Assessment of burnout, resilience, and thriving among academic health professionals: findings from an international study.

Introduction: Burnout, resilience, and thriving significantly impact academics, particularly in health professions, where responsibilities are extensive. This study aimed to explore these constructs among academic health professionals, examining sociodemographic and work-related factors influencing these outcomes. Methods: A cross-sectional study was conducted among academic health professionals via web-based professional networks from August 2022 to February 2023. Validated tools were used, and descriptive and inferential statistics were applied. Results: 505 participants were included, predominantly female (63%), with a mean age of 38.15 ± 9.6 years. High burnout was reported by 10.9%, 13.7% experienced exhaustion, and 6.3% were disengaged. Resilience and thriving were moderate at 59.2 and 51.9%, respectively. Age correlated negatively with burnout (r = -0.131, p = 0.003) but positively with resilience (r = 0.178, p < 0.001). Females reported higher exhaustion (p = 0.014), while males showed greater resilience (p = 0.016). Instructors exhibited lower resilience compared to assistant professors (p < 0.001) and associate professors (p < 0.001). Those at public universities reported higher exhaustion than those at private universities (p < 0.001). Conclusion: Variable levels of burnout, resilience, and thriving were observed among academic health professionals, influenced by sociodemographic and work-related factors. Interventions targeting resilience and thriving may mitigate burnout risk and enhance engagement among academics in health professions.

[Resources and utilization of medicinal plants in countries and regions involved in "the Belt and Road" Initiative].

The protection, development, and utilization of medicinal plant resources are important cornerstones of maintaining human health. However, due to factors such as the reduction of high-quality land resources, deterioration of ecological environments, and excessive and disorderly resource development, medicinal plant resources are becoming scarce, and some of them are insufficiently supplied. With the proposal of "the Belt and Road" Initiative, the cooperation between China and "the Belt and Road" partners(the countries and regions involved in "the Belt and Road" Initiative)is increasingly close, which provides a new opportunity for carrying out trade of medicinal plant resources and alleviating the problem of imbalance and relative inadequacy of medicinal plant resources in countries. This study first determined the distribution and species information of plant resources in countries and regions involved in "the Belt and Road" Initiative by investigating the database of plant distribution and that of medicinal plant resources. Then, according to the published data from the International Union for Conservation of Nature(IUCN) and the Convention on International Trade in Endangered Species of Wild Fauna and Flora(CITES), this study identified the rare and endangered medicinal plants and the medicinal plants under trade control in countries and regions involved in "the Belt and Road" Initiative and finally sorted out the list of potential medicinal plant resources in countries and regions involved in "the Belt and Road" Initiative that can be used by China. This data resource can not only be used for the overall protection of important endangered species but also scientifically guide the development and utilization of medicinal resources, providing guidance and a theoretical basis for the sustainable development of medicinal plant resources in countries and regions involved in "the Belt and Road" Initiative.

Characteristics and outcomes of the drug patent linkage system in China.

BACKGROUND: On July 4, 2021, China officially introduced the drug patent linkage system, which has made more localized adjustments than have similar systems in the US and South Korea. This study describes the characteristics and outcomes of China's patent linkage system. METHODS: For this study, we used the database of China's patent information registration platform for marketed drugs to capture all listed patents and patent certifications from June 25, 2021, to June 30, 2023. We used descriptive statistics for the above data to assess the impact of patent linkage on branded drug manufacturers, generic drug manufacturers, and the public's access to medicines. RESULTS: During the study period, the patents of 632 branded drugs were listed, and 5058 ANDAs submitted patent certifications to the Registration Platform. Of these 632 branded drugs, 462 (73.1%) drugs were approved before the year of patent registration, and the average number of listed patents per drug was 1.8, with a standard deviation of 1.4. However, of these 5058 ANDAs, P1 certifications accounted for 85.1%, and P3 and P4 certifications accounted for 16% combined. In addition, according to the detailed statistics of P2 certifications, we found that the proportion of patent invalidation cases was 46.4%. The remaining validity of the patents corresponding to P3 certifications was longer, with a median value of 17 months, and the IQR was 10-30.75, ranging from - 2 to 204 months. CONCLUSIONS: China's patent linkage aims to promote the balance of multiple interests -innovation, imitation and public health-and has its own system characteristics. Patent listing and patent certification are the key indicators reflecting the implementation effect of the system. From the perspective of system outcomes, ANDAs have been connected to the patent linkage system in an orderly manner, but the growth of patent challenges is not obvious. Moreover, manufacturers of foreign branded drugs that have not yet entered the Chinese market need to pay more attention to the role of patent listing.

