The land development by human beings has changed from the initial small-scale and low-level transformation to the comprehensive utilization of large-scale and high-intensity implementations. The contradiction between production-living-ecology space (PLES) has become increasingly prominent while drawing land dividends. As one of the important birthplaces of Chinese civilization and the ecological barrier in the northern region, the rapid urbanization and industrialization of the Yellow River Basin (YRB) make the ecological environment very fragile, and the imbalance of land and space development is extremely serious. Therefore, according to the multifunctional characteristics of land use, this paper establishes a classification system of production space (PS), living space (LS) and ecology space (ES), and discusses the spatiotemporal evolution and conflict distribution characteristics of the PLES with the help of the transfer matrix and spatial conflict index (SCI). The results are as follows. In 1990–2020, agricultural production space (APS), grassland ecology space (GES) and other ecology space (OES) yielded the largest proportion of PLES in the YRB. However, compared with 1990, the area of these spatial types decreased in 2020, while the urban living space (ULS) expanded rapidly. The distribution pattern of PLES was generally consistent, and the transformation between PLES in Ningxia, central Inner Mongolia, Loess Plateau and downstream areas was relatively intense. The conflict index of PLES showed an upward trend, but it was generally in a controllable range. The stable and controllable areas were concentrated in the upstream of the urban agglomeration, and the midstream and downstream were basic out of control and seriously out of control, respectively. Territorial space is the carrier of socioeconomic development, as well as the support of human survival and development, and the evolution of its pattern and function is the result of the continuous interaction between humans and land ,2. The iSince the beginning of the new era, China has attached great importance to land planning to address a series of negative problems caused by the overexploitation of land resources. The report of the 18th National Congress put forward the overall construction goal of “Intensive and efficient in the production space, livable and moderate in the living space, beautiful in the ecological space”, and made optimizing the spatial development pattern of the country the first step in the construction of ecological civilization. In 2017, the National Land Planning Outline was released to make specific arrangements for regional development, the construction of the main functional areas and development goals, and in the report of the 19th National Congress, it was further proposed to carry out the delineation of three control lines, namely the “ecological protection red line, permanent basic agricultural land and urban development boundary”.The YRB is a typical region of rapid economic and social transmutation ,17,18; hThe structure of this paper is as follows: In the 1980s, western countries launched a number of spatial planning research programs. By establishing evaluation models and using GIS and other methods, the suitability and mode of land spatial development were evaluated from the perspective of environmental protection ,21,22. TThe quantitative identification of the PLES is mainly based on the measurement of spatial quantity or quality, and the common measurement methods include land use type consolidation and the comprehensive index evaluation. On the one hand, from the existing research results, the method of land use consolidation is the most widely used, and it is based on the functions carried by each land use type to identify the pattern characteristics of the PLES intuitively and quickly ,24. HoweMost studies on the spatiotemporal evolution of the PLES have been conducted with the help of the ArcGIS platform and combined with econometric models for quantitative analysis. In the literature, most of the existing studies analyzed the spatial evolution characteristics of PLES in terms of quantity, speed and direction of change, as well as pattern, equilibrium and patch change ,31,32,33The study of “conflict” originated from sociology, and refers to the psychological or behavior contradictions caused by the incompatibility or opposition of different actors in goals ,35,36. WIn summary, many scholars adopt a variety of methods to carry out research on territorial space or PLES, with diverse research perspectives and rich research results. However, due to the interdisciplinary nature and diversified research standpoint, a unified research route has yet to be formed. Prominent problems such as the contradiction between humans and land caused by the continuous improvement of the utilization intensity of space resources have become increasingly prominent. Research on the spatial conflict of the basin combined with land use conflict and PLES is still rare. The contributions of this paper mainly focus on the following aspects: First, land use conflicts and PLES are combined to reclassify land use types and construct the PLES classification system. Second, taking the YRB as the research object, the spatiotemporal evolution of production, living and ecology space is described, and a conflict model is established to analyze the regional differences in spatial conflicts. Finally, this study provides a scientific basis and decision-making reference for the coordinated and healthy development of PLES, and provides a theoretical basis, technical support and typical case analysis for the management and regulation of land use spatial conflicts in the basin.2 . The Yellow River runs across the three strategic regions of East, Central and West China, and is a giant ecological corridor connecting the four geomorphic units of the Qinghai-Tibet Plateau, Inner Mongolia Plateau, Loess Plateau and North China Plain. The overall terrain of the basin is high in the west and low in the east. The average altitude of the western source region is over 4000 m, with numerous mountains and large topographic fluctuations. The elevation of the central region is 1000–2000 m; the geological structure is broken; and the soil texture is loose. Most of the eastern elevation does not exceed 50 m, and is mainly formed by the Yellow River sediment alluvial plain.The Yellow River is located at 31°31′–43°31′ N, 89°19′–119°39′ E, starting from the Bayan Har Mountains on the Qinghai-Tibet Plateau and flowing eastward through nine provinces (regions): Qinghai, Sichuan, Gansu, Ningxia, Inner Mongolia, Shaanxi, Shanxi, Henan and Shandong . The totThe YRB is a complex area of China’s “economy-society-environment” system. By the end of 2018, the total population of the YRB was 420 million, accounting for about 30% of the total population of China, and the regional GDP was 23.9 trillion yuan, accounting for more than a quarter of China. As the foundation and lifeblood of the development of northern China, it formed an obvious ladder development pattern of backwards upstream, rising midstream and developed downstream. In industrial and agricultural production, coal, oil, natural gas and mineral resources are abundant. Resource-based cities relying on the exploitation and processing of energy resources account for 47% of the total number of cities in the basin, and are important energy, chemical, raw materials and basic industrial bases. Agricultural and animal husbandry production also plays a pivotal role in the national economic pattern. The corresponding human living space is mainly concentrated in some river valleys in the upstream and plain areas in the midstream and downstream. Driven by natural environmental constraints and economic factors, the population distribution is dense in the middle and east, and sparse in the west. The ecological environment of the YRB is very fragile; the ecological functions of natural grasslands in the upper reaches are severely degraded; the middle reaches are faced with severe soil erosion problems; and urban life, industry and agriculture cause pollution to water resources. In recent decades, due to the rapid development of urbanization and industrialization, coupled with the complex geographical and climatic characteristics, the competition between production, living and ecology space has become an important factor restricting the sustainable development of this region.PLES is the reflection of humans’ diversified demands for various products and services in daily work and life. It is the result of the interaction of different spatial environments and spatial scale elements, and is manifested in different utilization structures and ways in land use . With thPS refers to the type of land use space that provides people with various products and services. This space takes land as the carrier to serve the most basic survival needs of human beings. It is the output of production and operation activities of the land use system, providing economic sources for most human beings and achieving the long-term goal of maintaining survival and development. . Among tLS refers to the type of land use space used by human beings for living, entertainment, science, education, culture and health, and some special purposes. This space aims to provide basic living conditions and security, and further meets the spiritual and cultural needs of human beings, which is the ultimate goal of the land use system . As the ES refers to the type of land use space that regulates the atmospheric environment, protects biodiversity, maintains soil and provides ecological products. This space is the foundation and support of production and living space, and is closely related to local natural resource endowment . It can The essence of PLES evolution is a complex process of land use change. Under the influence of various driving factors such as the social economy and natural environment, it is manifested in the competition of various stakeholders for land use structure and form. In this dynamic process, PS guarantees various products and services produced and developed by human beings; LS meets the purpose of human habitation and social needs; and ES provides the basic material basis for human survival. Taking human beings as the center, various spatial types form the basic relationship of conflict and coordination with their unique functions. For example, ES meets people’s ecological needs and provides raw materials for PS. However, if human activities in PS and LS exceed the ecological carrying capacity, this will lead to environmental problems such as ecological pollution. Therefore, the evolution of PLES is a complex dynamic process, and its driving factors are mainly expressed in two aspects. In terms of social factors, the level of economic development, policies and regulations, residents’ life, population, industrial development, transportation and education all inevitably have an impact on the evolution of the PLES. Population factors, for example, population growth, distribution, age structure, comprehensive quality and migration will directly or indirectly promote the PLES evolution. In terms of natural factors, topography and climate characteristics are the basic factors affecting the distribution and change of PLES, such as slope, elevation and soil. In addition, the conversion of cropland to forest and grassland, land reclamation and deforestation can also affect the quantitative change of PLES.S is the land area; n is the total number of land types; and i and j are land use types at the beginning and end of the study period, respectively. In this