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The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

The purpose of this paper is to investigate the hydrodynamic performance of liquid film seals with oblique grooves (OGs) and spiral grooves (SGs), considering cavitation, compare and analyze the differences between them.

Considering cavitation effect, the incompressible steady-state Reynolds equation was solved to obtain the sealing performance parameters of the liquid film seal with oblique groove and spiral groove.

The hydrodynamic performance of oblique groove seal (OGS) and spiral groove seal (SGS) shows a similar trend with the change of operating parameters. When the groove angle is less than 20°, the load-carrying capacity of SGS is better than that of OGS, while when the groove angle continues to increase, the hydrodynamic performance of OGS is slightly better than that of SGS, and more suitable for use under small differential pressure and high speed.

The hydrodynamic characteristics of liquid film seals with oblique grooves and spiral grooves considering cavitation effect were studied, which provides a theoretical reference for the application of oblique groove seal.

The purpose of this paper is to investigate the mechanism of transmitting economic policy uncertainty (EPU) shocks to capital structure.

The authors adopt a novel approach that bridges the asset pricing implications of EPU and the debt-financing decisions of Chinese firms by introducing a variable “policy-risk-induced equity return” (PRER). PRER is the product of the EPU beta and the EPU shock. Differentiating firms as per the signs of the EPU beta helps to shed light on the deep questions of whether their respective leverage targets and speeds of adjustment are different and how the targets and speeds are determined.

The empirical evidence shows that it is the equity market that channels EPU shocks to capital structure through PRER in China. Firms with positive (negative) EPU betas have PRER impact negatively (positively) the leverage target, conforming to the market-timing theory. EPU and non-policy uncertainty shocks cause the speed of adjustment to change over time. Overall, the intertemporal relation between EPU and leverage is negative. These results are robust to alternative leverage measures and after controlling for non-policy uncertainty shocks and conventional firm characteristics and have implications for academic research, policymaking, market stability, and corporate financing.

This study is the first to probe for, and provide insights into, the underlying reason why EPU impacts capital structure by connecting asset pricing to corporate financing for a large sample of Chinese publicly traded firms.

A cross-domain intelligent software-defined network (SDN) routing method based on a proposed multiagent deep reinforcement learning (MDRL) method is developed.

First, the network is divided into multiple subdomains managed by multiple local controllers, and the state information of each subdomain is flexibly obtained by the designed SDN multithreaded network measurement mechanism. Then, a cooperative communication module is designed to realize message transmission and message synchronization between the root and local controllers, and socket technology is used to ensure the reliability and stability of message transmission between multiple controllers to acquire global network state information in real time. Finally, after the optimal intradomain and interdomain routing paths are adaptively generated by the agents in the root and local controllers, a network traffic state prediction mechanism is designed to improve awareness of the cross-domain intelligent routing method and enable the generation of the optimal routing paths in the global network in real time.

Experimental results show that the proposed cross-domain intelligent routing method can significantly improve the network throughput and reduce the network delay and packet loss rate compared to those of the Dijkstra and open shortest path first (OSPF) routing methods.

Message transmission and message synchronization for multicontroller interdomain routing in SDN have long adaptation times and slow convergence speeds, coupled with the shortcomings of traditional interdomain routing methods, such as cumbersome configuration and inflexible acquisition of network state information. These drawbacks make it difficult to obtain global state information about the network, and the optimal routing decision cannot be made in real time, affecting network performance. This paper proposes a cross-domain intelligent SDN routing method based on a proposed MDRL method. First, the network is divided into multiple subdomains managed by multiple local controllers, and the state information of each subdomain is flexibly obtained by the designed SDN multithreaded network measurement mechanism. Then, a cooperative communication module is designed to realize message transmission and message synchronization between root and local controllers, and socket technology is used to ensure the reliability and stability of message transmission between multiple controllers to realize the real-time acquisition of global network state information. Finally, after the optimal intradomain and interdomain routing paths are adaptively generated by the agents in the root and local controllers, a prediction mechanism for the network traffic state is designed to improve awareness of the cross-domain intelligent routing method and enable the generation of the optimal routing paths in the global network in real time. Experimental results show that the proposed cross-domain intelligent routing method can significantly improve the network throughput and reduce the network delay and packet loss rate compared to those of the Dijkstra and OSPF routing methods.

The purpose of this paper is to explore the role of trust in the unobservable decision-making process of lead investors and follow-on investors in the specific context of equity crowdfunding (ECF) campaigns.

This work employs a case study approach. The author conducts a three-year inductive field study of Chinese ECF – AngelCrunch. The author gathered both campaign and platform-level data from the selected case covering a period of seven years from 2011 to 2018. The data set used for this study includes the characteristics of 189 online campaigns, 25 face-to-face interviews with the platform managers, early-stage investors and entrepreneurs, first-hand observations and quarterly reports on online campaigns supplemented with informal interviews with the authors for the reports.