Assessing the technical efficiency performance of Chinese ports logistics: Evidence from the DEA and fsQCA.

Ports are critical centers of international trade and global logistics now that economic globalization has taken hold. The efficiency performance of port logistics is crucial to building an emerging pattern of development in which domestic and foreign dual cycles are complementary for China. This paper examines the efficiency performance of 19 ports within five major economic circles in China. It explores how their efficiency is distributed, and the configurations of efficiency improvement during the new normal of China's economy. First, the DEA-BCC model is employed to calculate the technical efficiency performance and distribution of each port from 2011 to 2020. Then, fuzzy-set qualitative comparative analysis (fsQCA) was applied to integrate and analyze the influencing factors. The results show as follows: (1) Each port group performed differently on efficiency rankings, as well as regional distributions. Among these, the port groups of the Bohai Rim region, the Yangtze River Delta region, and the Bohai Rim region continue to rank highly. (2) From the perspective of configuration analysis, the results suggest that government support is not necessary for port logistics with better economic endowments. However, it is critical for backward ones. (3) A rational industrial structure can enhance levels of infrastructure, openness, and information technology, improving port performance. The findings can provide theoretical and practical references for better promoting the development of Chinese port management.al references for better promoting the development of Chinese port management.

The effectiveness of emerging markets' legal structure in explaining financial development.

This article examines the role of legal structure in explaining financial development in twenty-three emerging markets, which has not been explored in institutional economics literature before. This study relied on Pedroni, and Kao cointegration tests, which is followed by the renowned panel cointegration technique. The results of the Pedroni and Kao cointegration tests show that the variables understudy is cointegrated in the long-run. These findings are confirmed by the panel cointegration showing that legal structure (LS) has positive impact on financial development (FIND) in long-run that support Law and Finance, and New Institutional Economics theories in emerging markets. This study is the first to directly examine the long-run impact of LS on FIND in emerging markets, and the result remains consistent across alternative measure of FIND. The findings of this study have important policy implications for emerging markets. Policymakers should focus on creating a legal environment that is conducive to financial development. This includes strengthening the legal framework, improving regulatory regimes, and promoting market autonomy. Additionally, policymakers should work to attract foreign investment, which can help spur economic growth and development in emerging markets. The findings of the study are consistent across battery of robustness testing.

Diversity of returnee executives' foreign experience and corporate social responsibility performance.

Top managers' past experiences (e.g., foreign experience) significantly impact their decision-making behavior, which may influence firms' sustainable development. The available literature, focusing on the role of the increase in the number of top executives with foreign experience in corporate social responsibility (CSR), yields mixed results. In order to clarify the ambiguous relationship between executive foreign experience and CSR, we empirically examine the effect of the geographic diversity of top executives' foreign experience on CSR. Based on a hand-collected dataset of the top management team's (TMT's) foreign experience, we demonstrate the positive impact of the geographic diversity of returnee executives' foreign experience on firms' CSR using Chinese A-share listed firms from 2009 to 2018. Moreover, this impact is stronger in firms with political connections with the central government and in regions with good market development. Furthermore, the mechanism analysis shows that returnee executives drive firms' CSR by promoting corporate donations and green innovation. This paper offers clear policy implications by suggesting that hiring returnees with a broad geographic scope of foreign experience as corporate executives is an efficient way to enhance firms' CSR.

The adoption of renewable energy towards environmental sustainability: Evidence from Partial Least Square Structural Equation Modelling (PLS-SEM).

The effect of carbon emissions on the environment has made some of the Sustainable Development Goals difficult to achieve. Despite the efforts of international bodies, there is still a need to address the problem since the transition is not complete. Therefore, this study investigates the effect of globalization, economic growth, financial inclusion, renewable energy, and government institutions on carbon emissions from the period of 1998 to 2021. To be able to assess both the direct and indirect effects of the variables, the Partial Least Square Structural Equation Modelling is employed, where renewable energy serves as the mediator, and the Two-Stage Least Squares is employed as the robustness check. The findings of the study reveal that globalization promotes the use of renewable energy, but financial inclusion has a negative effect on renewable energy use. Renewable energy has a direct positive and significant effect on carbon emissions. Financial inclusion has an indirect negative and significant effect on carbon emissions. The results imply that more enlightenment on financial inclusion will help a smooth transition, and globalization should be embraced when all environmental regulations are enforced.

Current progress in international pediatric emergency medicine.