paper, ArcGIS10.2 software is used to calculate the statistics of PLES space types in different periods, and then an Excel pivot table is used to establish the PLES transfer matrix.The transformation of the PLES type and structure is realized by a land use transfer matrix model. The transfer matrix is a two-dimensional matrix that lists the transfer area of land use change according to the status quo of land cover in the same area and different phases, which serves as the basis of structural analysis and change direction analysis. It can not only reflect the area of each space type in a fixed region and at a fixed time statically, but also describe the area transfer of each space type at the beginning of the period and the area transfer of each space type at the end of the period ,47. ThisLand use systems are complex, dynamic, and fragile, so spatial conflicts need to be considered from the three aspects of system complexity, stability and fragility . To avoii and j are the j-th spatial types in the i-th spatial unit; m is the total number of spatial evaluation units in the YRB; and n is the total number of PLES types.The PLES complexity index reflects the gradual increase in the scale and intensity of land use due to rapid urbanization, and the continuous shaping of the surface morphology, resulting in the fragmentation of patches and the intensification of contradictions in space use. The area-weighted mean patch fractal dimension (AWMPFD) reflects the degree of interference of the domain plate on the measured patch, and to a certain extent reflects the impact of human activities on the spatial pattern. The higher the value is, the greater the external pressure on the patch. The AWMPFD in the landscape ecological index is used to characterize the spatial complexity index of PLES to measure the shape complexity of spatial patches. The formula is:The PLES vulnerability index reflects the ability of space patches to withstand external pressure. At different stages, various land use types have different responses to external disturbances. The weaker the resistance is, the more vulnerable it is to external influences, and the higher the level of spatial conflict. Therefore, from the perspective of landscape ecology, using the vulnerability of various landscapes inside the space to calculate the PLES vulnerability index, the formula is as follows: results ,26. ValuThe PLES stability index refers to the phenomenon where the regional spatial pattern fragments landscape patches under the interference of external pressure; the linear patches are “fishing nets”, and the dot-shaped patches show an agglomeration state, with increased density and separation, resulting in a decrease in the proportion of planar patches in the spatial unit. The more fragmented and complex the spatial form, the worse the stability within the spatial unit, the greater the spatial risk and the higher the intensity of spatial conflict. Therefore, the fragmentation degree of the landscape ecology is selected to represent the spatial stability index, and the formula is as follows:Using the moving window method in Fragstats 4.2 software to measure the spatial conflict level of the PLES in the YRB, taking into account the characteristics of the research scale, data type, data volume and spatial patch conditions, comparing different size window units  and referring to related research, it is found that the 4 km × 4 km window can better express the spatial conflict distribution characteristics. If the patch in the boundary area of the study area does not cover the entire unit area, the calculation is performed based on a complete unit area to calculate the index in each spatial unit mentioned above. Finally, the spatial conflict index is standardized to . According to the inverted “U”-shaped spatial conflict trajectory model, the space conflict index is divided into four categories: stable and controllable  and basically controllable , basically out of control  and seriously out of control .The PLES data of the YRB evolved from the land use type. These data come from the Resource and Environmental Science and Data Center of the Chinese Academy of Sciences. Among them, land use data include grid datasets of 1 km × 1 km in 1990, 2000, 2010 and 2020. The data are based on Landsat 8 remote sensing images, generated by the human-computer interaction visual interpretation and interpretation, including 6 primary types and 25 secondary types of cultivated land, forestland, grassland, water, residential land and unused land. Using ArcGIS 10.2 software, the land use types of the YRB were extracted based on the administrative division vector file; the PLES was divided by reclassification and other methods, and this software was used for mapping and data analysis.With the help of ArcGIS 10.2 software, the area of the PLES of the YRB in 1990, 2000, 2010 and 2020 was extracted, and the changes in the spatial area of each category were calculated. The results are shown in Overall, during the study period, the APS, GES and OES showed a shrinking trend, and the other four types of land use space had different degrees of expansion. Among them, ULS has the fastest growth rate, and the rest are IPS, RLS, WES and FES. The reason is that since the reform and opening up, the rich land and natural resources of the YRB gradually entered a stage of rapid development, coupled with its large population, rapid advancement of economic, social and cultural undertakings, rural surplus labor flows to cities and towns, urban land and transportation, and industrial and mining land rapidly increased, leading to the expansion of the ULS and IPS . In addiBased on the above analysis of temporal evolution characteristics, the spatial pattern characteristics of PLES in the YRB are further analyzed, as shown in 2 and 12,439 km2, respectively, during the period, and the growth rates were 225.22% and 169.52%. In internal conversion, from the perspective of roll-in structure, in terms of PS, APS is mainly converted from RLS and GES, and IPS is mainly converted from APS and GES; in terms of LS, both ULS and RLS are mainly converted from APS; in terms of ES, FES is mainly converted from APS and GES, and GES is mainly converted from APS and OES. The WES is mainly converted from APS, GES and OES, and OES is mainly converted from GES. From the perspective of roll-out structure, in terms of PS, APS is mainly transformed into ULS, RLS and GES, and IPS is most transferred to OES. In terms of LS, the transformation of ULS to other types of space is not obvious, and RLS is mainly turned to APS. In terms of ES, FES is mainly transformed into GES; GES is transformed into APS and OES; and OES is mainly transformed into GES.To explore the internal transformation characteristics of the PLES in the YRB, based on the distribution map of the PLES in Based on the above analysis, the spatial distribution of land conversion in different periods is further discussed . OverallBy calculating the spatial conflict index of four periods in the YRB, it is found that the average values of the spatial conflict index in 1990, 2000, 2010 and 2020 are 0.41, 0.43, 0.53 and 0.57, respectively . With thThe spatial conflict index of each spatial unit was further calculated, and the spatial distribution of the conflict index of PLES in the YRB from 1990 to 2020 was visualized by using ArcGIS 10.2 software . In geneThe spatial conflict levels of the three spatial types in the YRB were calculated and statistically analyzed , and the(1)From 1990 to 2020, PS and LS expanded by 0.87% and 6.75%, respectively, while ES decreased by 0.37%. In terms of spatial distribution, the APS of PS is concentrated in the traditional agricultural production area downstream, while the APS of the midstream and upstream is scattered. The distribution of LS corresponds to the agricultural and industrial production space. The density of LS in the downstream is significantly higher than that in the midstream and upstream, while the distribution of ecology space is more in the west and less in the east.(2)APS, GES and OES decreased, and the rest of the space types showed a trend of expansion. IPS and ULS expanded rapidly. In terms of transition and transition structure, each space type has different transformation directions, but the transformation between ES and PS is the main transformation direction. In the downstream area, the transformation between PS and LS is mainly reflected in the mutual transformation of PS and LS, and the transformation distribution of ES and LS is scattered.(3)From 1990 to 2020, the intensity of conflicts in PLES gradually increased, but it was still controllable. Stable and basic controllable space units accounted for more than 70%, and basic and seriously out of control space units gradually increased. In terms of space, the basic controllable space units are mainly distributed in the upstream region and relatively concentrated, while in the downstream region, they are mainly basic out of control and seriously out of control, and their distribution is relatively fragmented. Specifically, the variation range of conflict units in PS and LS is the same, while the variation range of conflict units in ES is smaller.(1)Although most of the upstream areas are in a stable and controllable state, as China’s Water Tower and ecological spatial agglomeration area, ecological protection should be considered in the first place; the relationship between the production, living and ecological environment should be correctly handled, promote the construction of water conservation capacity, strengthen regional desertification control and strictly implement the principle of ecological access. The construction of nature reserves should promote ecological restoration, adhere to local conditions, comprehensively utilize engineering measures and biological measures to manage the ecosystem, control the ecology space at different levels and scales, delimit the rigid core elements and elastic space of ecological protection, reduce the frequency of human social and economic activities and alleviate the contradiction between human activities in the ecology space and the ecological environment.(2)The midstream region should be committed to the spatial governance of soil erosion. On the one hand, it is important to protect forestland, grassland and unused land, enhance the soil and water conservation capacity, prevent the fragmentation of ecology space caused by urbanization and industrialization and take into account the economic and ecological benefits of land use. On the other hand, ecological restoration should be actively promoted to improve the management efficiency in the middle reaches. For irrigated agricultural areas, excessive consumption of water resources in agriculture and industry should be prevented; the proportion of ecological water should be increased; the intensity of land development should be strictly controlled; industries related to ecological environment protection should be developed; and the coupling and coordination level of PLES should be improved.(3)The downstream region, as the region with the most serious conflict, is densely populated and has high industrial and agricultural production intensity. First, it is necessary to improve the quality of the population while reasonably controlling the size of the population, with land efficient and intensive use as the development goal, optimize the industrial layout, focus on cultivating new industrial systems, strictly control the disorderly expansion of urban and rural construction land, improve the utilization efficiency of existing construction land and alleviate the contradiction between industrial and agricultural production and ecological protection to create a green ecological corridor in the lower reaches of the Yellow River. Second, for the vast agricultural production space, the level of agricultural mechanization should be improved, protect high-quality cultivated land resources, improve land output income and reduce dependence on land resources. Finally, the concept of green development was combined with technical means, using the theory and technology of sponge cities, green buildings and ecological materials to promote the construction of urban ecological civilizations and strengthen the positive impact of land invisible forms on the ecological environment.Based on the PLES perspective, this paper constructed a land use classification system in the YRB, and revealed the evolution characteristics and conflict index of PLES from 1990 to 2020. Strengthening spatial governance and improving land use efficiency is a complex system project that is affected by natural and human factors in various regions. Therefore, it is necessary to promote the scientific demarcation of the boundary of PLES in the YRB, strengthen the control and supervision of the boundary of various spatial types and divide the boundary of production, living and ecological spaces scientifically and reasonably according to the resource and environmental carrying capacity, spatial conflict level, spatial development suitability and social and economic development status of each region.