The findings from this study provide early insights onto the unobservable decision-making process of ECF investors. It demonstrates that lead investors use both selective signalling information and physical interactions with the entrepreneurs to build competence and relational trust on which they rely for making an early pledge. It also shows that follow-on investors differ from lead investors in the process of building trust for decision-making. Furthermore, this work uncovers the role of ECF platforms in facilitating the process of building interpersonal trust for the decision making, with challenges to maintain the notion of platforms in raising a small amount of capital from a large crowd.

This study is constrained by the limited scale of qualitative elements available. The findings of the study have implications for platform managers, investors and policy makers.

Building on entrepreneurial finance and trust theory, this work demonstrates how lead investors build competence and relational trust on which they rely to make an early pledge in the context of ECF. The perception of a lead investor and the commitment together with the selective and formative information by the entrepreneur/s are key in follow-on investors’ decision making. This study uncovers that crowdfunding enables additional and valuable information to be assessed by crowd investors to manage extreme risk and uncertainty occurred in early-stage investments. This work also demonstrates that virtual world has its limitations to build interpersonal trust for managing extreme risk.

This paper aims to investigate the relationship between earnings management and media reports, assess the roles played by the media in determining the reputation mechanism and examine whether the media has an influence on executives’ behavior in the case of earnings management.

This paper uses Chinese A-share listed firms from the period 2008 to 2012 to test the research questions using regression analyses.

Although the Chinese Stock Markets are still immature compared to those of developed countries, the media seems to play a role in affecting executives’ decisions about dabbling in earnings management. Specifically, firms receiving more media attention are more likely to undertake earnings management. Furthermore, negative media reports result in even higher levels of earnings management activities, indicating that managers tend to use earnings management to achieve earnings goals to reduce or relieve the pressure they feel from the media and to remedy any reputation loss. Moreover, the authors have found that firms whose CEOs have higher reputations are more likely to manage earnings and they are more likely to be affected by negative media reports. Similar results were found for state-owned enterprises (SOEs).

This study analyzes how the level and tone of media coverage affect earnings management rather than just assessing the overall effect of media coverage on earnings management. This paper verifies that the reputation mechanism of the media works in China, but it leads to different results than those experienced in developed countries. Reputational benefits have been introduced into the equation for measuring the governance effect of the media to derive a more in-depth analysis of the reputation mechanism. This paper is among the first to link news coverage and state ownership with earnings management.

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The factors that influence patient safety culture have received little attention. The authors aim to investigate the antecedents of patient safety culture (safety climate) in relation to medical staff to develop a comprehensive approach to improve patient safety and the quality of medical care in China.

The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was used to examine the attitudes toward patient safety among physicians and nurses. This medical staff was asked to submit the intra-organizational online survey via email. A total of 1780 questionnaires were issued. The final useable questionnaires were 256, yielding a response rate of 14.38%. One-way analysis of variance (ANOVA) was employed to test if different sex, supervisor/manager, age, working experience, and education result in different perceptions. Confirmatory factor analysis (CFA) was used to verify the structure of the data. Then linear regression with forward selection was performed to obtain the essential dimension(s) that affect the safety culture (safety climate).

The CFA results showed that 26 CSAQ items measured 6 safety-related dimensions. The linear regression results indicated that working conditions, teamwork climate, and job satisfaction had significant positive effects on safety culture (safety climate).

Hospital managers should put increased effort into essential elements of patient-oriented safety culture, such as working conditions, teamwork climate, and job satisfaction to develop appropriate avenues to improve the quality of delivered medical services as well as the safety of patients.

This study focused on the contribution that the antecedents of patient safety culture (safety climate) make with reference to the perspective of medical staff in a tertiary hospital in China.

Path planning is an important part of three-dimensional (3D) printing data processing technology. This study aims to propose a new path planning method based on a discontinuous grid partition algorithm of point cloud for in situ printing.

Three types of parameters (i.e. structural, process and path interruption parameters) were designed to establish the algorithm model with the path error and the computation amount as the dependent variables. The path error (i.e. boundary error and internal error) was further studied and the influence of each parameter on the path point density was analyzed quantitatively. The feasibility of this method was verified by skin in situ printing experiments.

Path point density was positively correlated with Grid_size and negatively related to other parameters. Point_space, Sparsity and Line_space had greater influence on path point density than Indentation and Grid_size. In skin in situ printing experiment, two layers of orthogonal printing path were generated, and the material was printed accurately in the defect, which proved the feasibility of this method.

This study proposed a new path planning method that converted 3D point cloud data to a printing path directly, providing a new path planning solution for in situ printing. The discontinuous grid partition algorithm achieved controllability of the path planning accuracy and computation amount that could be applied to different processes.