PURPOSE OF REVIEW: Over the past four decades, pediatric emergency Medicine (PEM) has witnessed significant global development, with a notable increase in training programs and official recognition by regulatory bodies. However, disparities persist in the recognition of PEM as an independent subspecialty, availability of training programs on a global scale, academic recognition, and the ability to provide high-quality care to children worldwide. There is paucity of published literature regarding development of PEM globally. This review explores the current trends and challenges in international pediatric emergency medicine. RECENT FINDINGS: Current trends in international pediatric emergency medicine encompass the provision of training in pediatric-focused emergency and acute care, increased propagation of evidence-based guidelines specific to the care of children, the growth of collaborative research networks and interest groups within national and international societies. Simultaneously, the field continues to face challenges such as the lack of recognition, inequities in access, and a lack of dissemination of global PEM initiatives. SUMMARY: While recent advancements have significantly enhanced the state of international pediatric emergency medicine, including pediatric specific research networks and training programs, barriers still hinder its overall quality. Many of these obstacles are not unique to pediatric emergency medicine but are directly affected by financial disparities and lack of governmental and public recognition of the essential role of pediatric emergency care.

Impact of sanitary and phytosanitary measures on agri-products quality upgrading and environmental protection.

Protecting human, animal, and plant life or health from additives, toxins, and contaminants in agri-products and promoting green free trade are the main components of Sanitary and Phytosanitary (SPS) measures. However, the SPS measures are heterogeneous. This study examines the impact of SPS measures on the measured export quality and discusses their influence on the environmental protection of the exporting country. International heterogeneous measures do not necessarily promote quality upgrading but greatly increase transaction costs. By contrast, China's agri-product' quality upgrading and environmental pollution are in sharp contrast. Based on a heterogeneous firm-trade model, this study obtains three hypothetical propositions and conducts empirical regressions using the Tobit method. This study finds that heterogeneous SPS measures hinder quality upgrading because firms present a different quality upgrading trend, which in turn impedes the environmental protection of the exporting country; the quality upgrading made by diversified SOEs is higher than that of foreign firms and private firms; the quality upgrading made by general firms is higher than that of processing firms; and protective SPS measures have a stronger negative effect on quality upgrading and environmental protection.

Research on the impact of equity incentive model on enterprise performance: A mediating effect analysis based on executive entrepreneurship.

In implementing the equity incentive system, this paper delves into the listed enterprises' selection of equity incentive models. While previous research has extensively covered the effects, models, and influencing factors of equity incentives, there needs to be more in-depth literature focusing on the diverse incentive models and their impact on corporate performance. Notably, there needs to be more literature on considering entrepreneurial spirit as a mechanism. It aims to explore the relationship between executives' choices under different incentive models, the entrepreneurial spirit fostered by these models, and their combined impact on corporate performance. The findings reveal that adopting the restricted stock incentive model by listed enterprises implementing the equity incentive system significantly positively affects enterprise performance. Mechanistic tests show that when a company implements the restricted stock incentive model, executives prioritize maximizing their interests, leading them to embrace more risk in their investment decisions. This behavior, in turn, stimulates the adventurous spirit of executives, positively impacting enterprise performance, particularly pronounced in companies with more concentrated executive power. Moreover, executives may be more inclined to invest in high-risk, high-reward innovative projects, a behavior indicative of innovation and more prevalent in firms with higher research and development (R&D) investment. However, the limitation of this paper is that the study evaluates the operation of the equity incentive system in China by taking listed companies in China as an example, which is not necessarily suitable for foreign developed capitalist countries. This study contributes to the study of principal-agent problems by exploring the relationship between executives, entrepreneurship and firm performance.

[The long 1992 year in medicinal (non-)security of Russia. Report I. Market trial].

The year 1992 is an important landmark in the history of Russian pharmaceutical market. It began not in January, but in December 1991, when orders of the President and the Government to open free market of medications were promulgated. The Yeltsin advisers conceived that market economy was infallible means to combat medication shortages, corruption and bureaucratic monopoly. However, panacea did not work. Moreover, it gave rise to completely new problems. The human and state security implies protection from threats of dependence. The unprepared dive into market plunged Russians and the country into deep dependence on imported medications and foreign pharmaceutical companies. The proposed study proceeds our publications in this journal and in journal "Pharmacia" in 2022. At that time, analysis of medication "famine" was implemented on basis of published sources and relied on journalistic evidences. The current study was carried out on the basis of archive documents of the Ministry of Health of the Russian Federation and authors interviews of representatives of the regulator. The first report reveals administrative mechanism that engendered crisis of medication supply in the first post-Soviet year of our country.