Internet of things technology began to spread to all industries of our lives; the application of medical internet of things in many hospitals highlighted its advantages and brought a lot of convenience to patients and medical staff. With the continuous progress of China's medical reform and the continuous improvement of patients' requirements for medical service quality, this paper discusses the application of medical internet of things in clinical nursing in ward, and the basic information collection, infusion, and mobile nursing were discussed and studied. Through the parallel control study of the laboratory itself, this paper evaluates whether the two different clinical measurement methods of medical internet of things technology and traditional technology are consistent in body temperature, pulse, respiration, and blood oxygen saturation. At the same time, it also deeply studies the value and advantages of internet of things technology in the application of other monitoring indicators in clinical nursing and analyses the problems in its application. The experimental data show that the two measurement methods with different principles can be completely replaced in clinical application, and the time efficiency of the new clinical nursing method under the medical internet of things technology in mapping body temperature, pulse, and respiration has been improved by 76.20% and 72.02%, respectively, surpassing the traditional information technology and realizing the intelligent, automatic, and standardized data acquisition method. It ensures the authenticity of data and the real-time of information flow and meets the needs of resource sharing and medical regional interconnection. Due to the complexity and breadth of clinical nursing work, the collection of transactional nursing information occupies a lot of manpower, material resources, and time; the computer processing process of nursing information has high requirements for information processing methods and technologies. Nursing information has different attributes and different processing methods. Highly subjective information must be collected and recorded on site by nurses with professional knowledge and stored on paper carriers or mobile devices . The objThe organic integration of internet of things and nursing activities is one of the important characteristics of nursing development in the 21st century. The advantage of the application of the internet of things in clinical nursing lies in that the information receiver with sensors replaces people to “perceive” the information of human body, facilities, and environment and is not limited by time and space . It can This paper aims at the current situation that the traditional methods have high labor intensity, low efficiency, high error rate, and low value embodiment, which makes the nurses in a high-tension working state for a long time, thus affecting the accuracy of clinical nursing diagnosis and treatment decision-making and effect, discusses the application of medical internet of things in clinical nursing in ward, and discusses and studies the basic information collection, infusion, and mobile nursing. Through the parallel control study of the laboratory itself, this paper evaluates whether the two different clinical measurement methods of medical internet of things technology and traditional technology are consistent in body temperature, pulse, respiration, and blood oxygen saturation. At the same time, it also deeply studies the value and advantages of internet of things technology in the application of other monitoring indicators in clinical nursing and analyses the problems in its application. The experimental data show that the two measurement methods with different principles can be completely replaced in clinical application, and the mapping efficiency of the new clinical nursing method under the medical internet of things technology exceeds the traditional information technology, realizes the intelligent automation and standardized data acquisition method, and ensures the authenticity of data and the real-time of information flow; it meets the needs of resource sharing and medical regional interconnection.The chapters of this paper are arranged as follows. With the development of technology and application, the connotation and extension of the concept of internet of things are also expanding. Its overall framework includes the following five parts, namely, community architecture, technological know-how system, preferred system, associated enterprise device, and useful resource system. The terminal sensing layer consists of sensing terminal devices, such as RF readers, electronic tags, cameras global positioning system, and various sensors, and other sensing terminals collect data information . The senThe application of internet of things technology in the hospital nursing information system is of great significance and value. First, internet of things technology can quickly evaluate patients and accurately grade patients. Based on the internet of things technology, the preinspection system is set at the same time. The preinspection system can effectively, quickly, and accurately obtain patient information and conduct triage according to the severity of patients' diseases . In addiCombined with the previous design, the internet of things network based on Wi-Fi and RFID technology is designed to realize specific applications. In this project, the medical internet of things is selected as the final technical landing point. The application environment and conditions of medical internet of things are as follows: Wi-Fi signal coverage has been realized in the ward environment, and the nurse workstation has network access to the hospital LAN. The hospital has its own database system; according to the environment and requirements, the overall structure of the designed medical internet of things network is shown in In this system, the sphygmomanometer, as a sensor node, has RFID read-write function and Wi-Fi communication function. In use, the sphygmomanometer first collects the patient's personal information in the label, then measures the patient's blood pressure data by the Coriolis auscultation method, and then connects the Wi-Fi network through the wireless access point to bind the patient information and blood pressure data and send them to the nurse station PC; the PC runs the application software to further save the data to the hospital database system . ThroughPortable Device. The sensor is concentrated in a portable device with high reliability, which meets the requirements of small volume and convenient use and has the performance of high measurement accuracy. (2) Low-Power Consumption. Due to the frequent use of sensing terminal equipment, but the amount of data collected is small and no high transmission rate is required, low-power consumption can ensure a long service time of the equipment without frequent charging [Automatic Networking. Each ward has at least 40 beds, so at least 40 sets of sensing terminal equipment shall be allocated. These 40 sets of equipment shall automatically form a network and send vital signs parameters to the server through wireless mode. (4) Expansibility. The environment of the ward is complex, there are many interference factors, and the environment and area of each ward are different. Therefore, it is necessary to ensure that the sensing terminal equipment can be used in different environments and has high expansion performance. Through the investigation of existing communication technology in the early stage and combined with the characteristics of the current hospital information system, the system structure developed is shown in According to the needs of clinical nursing and the application environment of the system, the following problems must be solved in the system design. (1) charging . (3) AutIn terms of technical implementation, the research and development of nRF905 low-power RF communication module with 433 MHz communication frequency band are focused. Combined with low-power MCU and physiological signal sensing equipment, it collects, analyses, and processes three key parameters that must be measured every day in the general ward: blood pressure, body temperature, and pulse. Accordingly, wireless electronic thermometer and wireless blood pressure pulse meter are developed in the sensing layer. The network realizes the conversion of RF communication into Wi-Fi communication and enhances the functions of temporary storage and automatic networking. In the application layer, the key physiological signal nursing system based on PDA and the real-time acquisition and control system based on PC are made.The body temperature sensor is mainly composed of temperature measurement circuit, main control chip, wireless transmission module, and power management module. The temperature measurement circuit is mainly composed of chip and thermistor. The main control chip of TI company and the wireless transmission module is nRF905 module , 24. TheThe sphygmomanometer adopts a high-performance sound pressure sensor to judge the blood pressure value by extracting the Coriolis sound signal of auscultation. This method can eliminate the individual difference of the oscillography electronic sphygmomanometer and improve the accuracy of blood pressure measurement. In the design process, the Coriolis tone delay time technology is developed to further accurately determine the systolic and diastolic blood pressure and ensure the accuracy of individual measurement. High precision pressure sensor and customized Coriolis sound sensor are used to extract blood pressure related signals, and the overall performance of the system is improved through linear deflation and automatic pressure zeroing. The appearance of the mercury manometer is simulated by liquid crystal, with high scale resolution , 27. It The main functions of application layer service software are maintenance, display, collection, writing, viewing, and alarm of life parameter information. The maintenance function is mainly used for database maintenance, including adding, deleting, and updating records. The man-machine