 to 2023? How has the coordination of their development speed evolved? What are the main sources of regional differences? Which factors are the key drivers that promote coordinated development between the two systems? The main findings are as follows. (1) The national coupling coordination degree increases steadily. Spatially, there is a pattern of “eastern region leading, central and northeastern regions catching up, and western region showing internal divergence”. This pattern is consistent with differences in development intensity and accessibility across regions. (2) From 2019 to 2023, the coordination of development speed improved in most provinces. A few developed or special provinces show short-term mismatch, which may reflect timing gaps between land-use controls and the provision of public services. (3) Gaps between regions are the main source of overall differences, and there is a trend toward convergence. This is in line with interregional equalization and the narrowing of efficiency gaps. (4) Well-being of residents, social development, and digital innovation are the core driving forces. Digital inclusive finance and the intensity of parcel delivery services also provide important support. There are clear interaction effects among the driving factors, and these effects are stronger in areas where planning improves accessibility and reduces transaction costs. Full article

Public cultural facilities are the cornerstone of the construction of the public cultural service system. Exploring the spatial pattern of public cultural service facilities is significant for clarifying regional differences in public cultural services, optimizing the allocation of urban cultural facilities, and promoting the equalization of public cultural services. This study constructs a dual-dimensional equalization evaluation system of geographical density and per capita quantity to reveal the spatial mismatch phenomenon of public cultural facilities in Xinjiang. Using methods such as the nearest neighbor index and kernel density analysis, combined with the geodetector, the distribution patterns of public cultural facilities in 14 prefectures and cities in Xinjiang are systematically analyzed. The results show that public cultural facilities in Xinjiang exhibit significant agglomeration characteristics, with museums having the most prominent spatial agglomeration degree (NNI = 0.523) and imbalance degree (S = 0.284). A spatial pattern centered on Urumqi characterized by “dense in the northwest and sparse in the southeast” has formed. There exists a spatial mismatch phenomenon between high-density and low-per capita population and low-density and high-per capita population in terms of geographical density and population distribution. Population size is the key factor in facility distribution, while cultural demand and economic level are the main factors, and fiscal capacity and education level are secondary factors, with transportation conditions being general factors. In this paper, we analyze the spatial differentiation characteristics of public cultural facilities in Xinjiang and the influencing factors in order to provide typical cases and practical references for optimizing the allocation of urban cultural facilities and promoting their equalization. Full article

The equitable distribution of basic educational services is crucial for attaining educational fairness and promoting balanced demographic and economic growth. This research leverages point-of-interest (POI) data to analyze the spatial arrangement of basic educational service facilities in the Yellow River Basin of China. Employing kernel density analysis and spatial autocorrelation with a geographic information system tool, this study examines the spatial distribution of these facilities. It also applies geographically weighted regression to identify the primary factors influencing their spatial layout. This study reveals a pronounced disparity between the four downstream and five upstream provinces of the Yellow River Basin in terms of basic educational facility availability. In the downstream provinces, facilities constitute 82.45% of the total, markedly surpassing the level of 17.55% in the upstream provinces. The kernel density analysis shows that areas with a high concentration of educational facilities often align with provincial capitals, including Taiyuan in Shanxi Province, Xi’an in Shaanxi Province, Zhengzhou in Henan Province, and regions around Shandong Province. Significant regional differences exist within the Yellow River Basin. Preprimary, primary, and secondary education facilities exhibit strong spatial clustering, with Moran’s I indices of 0.26, 0.19, and 0.09, respectively. High–high clusters of preprimary education are predominantly found in the western region of the basin, whereas low–low clusters appear in some eastern and northern areas. Primary and secondary educational facilities show high–high clustering in the north. The spatial distribution of these educational facilities is chiefly influenced by the permanent population and the proportion of the tertiary industry. Per capita gross domestic product (GDP) and educational fiscal expenditure play secondary roles in influencing the spatial layout. The results have important practical significance for promoting the equalization of basic education public services and equal educational opportunities for the school-age population in the Yellow River Basin. Full article

The digital economy enhances economic efficiency and improves economic structure, driving economic growth through transformations in efficiency, momentum, and quality. It has become a new driving force for advancing common prosperity. This study uses SDM, SDID, and SPSTR models to explore the impact of digital economy on common prosperity, which constructs the index system to evaluate the common prosperity from process index and outcome index. According to the panel data of 76 cities in the Yellow River Basin from 2011 to 2021, and the findings are as follows: (1) The digital economy exhibits a development pattern characterized by high activity downstream and lower activity upstream, and the development trend is stable. The development pattern of common prosperity has changed from sporadic distribution to regional agglomeration, and the level of common prosperity in most cities has improved. (2) The digital economy has a significant positive spatial effect on common prosperity. And the findings are robust after introducing the “Big Data” exogenous policy impact, dynamic SDM model, and other methods. Moreover, spatial heterogeneity exists. The promotion effect in the upper and lower reaches is stronger, while the middle reaches are weakly affected by the digital economy. (3) The spatial spillover effect of the digital economy on common prosperity has a boundary, and the positive spillover reaches a maximum value at 600–650 km. (4) Nonlinear analysis confirms that the digital economy provides momentum for common prosperity industrial structure optimization that can effectively stimulate the “endogenous” growth mechanism, strengthen the marginal increasing effect of the digital economy driving common prosperity and enhance the effect of “making a bigger pie”. The digital economy makes effective use of digital resources and technologies, promotes the equalization of public services, exerts a positive impact on the realization of common prosperity, and consolidates the effect of “dividing a better cake”. Full article