The association between disability and all-cause mortality in low-income and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: There are 1·3 billion people with disabilities globally. On average, they have poorer health than their non-disabled peers, but the extent of increased risk of premature mortality is unknown. We aimed to systematically review the association between disability and mortality in low-income and middle-income countries (LMICs). METHODS: We searched MEDLINE, Global Health, PsycINFO, and EMBASE from Jan 1, 1990 to Nov 14, 2022. Longitudinal epidemiological studies in any language with a comparator group that measured the association between disability and all-cause mortality in people of any age were eligible for inclusion. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. We used a random-effects meta-analysis to calculate the pooled hazard ratio (HR) for all-cause mortality by disability status. We then conducted meta-analyses separately for different impairment and age groups. FINDINGS: We identified 6146 unique articles, of which 70 studies (81 cohorts) were included in the systematic review, from 22 countries. There was variability in the methods used to assess and report disability and mortality. The meta-analysis included 54 studies, representing 62 cohorts (comprising 270 571 people with disabilities). Pooled HRs for all-cause mortality were 2·02 (95% CI 1·77-2·30) for people with disabilities versus those without disabilities, with high heterogeneity between studies (τ2=0·23, I2=98%). This association varied by impairment type: from 1·36 (1·17-1·57) for visual impairment to 3·95 (1·60-9·74) for multiple impairments. The association was highest for children younger than 18 years (4·46, [3·01-6·59]) and lower in people aged 15-49 years (2·45 [1·21-4·97]) and people older than 60 years (1·97 [1·65-2·36]). INTERPRETATION: People with disabilities had a two-fold higher mortality rate than people without disabilities in LMICs. Interventions are needed to improve the health of people with disabilities and reduce their higher mortality rate. FUNDING: UK National Institute for Health and Care Research; and UK Foreign, Commonwealth and Development Office.

Fishing for oil and meat drives irreversible defaunation of deepwater sharks and rays.

The deep ocean is the last natural biodiversity refuge from the reach of human activities. Deepwater sharks and rays are among the most sensitive marine vertebrates to overexploitation. One-third of threatened deepwater sharks are targeted, and half the species targeted for the international liver-oil trade are threatened with extinction. Steep population declines cannot be easily reversed owing to long generation lengths, low recovery potentials, and the near absence of management. Depth and spatial limits to fishing activity could improve conservation when implemented alongside catch regulations, bycatch mitigation, and international trade regulation. Deepwater sharks and rays require immediate trade and fishing regulations to prevent irreversible defaunation and promote recovery of this threatened megafauna group.

The potential for cascading failures in the international trade network.

In our study, we introduce indicators that quantify the influence of each country in complex trade scenarios involving the exchange of raw materials, intermediate goods, and final products across multiple countries. We systematically employ an agent-based model to simulate the propagation of failures from one node to the entire network. This approach allows for the assessment of the impact of each country and the identification of patterns of interaction in the multi-step trade network. Unlike conventional analyses of trade networks, which depict straightforward single-step import/export transactions, our approach captures the intricate realities of processes like raw material procurement, production, and sales in numerous countries from a macroscopic perspective. The findings of our analysis of trade data spanning from 1990 to 2022 reveal several key insights. Firstly, sensitivity to changes in trade volume leading to global failures within interconnected networks has intensified over time. The potential of failure propagation across countries has increased over time, as has the interconnectedness of countries in the global trade landscape. Secondly, despite the increased sensitivity to changes in global trade volume, many countries have become less vulnerable to the influence of others within their multi-step trade networks. This trend aligns with deglobalization, which is evidenced by events such as Brexit and the surge in protectionist measures; these changes indicate a shift in the balance of influence within global trade networks. Thirdly, the results of our analysis of the relationship between load changes and global failures from a regional perspective reveal an intriguing phenomenon: despite limited direct trade connectivity, the interaction between the Latin American and Sub-Saharan African regions is considerable. This suggests the existence of hidden connections between intermediary countries, such that one region's actions can alter the load sensitivity of another, impacting them in unforeseen ways. Furthermore, intra-regional interactions are diminishing in East Asia, while Europe is experiencing a gradual increase in interactions. These trends reflect evolving regional influence, the dynamics of geographic proximity, and the results of economic integration efforts. Additionally, even though the observed period was not long enough to confirm a long-term trend, the previous trend direction was affirmed to persist despite a temporary decrease in trading and reduced sensitivity due to the COVID-19 pandemic. Our study highlights the complexity of global trade dynamics and the need to consider multi-step trade networks and their potential cascading effects when analyzing trade patterns and vulnerabilities.

Globalization, platform work, and wellbeing-a comparative study of Uber drivers in three cities: London, Helsinki, and St Petersburg.