interface of the system is written based on C++ language, and the development tool is MFC application program based on VC++ 6.0 dialog box class . The bast test, correlation coefficient, and Bland Altman method.Under the condition of overcoming individual differences, the experimental research design scheme of self parallel control is adopted. With the help of traditional measurement tools and medical internet of things, the control group and experimental group are set. The same person collects four vital sign parameters, body temperature, pulse, respiration, and blood oxygen saturation at 7 different time points in a day. This experiment is aimed at healthy groups to verify the feasibility and accuracy of the new technology in clinical nursing application. For the above data management work, the personnel in charge of nursing division or above shall be invited to guide and participate in data quality control, supervision, and management. Because the data collected by the two methods of comparison have the characteristics of point and surface differences, the latter is processed by the mean method and then compared. SPSS 22.0 statistical software was used to analyse the continuous repeated measurement data collected in the experiment by analysis of variance, paired t test, and then the correlation test is carried out for the two groups of data samples to understand the degree of correlation and bias. The above analysis of variance shows that the data of two different principal measurement methods of R are completely consistent, and there is no statistical difference, while the data of temperature, pulse, respiration, and blood oxygen saturation are not completely consistent, and there are statistical differences. With the help of the plot's submenu, the mean change trend diagram of the indicators measured repeatedly for 7 times is made, and the linear correlation regression equation of temperature and pulse is calculated, as shown in After the experiment, the data stored in the medical IoT system were transferred, and the tables were counted after counting. Finally, the recorder shall fill in the comparison form uniformly and the supervisor shall check it. The experiment is started after completing the pre-experiment. First, the data are entered into excel by the double entry method and then imported into SPSS 22.0 software for statistical analysis and description. The analysis of variance is used to understand the difference between the two groups of data, and the degree of difference is statistically described by paired F = 8.504, P=0.005 ≤ 0.005, there is no linear correlation, and the control data of the two groups are different. The blood oxygen saturation results of control group (ECG) and experimental group  were 98.00 ± 0.52 and 98.63 ± 0.81. Due to the difference in precision between the two different methods, it is necessary to further analyse the data in combination with clinical application standards. Therefore, the Bland Altman analysis method is used to evaluate the consistency of the two different measurement methods, and the calculated results are shown in t test, as shown in The difference between the measurement results of the two different methods is described by paired Through data analysis and clinical consistency evaluation, it is concluded that these two different measurement methods can completely replace each other in the accuracy of temperature, pulse, respiration, and blood oxygen saturation measurement, and the accuracy and sensitivity of medical internet of things are higher. The medical internet of things is fully used, highly operable, highly accepted by patients, and has strong clinical practicability and popularization. Under the internet of things technology, the integration of temperature, pulse, respiration surveying, and mapping in the three nursing test sheets has improved the time efficiency by 76.20% and 72.02%, respectively, compared with the traditional surveying and mapping methods 1 and 2. Time comparison of different surveying and mapping methods is shown in Intelligent automation and standard dynamic data collection are realized in information collection, highlighting the advantages of standard collection, unified access, and transmission, data sharing, and unified service. It shortens the operation time of nurses' manual measurement of temperature, pulse, and respiration, reduces the error rate of data input system, and reduces the process links of vital signs measurement and drawing. In terms of monitoring human physiological parameters, it is more widely used and more powerful, convenient, and practical than the current ECG monitor. For example, the increased fall index, sleep index, and other more than a dozen indicators, including the noninvasive blood glucose and blood pressure monitoring channel to be opened soon, to comprehensively monitor the health status of patients, undoubtedly extend the nurse workstation to the patients and directly point the nursing safety management and nursing quality monitoring to the target of real-time dynamic management. It laid a solid foundation for realizing nursing scientific management and intelligent decision-making.The medical internet of things system in this test is seamlessly connected with NIS. Taking only one routine nursing work “mapping temperature, pulse, and respiration” as an example, the mapping efficiency of internet of things is about 76.2% and 72.02% higher than that of traditional methods . This result shows that the application of the new technology directly reduces the indirect nursing time. While improving the work efficiency and reducing the labour intensity, it also correspondingly reduces the office consumables. Especially, when a large number of patients are treated in the ward and temperature, pulse, and respiration surveyed, nurses will have a deeper experience in artificial intelligence mapping, which provides technical support for the transformation of the nursing workflow of collecting vital signs. In addition, compared with the traditional working mode, it highlights its strong artificial intelligence characteristics in the standardization, authenticity, correctness, timeliness, and sharing of data collection, which lays a solid foundation and rich resources for enriching the clinical nursing database system, and provides a scientific and safe guarantee for patient condition monitoring management, safety management, and high-quality service.The use of medical internet of things in the ward can greatly improve the work efficiency of medical staff and reduce work errors. At the same time, it can also make the doctor-patient relationship more harmonious and improve the patient's nursing satisfaction. Medical internet of things can concentrate all information on the same platform so that resources can be used effectively; this paper designs and implements a new clinical nursing method based on medical internet of things. Based on the design principle of improving the automatic management level of hospital ward, reducing the work intensity of medical staff, reducing cost investment, and reducing patient bed accompanying, communication technology, photoelectric detection technology, microcomputer technology, computer network technology, and relational database technology are successfully applied to the ward intelligent monitoring system based on internet of things. The use of the system provides convenience for nurses' nursing work, provides a reliable safety guarantee for patients' daily treatment, and has high application value. The trial in several clinical wards shows that the system has high accuracy, stability, and consistency in the measurement of blood pressure, pulse, and body temperature. At the same time, both the sensor end and the application end can output reliable alarm signals when the data are abnormal or reach the warning value. Finally, the system is divided into multiple functional modules in a reasonable way, which can be customized and tailored to meet the application of different levels of hospitals or wards.


College students are taken as the research sample, with the purpose of exploring the characteristics of physical exercise and health education path of students under artificial intelligence (AI) algorithm. First, related literature is studied to understand the physical education system of college students. Then, the current situation of physical exercise of college students is investigated through the interview survey, and the mathematical statistics method is used to analyze the survey results. Moreover, the necessity and paths to carry out health education are discussed through the analysis of the physical exercise behavior of college students. Finally, the college smart sports classroom (SSC) is constructed using AI and the big data analysis method. The experimental results indicate that more than 50% of college students can actively participate in physical exercise. Besides, boys are more likely to take dangerous coping behaviors, while girls are more prone to choose to resist coping behaviors. In addition, there is little difference in age of the distribution of different coping behaviors in physical exercise. Freshmen are more inclined to take risky coping behaviors, and the quantity of students taking resistant coping behaviors increases with the increase of grades. Therefore, relevant physical health education for college students can promote the good habit of health exercise. This study can provide a reliable experimental basis for the development of sports education in the future. With the rapid development of science and technology today, the material life of people has been greatly improved. Youths are the foundation and driving force of national development, and their healthy growth is vital to the development of the motherland . The knoAt present, the era of information technology (IT) where all things are interconnected and intelligent is coming, and many new information technologies are coming one after another, such as mobile Internet, Internet of Things (IoT), big data, and cloud computing. The Smart Sports Classroom (SSC) is a specific branch of the smart classroom (SC). There is almost no research on the SSC, and no scholars have found a clear conception of the SSC . GeneralAlthough SSC has grown mature in theory, there are few cases of its application in the actual classroom. Therefore, taking college students as the research sample, the relevant literature is first studied to understand the physical education system of college students. Second, the questionnaire survey is conducted to investigate the current situation of the physical exercise of college students, and survey results are made mathematical statistics analysis. Furthermore, the necessity and path of health education are discussed based on the analysis of the physical exercise behavior of college students. Ultimately, the university sports fitness center is built by AI and the big data analysis method. The innovation lies in the combination of AI and college physical education curriculum, which improves the quality of the college physical education curriculum and provides new research ideas for the physical and health education of college students.As an emerging force in the development of a country, it is extremely important for young people to have a healthy body. Physique is the comprehensive and relatively stable characteristics of the quality and structure, physiological functions, and psychological factors of the human body based on heredity and acquisition. Physical fitness usually includes five dimensions, including physical development, physiological function, physical