An important feature of China’s housing market is the coexistence of a high house-price- to-income ratio and high homeownership rates. The purpose of our study is to reveal the root causes of this paradox from a new perspective and theoretical foundation. Based on questionnaire data from Hangzhou and logistic regression models, our research finds that the most important factors driving middle and lower-income groups to buy homes are its unique household registration and school district housing system, underdeveloped housing rental market and inadequate regulatory system, and the wealth appreciation effect caused by the continued rise in housing prices. Furthermore, intergenerational wealth transfers, private lending, and China’s generous home mortgage policies have made homeownership possible for this groups. However, the high house-price-to-income ratio leads to heavy financial pressure on the middle- and low-income groups and is not conducive to sustainable and healthy economic development. To this end, we suggest that the government accelerate the equalization of public services, improve the regulatory system governing the rental housing market, and control the unreasonable rise in housing prices and diversify investment channels for residents. Full article

The equalization of marine public services is an effective way to achieve harmonious coexistence of the sea. In this paper, a variable fuzzy recognition model is used to measure the equalization level of marine public services in 11 provinces and cities in China’s coastal areas from 2006 to 2019. The Dagum Gini coefficient, kernel density estimation model, and convergence model are used to study their regional differences, distribution dynamics, and convergence characteristics. The results show that the equalization level of marine public services in China’s coastal areas increased year by year from 2006 to 2019. In terms of spatial distribution, the equalization level of marine public services in coastal areas presents an unbalanced distribution pattern. The overall regional differences in the equalization level of marine public services in China’s coastal areas have narrowed, and the inter-regional differences are the main reasons for the overall differences. The absolute difference in the equalization level of marine public services in China’s coastal areas shows an expanding trend. The equalization level of marine public services in China’s coastal areas has α convergence and β convergence. Full article

The spatial allocation of urban public sports facilities is critical for ensuring equitable access to basic public services and maintaining urban spatial cohesion. This study examines central cities in the Yangtze River Delta, utilizing Point of Interest (POI) data to characterize urban sports service facilities. Employing methods such as kernel density estimation, the nearest neighbor index, spatial autocorrelation, and coefficient of variation, this study analyzes the spatial aggregation, synergy, and equalization of sports service facilities at the community scale. The findings indicate that: (1) the spatial distribution of sports service facilities within community life circles demonstrates a clustered pattern, forming a concentric core-to-periphery structure, with notable variations in clustering degrees across different cities; (2) synergy among sports service facilities has significantly improved, with the emergence of multiple high-value clusters and low-value dispersions across various cities; and (3) the level of equalization of sports service facilities in community life circles follows the general order of Shanghai > Nanjing > Hangzhou > Hefei. These insights offer valuable guidance for the planning and optimization of urban public sports facilities. Full article

High-quality and equitable primary education services promote the building of a harmonious socialist society and are an important basis for improving people’s quality of life and promoting high-quality and sustainable regional development. Here, we take Chengdu City as a test area, integrate data from multiple sources, use the random forest model to simulate the distribution data of primary school-age children in Chengdu City in 2020, and use the kernel density estimation method and the multi-traffic mode two-stage floating catchment area method to measure the spatial distribution characteristics and accessibility of primary school educational facilities in Chengdu City and combine the imbalance index and spatial autocorrelation analysis, examination of the equalization of the distribution of primary school educational facilities, and the correlation between school-age population and accessibility. The results show that in the past decade, the population of Chengdu has grown rapidly, and the number of primary school-age children has also been increasing. The overall distribution of primary school-age children in Chengdu presents a decentralized pattern of “one point with multiple cores”, with the population decreasing from the center to the periphery, and the population distribution dominates the spatial distribution of primary school facilities, which also highlights the imbalance in the construction of primary school facilities to some extent (S = 0.257), which was mainly manifested by the fact that the central-eastern part of the city has more primary school facilities, while the western part has fewer. In addition, the results of both accessibility and autocorrelation analyses show that the overall accessibility of the central circle of Chengdu was high, while the accessibility of the second and third circles was at a lower level and below, with very obvious cross-regional and cross-circle differences. This study can not only provide more accurate recommendations for the allocation of educational facilities but also serve as a reference for evaluating the spatial equity of other public services in the city. Full article