BACKGROUND: Globalization of platform work has become a challenge for wider social and employment relations and wellbeing of workers, yet on-location work remains governed also by local regulatory context. Understanding common challenges across countries and potential for regulatory measures is essential to enhance health and wellbeing of those who work in platform economy. Our comparative study on platform work analyzed concerns of Uber drivers in three cities with a different regulatory and policy context. METHODS: Drawing from current understanding on employment and precarity as social determinants of health we gathered comparative documentary and contextual data on regulatory environment complemented with key informant views of regulators, trade unions, and platform corporations (N = 26) to provide insight on the wider regulatory and policy environment. We used thematic semi-structured interviews to examine concerns of Uber drivers in Helsinki, St Petersburg, and London (N = 60). We then analysed the driver interviews to identify common and divergent concerns across countries. RESULTS: Our results indicate that worsening of working conditions is not inevitable and for drivers the terms of employment is a social determinant of health. Drivers compensated declining pay with longer working hours. Algorithmic surveillance as such was of less concern to drivers than power differences in relation to terms of work. CONCLUSIONS: Our results show scope for regulation of platform work especially for on-location work concerning pay, working hours, social security obligations, and practices of dismissal.

Influence of international industrial transfer on the structural power of global value chain -Empirical evidence from manufacturing in RCEP Countries.

International industrial transfer (IIT) has spawned changes in the deep-seated structural power of value-added. We creatively construct an IIT index which includes both scale and direction, and constructs the structural power (SP) of value-added based on added value. Furthermore, based on 15 RECP countries from 1995 to 2018, this study uses a two-fixed-effect regression model to investigate the IIT on the structural power of value-added of RCEP countries. The results show that: (1) IIT can significantly promote the structural power of value-added of RCEP countries, and the benchmark regression conclusion is still valid after a series of robustness tests; (2) Heterogeneity analysis shows that IIT has a more significant promoting effect on the structural power of value-added in developed countries than in developing countries and a more significant promoting effect on the structural power of value-added inward than on the structural power of value-added outward; (3) Intermediary mechanism test shows that IIT mainly affects the structural power of value-added through trade openness and foreign direct investment. The conclusions of this paper provide useful enlightenment for enhancing the structural power of manufacturing value-added in RCEP countries in the context of global value chain division.

[Foreign Medicine "Angdi Moniu" in Qing Dynasty Court].

There is a kind of historical relics called "Angdi moniu" in the Palace Museum, which looks like metal and appears frequently in the archives of the Qing Dynasty as a foreign medicine.It is stated that it can treat sores and pus in the HanXiu CaoTang Biji and it was also found in the archives of the Palace Office. However, no researcher in the academic community has yet conducted an in-depth research of what exactly is it. Through the investigation of cultural relics, in-depth research of Chinese and foreign literature, and the use of linguistic methods, this paper examines "Angdi Moniu" and its related items, and clarifies that "Angdi Moniu" is antimony, related items are antimonials and antimony cup.

Bank market structure and firm innovation-evidence from China.

This study explores the impact of bank market structure on firm innovation in China using a two-way fixed effects model. Our analysis is based on a dataset comprising 2,412,316 firm-city level observations. Our findings suggest that there exists a U-shaped relationship between bank market structure and firm innovation in China. Specifically, we identify that the financing channel is a crucial pathway through which bank market structure influences firm innovation. Moreover, our results indicate that this relationship is mainly driven by small firms and innovative firms, and is more pronounced in regions with stronger intellectual property rights protection or greater openness to foreign markets. In sum, this study contributes to the existing literature by advancing our understanding of the impact of bank market structure on innovation in Chinese firms.

Spatial effect of biomass energy consumption on carbon emissions reduction: the role of globalization.

As globalization proceeds, increasing biomass energy consumption is an important pathway to replace fossil fuels for tackling climate change by reducing emissions. This study explores the spatial spillover effect in biomass energy carbon reduction, which is frequently ignored when investigating environmental factors. It uncovers whether globalization and its dimensions can strengthen the spatial effect of biomass energy carbon reduction. Besides, we reveal whether biomass energy consumption can promote CO2 emissions reduction while ensuring economic progress. Results show that (1) owing to the spillover effect, biomass energy consumption plays a significant role in direct and indirect enhancing carbon emissions reduction, with their feedback effects of - 0.003 or 3.3% of the direct effect. (2) Increasing overall, social and political globalization enhances biomass energy consumption's carbon reduction effect. (3) In countries with higher economic development, overall, economic and political globalization has a better promotion in the spatial effect of biomass energy carbon reduction. (4) Developing biomass energy can support the environment quality while enhancing economic growth.