fitness, and athletic ability development, mental development, and adaptability development . PhysicaThe correlation between physical fitness and physical exercise has received more research attention. In summary, there are many studies on the physical exercise of students, and most of them analyze the impacts of physical exercise on physical health. However, the research on the intervention of physical exercise from the perspective of health education is relatively rare. Therefore, the current status of physical exercise of students is analyzed, and AI technology is applied in the health education and exercise of students, which exerts an extremely important role for the healthy development of adolescents.Investigating the current status of physical exercise of college students is conducive to understanding the importance of the lifelong sports concept of college students and the formation of good daily physical exercise habits. The sports classroom can play a guiding role in the physical exercise of students. The necessity of applying AI to sports classrooms can be analyzed from multiple perspectives such as students, society, and schools .From the perspective of social development, the construction of SSC in colleges and universities is to use the Internet, big data, AI, and other technologies to intelligently transform and innovate the college sports classrooms. The innovation of technology and teaching methods can provide powerful support for digital classrooms and smart campuses, contributing to the development of the smart society of China . SSC in At present, AI technology is widely used in the field of educational technology, including learning platforms, learning environments, and learning tools. Big data, a terminology of the IT industry, refers to the data set that cannot be captured, managed, and processed by conventional software tools in a certain time range. It is a massive, high-growth, and diversified information asset that requires new processing modes to acquire stronger capabilities of decision-making, insight, and process optimization. The hot research areas are introduced as follows, including intelligent learning platforms, intelligent learning environment, and intelligent auxiliary teaching tools. (1) Intelligent learning platform: online learning platforms represented by massive open online courses (MOOC) can record massive data of the learning process of learners. Based on data analysis, the platform can accurately grasp the learning status of each learner and then provide personalized teaching diagnoses and teaching recommendations for learners. Accordingly, numerous studies based on learner behavior data have gradually become research hotspots, i.e., predicting academic performance based on learning behavior characteristics of learners. (2) Intelligent learning environment: intelligent learning environment includes smart campus, smart classroom, and smart library. Smart campus integrates teaching resources and applications through network information technology and AI technology and realizes the smart and scientific decision-making of campus management. For example, the smart campus system designed by Professor Uskov of Bradley University covers the teaching environment, teaching management, and teaching process. Smart classrooms use advanced information technology, network technology, computer technology, and AI technology to provide multiple data support for various decisions of classroom teaching activities, such as learner type identification and utility analysis of content display methods. (3) Intelligent auxiliary teaching tool: intelligent auxiliary teaching tool is an intelligent system that simulates the role of human teachers and assists learners to learn, such as an intelligent teaching system and teaching robots. Intelligent auxiliary teaching tools can continuously evaluate the learning state or learning ability of learners in the process of learning knowledge, and implement precise intervention according to their state.In general, the digital detection of SSC mainly combines intelligent bracelets and other equipment with background data software to establish the sports health records of each student. Parents can know the movement of the children through the data at any time. Besides, schools can find the shortcomings of physical education timely to make improvements and detect whether the students have discomfort during sports exercise. In addition, systematic data helps schools understand the situation of students and the quality of sports at any time. The complex date operation of the background tends to be more accurate with the continuous advancement of SSC. Different background system operation modes have their own characteristics, but in general, they have a relatively unified idea.Browser/Severe (B/S) architecture is the architecture mode combining browsers and servers, which is a transformation and improvement of Client/Severe architecture with the rise of Internet technology. In the B/S framework, the user work interface is realized through the World Wide Web (WEB) browser. A few transaction logics are implemented in the front end (Browser) while the main transaction logic is implemented in the Server, forming a three-tier structure. B/S architecture is a network architecture model after the rise of WEB, and the WEB browser is the most important application software of the client. This pattern unifies the client, concentrates the core part of the system function realization to the server, and simplifies the development, maintenance, and usage of the system. The B/S architecture simply requires a browser on the client, such as Netscape Navigator or Internet Explorer, and a database in the Server, such as Oracle, Sybase, Informix, or SQL Server. The data interaction between the browser and the database is realized through Web Server, which greatly simplifies the client computer load, reduces the cost and workload of system maintenance and upgrading, and reduces the overall cost of users. Virtual Reality (VR) is a new practical technology developed in the twentieth century, containing a computer, electronic information, and simulation technology. It is basically achieved by the simulation of the computer of the virtual environment, which gives people a sense of environmental immersion. With the continuous development of social productivity and science and technology, the demand for VR technology is growing in all walks of life. VR technology has also made great progress and has gradually become a new field of science and technology.The literature search method  is adoptThe sample data is collected through the questionnaire survey to evaluate the physical exercise of students. During the questionnaire design , the hazIn the questionnaire, the value of exercise intensity is represented by the common physiological indicators, such as heart rate. Generally, it is believed that 120 times/min represents small exercise intensity, 120–150 times/min denotes medium exercise intensity, and 150–180 times/min or more than 180 times/min signifies large exercise intensity. The options of some questions on the scale are based on the Likert Score Sum Scale, among which 1–5 reveals “totally disagree,” “basically disagree,” “neither disagree nor agree,” “basically agree,” and “totally agree,” respectively. This questionnaire does not involve personal privacy in the whole process of questionnaire design, distribution, and data collection. Besides, the whole questionnaire survey is conducted with the consent of participants (not less than 18 years old). This survey has been approved by the leadership of higher vocational colleges and relevant departments. The questionnaire is not open to the public and is only used for research purposes .An equal amount of sampling questionnaires is issued in three representative undergraduate universities to reduce the deviation of the survey results and improve the strictness, scientificity, and representativeness of the questionnaire. A total of 321 questionnaires are distributed and 309 are recovered, with a recovery rate of 96.26%. Therefore, the questionnaire survey is effective. After reviewing the returned questionnaire and eliminating the questionnaire with obvious defects to ensure the validity of the questionnaire, there are, ultimately, 285 valid questionnaires in total. Cronbach’s α coefficient is a statistic of the average value of the half reliability coefficient obtained by all possible project division methods of the scale, which is the most common reliability measurement method. It was first named by American educator Lee Cronbach in 1951. If a scale has n questions and the average correlation coefficient between questions is r, the standardized α coefficient of this scale is given as follows:The questionnaire is evaluated by Cronbach’s α value to verify the reliability, stability, and index system of the physical exercise questionnaire of college students and to test the reliability coefficient of the questionnaire . The intThe characteristics of physical exercise of college students are investigated and analyzed. In the physical education class, the “health first” is adhered to while implementing the teaching concept of “jogging.” Besides, mobile internet, Internet of Things, big data, and cloud computing are integrated to innovate the physical education model further, enhance the initiative of students in learning, improve teaching efficiency, visualize physical education data, organically integrate both inside and outside classes, and promote exchanges among students, teachers, parents, and schools .In the SSC built by universities, the overall structure of the intelligent service platform takes humanity as the core through the intelligent terminal equipment platform, the stadium intelligent platform, and the health cloud management platform. AI equipment supports powerful background data analysis, processing, storage, and extraction, and organically integrates students, teachers, parents, experts, scholars, and multiple elements, so that smart equipment terminals and stadium equipment are combined. The information platform connected to the health cloud management platform, stadium intelligent platform, and intelligent terminal equipment platform provides SSC with an intelligent, informatized, and integrated service support environment. In the university logistics center, the function of the health cloud management platform is like the brain of a person, which is the cloud intelligent database of the university logistics center. Cloud computing and other science and technology are adopted to collect, store, and control SSC data in colleges and universities. The data are collected through terminal equipment and transmitted to the cloud platform for processing and analysis. Finally, relevant information about student physical exercise is given.The process of classroom teaching analysis includes the collection, representation, analysis, and display of teaching behavior data, which needs to be realized through the application system. A logical framework of a smart classroom teaching behavior analysis system is designed to rationalize the feasibility of the research method while positioning and combing the research elements and the relationship between elements. The framework takes classroom teaching behavior analysis as the goal, covering the acquisition, storage, modeling, processing, and analysis involved in the analysis process, along with the supportive environment as an application system. The logic architecture of the system is divided into five parts: data acquisition module, data analysis module, smart service module, the