Background: In the context of sustainable development, urban–rural integration is not solely focused on high economic growth but has been expanded to a wider range of social and ecological fields. Objectives: To analyze the spatial and temporal evolution of the coupling coordination level of urban–rural economic, social and ecological integration subsystems in the Yangtze River Delta and to explore its main obstacles, in order to provide countermeasures to promote the sustainable development of urban and rural areas. Methods: Panel data of 16 cities in the core area of the Yangtze River Delta from 2005 to 2020 were selected, and the entropy method was used to calculate the comprehensive development level of each subsystem, based on which the coupling coordination degree was measured by the coupling coordination model, and the obstacle degree of each indicator was obtained by the obstacle degree model. Outcomes: The urban–rural integration level kept a steady rise, and the “economy–society–ecology” coordination level transformed from borderline imbalances to moderate coordination. The high-value areas presented an initial “Π” shape distribution that later turned into a “>” shape, while the backward areas were primarily located at both ends of the north and south. The key obstacle factors included per capita GDP, population urbanization rate, urban and rural basic pension insurance coverage, faculty–student ratio in urban and rural primary and middle schools, per capita park green land, road network density and fertilizer application per unit area of sown. Recommendations: The systematic coordination of urban–rural integration should be promoted according to local conditions, with emphasis on broadening urban–rural communication channels, promoting the equalization of urban–rural public services and establishing the urban–rural collaborative mechanism for environmental maintenance. Full article

The scientific evaluation and identification of the relationship between urban comprehensive carrying capacity and urbanization in Northeast China, a famous old industrial base, is an important basis for realizing the overall revitalization of the region. Using a panel data set of 34 prefecture-level cities in Northeast China from 2003 to 2019, this study constructs an ordinary panel data model to identify the relationship between urban comprehensive carrying capacity and urbanization. The results show that urbanization has significantly positive effects on urban comprehensive carrying capacity, and there is a significant inverted U-shaped curve relationship between urban comprehensive carrying capacity and comprehensive urbanization in Northeast China, especially in the shrinking cites. In addition, the economic urbanization variables of the fixed-asset investment, the total retail sales of social consumer goods, and the social urbanization variable of internet users play significantly important roles in forming of the inverted U-shaped curve relationship with the urban comprehensive carrying capacity of the shrinking cities in Northeast China. Hence, innovation-driven economic regrowth, promoting equalization of basic public services, alleviating talent outflow, and strengthening the leading roles of the core cities are effective measures for improving urban comprehensive carrying capacity and urbanization quality in Northeast China. Full article

Background: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people’s quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. Methods: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. Results: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 “Floating so that staffing is equalised among units” is strongly associated with a shorter PU healing time. Conclusion: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times. Full article

Achieving the equalization of public services is one of the main goals of regional highquality development at this stage. It plays an important guiding role in optimizing the spatial pattern of a metropolis. Taking Beijing–Tianjin–Hebei as the research area, this paper used hotspot analysis, spatial measurement, and other methods to conduct quantitative analysis and empirical research based on POI data, census data, etc., to identify regional public service centers and population distribution centers, and compared and matched them. This study built public service evaluation indicators, comprehensively evaluated the public service level of each district and county in the region, established a spatial error model, and empirically analyzed the differences in the comprehensive public service level of 200 districts and counties in the Beijing–Tianjin–Hebei region. The results show that there is a certain degree of mismatch between the comprehensive hotspots of density of public service facilities and the hotspots of permanent populations in the Beijing–Tianjin–Hebei region. The spatial differentiation of the comprehensive level of public services is obvious, showing the characteristics of “high, middle, and low in the north” and “high in the core urban area and low in other districts and counties”. Government policies, economic development level, and the level of urbanization have a significant positive effect on the public service level. The article also discussed the policy implications of the conclusions, as well as corresponding countermeasures and suggestions. Full article

The intense development of urban–rural integration has brought about a constant increase in people’s demand for public culture. In particular, as the equalization of public cultural services is promoted, narrowing the gap between the services offered in urban and rural settings has gradually become the dominant orientation to promote urban–rural integration and enhance the rights and interests of the people. Starting from the principles of the new public service, this research conducted field interviews in Xuling Town, Anhui Province, China. The Zaltman metaphor elicitation technique (ZMET) was used to analyze the interview content, and five inferences about the construction of township public culture were drawn: (1) cultural facilities have a significant impact on township public cultural construction; (2) the role of cultural talents is essential but lack of talent is normal in townships; (3) carrying out cultural activities is the top priority of township public cultural construction; (4) cultural management is an indispensable auxiliary link but the management level is insufficient; (5) and the cultural activities of traditional festivals are particularly important. Moreover, on the basis of these five inferences, the fuzzy-set qualitative comparative analysis (fsQCA) method was used to analyze the survey data and verify the underlying problems around public cultural service effectiveness as well as resource allocation in township areas. Finally, countermeasures are proposed on how to narrow the gap, which are of reference significance for improving the quality of township public cultural services in the context of urban–rural integration and meeting the cultural needs of residents. Full article