system supporting technical standards, and information security module. The current status of physical exercise of students is investigated by questionnaire survey, and the results are shown in Furthermore, the correlation between the normal exercise intensity of college students and different physical exercise coping behaviors is analyzed, and the results are shown in By investigating the status quo of physical exercise of college students and the corresponding statistical analysis, the perception level, gender difference, age difference, and physical exercise habits of college students are all related to the coping behavior of the physical exercise of college students. Results suggest that girls do better than boys in haze protection, but some girls resist physical exercise to prevent haze damage. Boys are less concerned about choosing corresponding protective gears or adjusting the original planned physical exercise content based on air quality than girls, forming a typical physical exercise risk response behavior. The characteristics of boys and girls in physical exercise coping behavior choices can be judged from gender differences. The number of students who choose to resist coping behavior increases with grades. Usually, juniors and seniors no longer need to choose compulsory physical education, making daily physical exercise motivation decline. When the weather or environment is slightly unfavorable, it is easy to resist. Therefore, the physical exercise coping behavior of college students in the face of haze is also related to their usual exercise habits. It is essential to cultivate the concept of lifelong physical education for college students and to develop good daily physical exercise habits.As shown in The comparison results of physical exercise effects of different system models are shown in The path of physical education in colleges and universities is as follows. First, define the level of sports resources in colleges and universities and formulate different levels of development planning. According to the proportion of sports resources, colleges and universities can be divided into upper sports resources schools, middle sports resources schools, and lower sports resources schools. Schools with different levels should adopt different development strategies. The upper sports resource schools mainly adopt the “independent” development strategy, and the education authorities only formulate various development standards and development indicators for schools to fully mobilize the enthusiasm and initiative of the school, which formulate its development planning and implementation measures independently. Middle sports resource schools adopt the development strategy of “joint promotion.” The main function of the education department is to plan and regulate its strategy, provide support, and help for its insufficient sports resources, and encourage schools to actively cooperate with enterprises and communities in manpower, material, and financial sports resources.Second, exploring distinctive sports resources in colleges and universities in the region, and actively developing specific sports courses. With a vast territory, there is a huge gap in the development of various regions in China due to various reasons such as history, resources, and geographical location. Therefore, China is often divided into several different regions to facilitate the management and distinction according to different division methods. For example, by administrative region, China is divided into East China, South China, Central China, North China, Northwest China, and Southwest China. By economic zone, the country is divided into the eastern coastal area, central inland area, and western remote area. According to the six comprehensive economic zones, the whole country includes the Northeast China Economic Zone, Economic Zone of Middle Yellow River, Economic Zone in the Middle and Lower Reaches of the Yangtze River, Southeast Coastal Economic Zone, Southwest Comprehensive Economic Zone, and Northwest Economic Zone.Last, accurately grasping the sports needs and hobbies of different classes of college students and enhancing the particularity of physical education. Under the background of the growing differentiation of social classes, is there any class difference in fitness needs and hobbies among people of different social classes? According to the investigation and study of relevant information, there are certain differences in the sports life of members of all social strata. These differences are reflected in the sports population, sports activities, sports venues, and sports consumption level. Statistics based on the China Health and Nutrition Survey show that like social stratification, sports participation groups are also stratified, and people at different levels have different sports participation preferences. There are demographic differences in the sports participation of residents, such as gender, place of residence, education level, occupation type, and income level.In summary, a questionnaire survey on the current status of physical exercise of college students reveals that more than half of college students can actively participate in physical exercise under the premise of ensuring that their health is not threatened in the face of haze, but the characteristics of their physical exercise behaviors are not certainly beneficial to health. Thus, AI technology is adopted to build the SSC in colleges and universities, which can make the physical exercise behaviors of students more active and develop healthy physical exercise habits, providing experimental references for the later development of physical education. However, there are also some shortcomings that are worth noting in future research. The technologies such as the Internet, the IoT, and big data on which the development of SSC relies are also developing and improving. Therefore, the construction of SSC is a dynamic process. In addition, it is necessary to constantly update the technology, and put forward the corresponding teaching mode and construction path in different classroom construction stages. Moreover, the teaching mode can further practice SSC. The experimental intervention of the SSC control group and an experimental group can be set to analyze the teaching effect of SSC attitude and behavior, and continuously improve the physical education mode.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by the Shanghai Normal University Ethics Committee. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.Both authors listed have made a substantial, direct, and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Several studies have reported, in emerging economies, an incidence of congenital heart defects that is higher than average because of several factors, including genetics, high prevalence of consanguineous marriages, malnutrition, poor sanitation, and high fertility rates . CongeniJivanji et al. presented very clearly the situation in sub-Saharan East Africa: Kenya, Tanzania, and Uganda, with their commentaries on affordability, access, and awareness. They listed all challenges faced in developing a cardiac program in that region, with problems such as corruption at various levels described with a very clear narrative .Giamberti et al. presented their remarkable experience over a 17-year period of creating and developing a pediatric cardiac unit in Cameroon, central Africa, with accurate description of barriers and facilitators encountered for the set-up. This team not only organized the clinical activities but also a fruitful bilateral exchange of collaboration with the local caregivers, with continuous educational programs, and constant monitoring of the progress made. The most successful result is that this unit, the only one active in the entire country of Cameroon, is now attracting patients from surrounding countries .Cvetkovic reported her experience gained in various visits to India, Malaysia, Nigeria, Kenya, Tanzania, and Mauritius. Thanks to the opportunity of experiencing different environments, she presented her approach to improve the quality of anesthesia derived from the combination of the following: regular teaching and education sessions, careful patients selection, patients preparation for surgery with meticulous pre-operative care, individualized type of anesthesia, and structured daily team briefing (Cvetkovic). The results were very encouraging, particularly because every visit was followed by regular interaction between visiting and local teams (Cvetkovic).Howes, a specialist nurse with years of experience in Pediatric Cardiac Intensive Care Unit who was involved in many visits with different teams, presented her interesting perspective regarding the protocol of early extubation after repair of complex congenital heart defects. Advantages and disadvantages of early extubation were analyzed, balancing the potential risks  vs. the needs dictated by limited resources in terms of personnel, equipment, infrastructures. Most of these aspects can be taken into consideration in different types of environments (Howes).Zain et al., who reported the experience of the local team in a rural area of North-East Malaysia, exposed to the beginning of pediatric cardiac surgery activities from scratch, initially with a surgeon in place for a couple of years, then with regular visits of alternating teams. Their experience is another confirmation that, if a program is well-organized and sustained, it can lead to stepwise growth of the local team until reaching autonomy for surgical management of the vast majority of children born with congenital heart defects in a region without any alternative available for treatment. The visiting teams now are mostly helping the local team for assistance in the surgical management of the most complex malformations, and to continue the educational and supporting program .A relatively new perspective has been presented by The last two articles of this Research Topic reviewed the entire issue of humanitarian activities in low and middle-income countries.Novick et al. reported their approach, accomplished after mastering the assistance in pediatric cardiac surgery, starting from visiting Colombia in 1991 and since then having visited 32 countries, having completed over 560 trips of between 1- and 4-weeks in duration, with nearly 10,000 patients operated on in total. Their comprehensive approach covers many steps, including the request for assistance, a site visit, the preparation for program implementation, different types of program models accordingly with the match between the local needs and the visiting team availability , the nursing education and empowerment, and the attention to the services of interventional cardiology, anesthesia, perfusion, biomedical engineering, operating room . Because of their very extensive experience across many countries, Novick et al. also analyzed the difficulties of providing service in conflict zones, the need to provide benchmarks and indicators of improvement, as well as quality improvement and assessment, and ethical considerations on the entire matter.Murala et al. provided a detailed overview of the current global situation, with report of the current units involved in these humanitarian activities with short and long-term programs. In particular, for the short-term programs the analysis included persistence and continuity, cooperation with Non-Governmental Organizations, focus on types of congenital heart defects, on site issues, view from the host programs, and financial aspects. Then they proposed elements to consider in a model for establishing long-term programs: shared vision, spark plug , communication and coordination, training, material support, exit strategy, data collection, and analysis .Nichani and Nichani explored in a clever and original way the potential benefits of this work performed by teams from the so called “high income countries” to the low-income regions of Africa and Asia to provide care for children born with congenital heart defects.In the final article, In fact, there are also advantages for those teams organizing these humanitarian activities, such as gained experience on unusual cases, team-building, and improvement. Furthermore, a deeper connection to the main meaning of the medical profession is an extremely important part of the experience.This is, to the best of our knowledge, the first time that the many benefits for the traveling medical teams, in addition to the recipients, have been considered in all the literature published on this topic.We hope that this Research Topic will help all readers and interested individuals so that in the future the diagnosis of congenital heart defects and rheumatic heart diseases will no longer be the death sentence, for the majority of children in the world, that it currently is.All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Since the first case of the novel coronavirus (SARS-CoV-2) was reported in Wuhan, China, in December 2019, the coronavirus disease (COVID-19) has quickly spread to all the corners of the world. Amid the global public health threats posed by the COVID-19 pandemic, active cooperative governance has gradually emerged as the most powerful weapon against its spread. To facilitate international cooperation for pandemic governance, this paper applied the evolutionary game theory to analyze the factors influencing active cooperative governance and, based on the results, proposed a series of recommendations for promoting international cooperation. (1) leveraging the role of international organizations to reduce the cost of realizing the strategy of active cooperative governance, (2) promoting the international exchange of related experiences to lower the cost of active pandemic governance, (3) sustaining productive and daily activities during the pandemic in a classified and hierarchical manner to reduce the economic loss incurred by active pandemic governance, and (4) optimizing the incentive measures of international organizations to facilitate the selection of active cooperative governance. Finally, from the four aspects of resource management of pandemic treatment, supply management of living materials, population flow cooperation management, and governance fund cooperation management, this paper gives the path of international pandemic cooperative governance. Since the first case of the novel coronavirus SARS-CoV-2) was reported in Wuhan, China, in December 2019, the coronavirus disease (COVID-19) has quickly spread to all the corners of the world  and F(y) be 0. Five strategy equilibrium points for Affected Countries 1 and 2 are obtained: O , C , A , B , and D , where x* = Let x*, y*) as the saddle point. When the probability of active governance being initially adopted by both Affected Countries 1 and 2, , falls within ABCD, the two countries will lean toward the strategy profile of active cooperative governance over time. In other words, the system will converge to . However, when the said probability falls within AOCD, the two countries will lean toward passive non-cooperative governance, and the system will converge to . The details are mentioned in According to Friedman's methods, this study identifies  and  as the evolutionarily stable strategies for the two affected countries. The corresponding strategies are for both countries to choose passive and active pandemic governance, respectively, with , economic losses caused by active pandemic governance (Le1 and Le2), and the cost of realizing the strategy of active cooperative governance (Ce). The partial derivatives of Cpk, Lek, and Ce are computed with respect to SABCD. Considering that the above parameters are all above 0, Rp + Rs > Rpk − θLpk − Ce, and Rik + Rpk + Lpk < Cpk + Lek, the following can be obtained:To enable each affected country to converge to the state of active cooperative governance, this study first observed the effects of changes in the following parameters on This implies that, if the costs of active pandemic governance, the economic losses caused by such governance, and the cost of realizing the strategy of active cooperative governance are lower, the affected countries are more likely to choose the strategy of active cooperative governance over time.In reality, first of all, in terms of the cost of controlling the pandemic, due to the differences in the economic level between countries and the ability of national financial investment, developed countries can spend more manpower and material resources to control the pandemic, while poor countries cannot afford the huge investment in pandemic prevention materials; secondly, in terms of the capacity of bearing economic loss, in order to reduce the death and spread of patients, developed countries tend to take longer-term measures of trade stop, blockade and isolation, while poor areas cannot afford long-term economic losses. Finally, in terms of the cost of cooperation strategy, if the two countries have a similar political and economic background and previous cooperation foundation, the resistance of cooperation between the two countries will be greatly reduced, thus contributing to the realization of cooperation. However, if there are huge economic differences and national contradictions, the increase of cooperation costs will hinder the realization of cooperative governance. Therefore, the lower the cost of controlling the pandemic, the smaller the economic loss and the lower the cost of achieving the cooperation strategy are conducive to the realization of the cooperation strategy.SABCD are also observed: individual returns of active pandemic governance (Ri1 and Ri2), public returns of active cooperative governance (Rp), shared returns of active cooperative governance (Rs), and losses incurred by the pandemic (Lp1 and Lp2). The partial derivatives of Rik, Rp, Rs, and Lpk are obtained with respect to SABCD. Considering that θ > 0, Rp + Rs > Rpk − θLpk − Ce, and Rik + Rpk + Lpk < Cpk + Lek, the following can be obtained:Furthermore, the effects of the following parameters on This implies that, if the individual returns of active pandemic governance, the public and shared returns of active cooperative governance, and the losses incurred by the pandemic are higher, the affected countries are more likely to choose the strategy of active cooperative governance over time.Specifically, in reality, first of all, in the area of self-earnings, controlling the pandemic situation and reducing the number of infected persons will bring their own benefits to the national health, the credibility of the government, and the enhancement of the international image, which will promote the countries to actively respond to COVID-19. Secondly, active governance will reduce the number of domestic infections and reduce the number of domestic infections that will affect other countries' prevention of the pandemic. The prevention in own country can bring positive externalities to the prevention of other countries. At the same time, the cooperative governance will bring the partners the common benefits of the two countries' trade recovery. The improvement of public benefits and common benefits will promote cooperation. Finally, in terms of the harm of the pandemic, the more serious the economic and social harm caused by the pandemic, the more difficult it is for a single country to deal with it, and the need for other countries to cooperate, the easier the cooperation strategy will be achieved. Therefore, the greater the individual benefits, public benefits, common benefits, and the harm of the pandemic, the easier the cooperative governance strategy will be achieved.F), subsidy for active pandemic governance (Sf), and reward for forming an alliance in active cooperative governance (E), are now added to the payoff matrix shown in The above analysis is set against an unconstrained background. However, in reality, the affected countries are under constraints imposed by a variety of international organizations currently in force, including the United Nations (UN), WHO, World Trade Organization (WTO), IMF, International Labor Organization, and Food and Agriculture Organization , 34. To x*, y*), where First, this study defines the system of replicator dynamics equations and lets them be 0. Once again, five strategy equilibrium points for the two affected countries can be obtained: O , C , A , B , and D , falls within ABCD, the countries will lean toward the strategy of active cooperative governance over time. In other words, the system will converge to B . However, if the probability falls within AOCD, the countries will lean toward passive non-cooperative governance, and the system will converge to O . If the probability of the affected countries choosing the strategy of active cooperative governance is to be increased over time, it is necessary that saddle point D is moved to the origin 0, in order to expand the surface area of ABCD. Considering that the surface area of ABCD is defined as x* and y* are substituted into SABCD, the following can be obtained:Similarly, according to Friedman's method, the strategy equilibrium points  and  are identified as evolutionarily stable strategies. When the probability of active governance being initially adopted by both Affected Countries 1 and 2, (SABCD: costs of active pandemic governance (Cp1 and Cp2), economic losses caused by active pandemic governance (Le1 and Le2), the cost of realizing the strategy of active cooperative governance (Ce), individual returns of active pandemic governance (Ri1 and Ri2), public and shared returns of active cooperative governance (Rp and Rs), and losses incurred by the pandemic (Lp1 and Lp2).The previous section has already probed the effects of the following parameters on SABCD: coalition government's punishment for passive pandemic governance (F), subsidy for active pandemic governance (Sf), and reward for forming an alliance of active cooperative governance (E). The partial derivatives of E, F, and Sf are computed with respect to SABCD. Considering that Cpk + Lek > Rik + Rpk + Lpk + F + Sf, Rp + Rs + E > Rpk + θLpk + Ce + Sf, and Rp + Rs > Cpk + Lek + Ce, the following can be obtained:In this section, the analytical focus shifts to the effects of the following parameters on This means that if the joint organization punishes the countries that choose not to actively control the pandemic, subsidizes the countries that choose to actively control the pandemic, and rewards the alliance for actively cooperate to governance the pandemic, over time, each country will be more likely to choose the strategy of active cooperative governance. Specifically speaking, first, the punishment for the countries who negatively respond to the pandemic will promote the realization of cooperation, such as the World Health Organization's public criticism of the negative attitude of the United States in the early stage of the pandemic; second, subsidies will be given to the countries with active governance, and the financial assistance, scientific research and material assistance provided by the World Health Organization to the poor areas will help them control the pandemic. Finally, on the reward for the governance alliance, the WHO thanks the EU leaders for their efforts in uniting the world to fight the pandemic and providing the EU with materials for defeating the pandemic. Therefore, punishing the countries that negatively respond, subsidizing the countries that positively governance and rewarding the cooperative governance alliance are conducive to the achievement of cooperative strategies.Summarizing the above, three conclusions can be drawn. First, if the costs of active pandemic governance, the economic losses incurred by such governance, and the cost of enabling the strategic choice of active cooperative governance are lower, the affected countries are more likely to choose active cooperative governance over time. Second, if the individual returns of active pandemic governance, the public and shared returns of active cooperative governance, and the socio-economic impacts of the pandemic are higher, the affected countries are more likely to adopt active cooperative governance over time. Third, if the coalition punishes countries for passive pandemic governance, subsidizes countries for active pandemic governance, and rewards alliances of active cooperative governance, the affected countries are more likely to opt for active cooperative governance over time. Additionally, the strategic continuity of active cooperative governance is determined by the magnitude of its returns and the constraints imposed by the coalition.This study adopts the evolutionary game model to analyze factors influencing the strategic choice of active cooperative governance, along with the ways to enable such a choice. The individual returns of active pandemic governance, public and shared returns of active cooperative governance, and the socio-economic impacts of the pandemic are some of the more objective variables. Thus, to enable the strategic selection of active cooperative governance, efforts should be made to regulate the costs of active pandemic and active cooperative governance, the economic loss incurred by active pandemic governance, and the incentives for active and passive pandemic governance. The detailed measures are as follows: (1) leveraging the role of international organizations to reduce the cost of adopting active cooperative governance, (2) promoting the international exchange of related experiences to lower the cost of active pandemic governance, (3) sustaining productive and daily activities during the pandemic in a classified and hierarchical manner to reduce the economic loss incurred by active pandemic governance, and (4) optimizing the incentive measures of international organizations to guide countries adopt the strategy of active cooperative governance.To reduce the cost of strategic selection, the UN—as the most authoritative of comprehensive international organizations—approved a draft resolution titled “Global Solidarity to Fight the Coronavirus Disease 2019 (COVID-19),” introduced by six countries including Singapore, Ghana, and Indonesia, during the UN General Assembly. The resolution was co-sponsored by over 180 countries. The General Assembly's call for global solidarity and concerted efforts against the pandemic marked an important step in advancing international cooperation. The approval of the draft resolution saved the costs of negotiation and contract administration and lowered the threshold and resistance against international cooperation.To reduce the cost of governance, the mortality rate of COVID-19 patients approximated to 4% in China and exceeded 6% in other regions. It is necessary for the hardest-hit areas such as Europe to draw on China's therapeutic regimens for a higher recovery rate. China has shared its experience and practices with over 10 countries including France, Portugal, and Denmark with regard to virological characteristics, anti-pandemic philosophy, and the latest research achievements in pathology. It also imparted to Europe information that is highly instrumental in clinical treatments, including information on Chinese medicine and many other clinical regimens, as well as the recommended dosage, contraindications, and efficacy of an antimalarial drug and other agents.To reduce economic losses, it is important to ensure the smooth and continued operations of the global economy and trade. On the one hand, excessive draconian measures should be prohibited. Emergency measures should not stand in the way of global trade and supply chain operations. On the other hand, countries should endeavor to enact trade facilitation policies. Measures like tariff reduction, the lifting of trade barriers, and unimpeded trade should be implemented proactively, whereas trade disputes such as trade wars and tariff wars should be avoided. In terms of pandemic prevention and economic growth, we should learn from China's experience and implement production by classification according to the costs and benefits of pandemic prevention and production in various industries. First of all, no matter how severe the pandemic situation is, it is necessary to ensure the production of enterprises supplying medical materials, water, electricity, gas, communications and other basic living materials. Basic material support is the basis of pandemic prevention and control, and only by ensuring the production of these enterprises can we better prevent and control the pandemic. Second, governments should ensure safe production among enterprises by category and in stages on the premise that prevention and control can be carried out effectively. Enterprises in which employees can be segregated during production, those where production and consumption are separable, and those that encounter less negative impact from pandemic prevention and control can carry out production with specific conditions during the outbreak. However, enterprises that are unable to meet these criteria must wait for the pandemic to ease or end before they can resume production.To optimize incentive measures, international organizations should reward countries that actively engage in global pandemic governance. They should offer them incentives such as waiving or reducing the current year's membership fees and lowering import and export tariffs.The above discussion analyzed the influencing factors and enabling mechanisms associated with strategy realization for active cooperative governance. After strategy realization, measures to exploit each country's advantages to the fullest for the sake of global resource allocation against COVID-19 also warrant further investigation.First of all, the COVAX Global New Crown Vaccine Initiative (New Crown Pneumonia Vaccine Implementation Program), jointly led by the World Health Organization and the GAVI Alliance, is currently the most effective mechanism for the equitable sharing of safe and effective vaccines worldwide, with the goal of promoting equitable global vaccine distribution. Effective vaccines should become global public goods, and first be provided to people in urgent need around the world . The ultAlthough this study scientifically expounds the view of international cooperation to respond to the COVID-19 by using game theory, it still has the following limitations. First, the game theory assumes that all subjects participating in decision-making are rational and represent their interests. However, in reality, the behavior of countries cannot keep rational all the time, which will affect the applicability of the conclusion. Secondly, although we consider the factors that affect the cooperation between countries as much as possible, there are still some factors that are difficult to consider, such as political factors, which will affect national decision-making. Third, our results have not taken into account the dynamic changes of the COVID-19. Despite the limitations, this study has important implications for international cooperation to manage pandemics.In the face of the global public health threats posed by the COVID-19 pandemic, active cooperative governance has evolved into the strongest weapon against the outbreak. That being said, some national governments have stuck to passive solutions due to an inadequate understanding of the dangers of the outbreak. To facilitate international cooperative governance, this paper studies the factors of active cooperative governance in each pandemic area based on the evolutionary game method, and based on the analysis of influencing factors, gives the policy path of how to promote international cooperation in a pandemic situation and how to carry out national cooperative governance in a pandemic situation.What factors affect the international cooperation of pandemic control? First, if the costs of active pandemic governance, the economic losses incurred by such governance, and the costs of enabling the strategic choice of active cooperative governance are lower, the affected countries are more likely to choose the strategy of active cooperative governance over time. Second, if the individual returns of active pandemic governance, the public and shared returns of active cooperative governance, and the socio-economic impacts of the pandemic are higher, the affected countries are more likely to adopt the strategy of active cooperative governance over time. Third, if the coalition punishes countries for passive pandemic governance, subsidizes countries for active pandemic governance, and rewards alliances of active cooperative governance, the affected countries are more likely to opt for active cooperative governance over time.The following recommendations are also proposed for enabling active cooperative governance among countries: (1) leveraging the role of international organizations to reduce the cost of realizing the strategy of active cooperative governance, (2) promoting the international exchange of related experiences to lower the cost of active pandemic governance, (3) sustaining productive and daily activities during the pandemic in a classified and hierarchical manner to reduce the economic losses incurred by active pandemic governance, and (4) optimizing the incentive measures of international organizations to guide countries and effectively facilitate the selection of active cooperative governance strategies. The marginal contribution of this study lies in drawing upon the evolutionary game perspective to identify the enabling mechanisms and cooperative pathways underlying international cooperative governance.How to carry on the international pandemic situation cooperation governance? First, in terms of medical material management, global allocation of medical equipment resources, collective cooperation in scientific research, and relevant assistance from medical staff; second, in terms of supply management of living materials, global allocation of food and other necessities of life, and international trade cannot prohibit or restrict exports; third, in terms of population flow and cooperation management, countries in the severely affected areas should restrict population Outflow: countries with a good pandemic situation should restrict the inflow of population, and countries close to the end of the pandemic should strictly prevent the import from abroad. Fourthly, in terms of fund management for pandemic control, through the United Nations and other international organizations, a fund pool for pandemic control should be set up to increase financial assistance to the severely affected areas, vulnerable areas, and economically difficult areas.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.HY and XZ: conceptualization. HY, SH, and YW: methodology. XZ, XL, and ZS: validation. HY, YW, and LX: formal analyses and investigation. HY, YW, XL, and XZ: writing—original draft preparation. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.