Continuous resource misallocation not only results in total factor productivity loss but also leads to ecological degradation. Therefore, in the process of changing from extensive growth to intensive growth, Chinese agriculture should pay attention to the problem of resource misallocation. There is currently a lack of relevant research, especially concerning the spatial spillover effects of resource misallocation at the city level. To fill this gap, we employ a spatial panel model for empirical testing on the basis of measuring agricultural green total factor productivity (GTFP) in 306 cities in China from 1996–2017. We found that there is positive spatial autocorrelation in Chinese agricultural GTFP, but it decreases year by year. Misallocation in land, labor, machinery and fertilizer all directly hinder the local GTFP. The eastern is mainly negatively affected by neighbor resource misallocation, while the central and western are mainly negatively affected by local resource misallocation. Finally, the indirect effect of neighbor resource misallocation on GTFP gradually shifts from inhibiting effect to a facilitating effect with increasing spatial distance. These findings have clear policy implications: Chinese government should strengthen agricultural green technology innovation and diffusion, strengthen environmental regulation and promote the free movement of labor between regions and sectors. Since its reform and opening up , China has made great achievements in agriculture, feeding 1/5 of the world’s population on less than 10% arable land ,3. In orHowever, in the process of changing from extensive growth to intensive growth, Chinese agriculture has had to pay attention to the problem of resource misallocation. It is generally accepted that in a perfectly competitive economy, homogeneous factors should have the same marginal returns, otherwise there will be a flow from the side with lower returns to the side with higher returns, and eliminating such gaps will eventually lead to achieving market equilibrium. If factor markets are distorted, the free flow of factors will be restricted, resulting in an inability to be allocated to where they are most efficient ,6. In thThe Chinese agricultural sector has been largely dominated by the government in terms of resource allocation, with the flow of resources being regulated, and thus being unable to be allocated to the most efficient side (region or sector). This has led to an imbalance between marginal factor returns and factor prices, resulting in serious distortions in the allocation of agricultural production factors. Adamopoulos et al.  found thThe continuous resource misallocation not only results in TFP loss, but also leads to ecological degradation. On the one hand, lower factor price reduces producers’ willingness to improve the efficiency of resource use through technological innovation, leading to a stagnation of resource-saving technological progress ,16. On tThe paper contributes to the literature in three major ways. Firstly, this paper uses data from 306 cities in China as the research sample. Most of the existing studies on resource misallocation and total factor productivity use provincial and farmer-level data, and there is a lack of empirical studies at the city level. The motivation for using city-level data in this paper stems from two points: On the one hand, it is difficult to precisely capture the spatial spillover effects of resource allocation on the impact of agricultural GTFP due to the huge differences in cropping structure, economic development, policies and resource endowments among provinces. In contrast, there is relatively little variation in various aspects across cities in the same province, thus allowing the interference of external factors in the empirical results to be eliminated. On the other hand, data at the household level are limited by the method of sample collection and the perceptions of the respondents, which may lead to problems, such as sample selection bias. The data at the city level are directly sourced from official statistics, which can effectively avoid biased results caused by data distortion. For this reason, this paper collects a total of 306 cities in China from 1996–2017 as a balanced panel data for the study sample.Secondly, this paper focuses its research on green growth in agriculture. Existing studies on the impact of resource misallocation on green growth have mainly focused on regions and industries ,20,21,23Thirdly, this paper uses a spatial panel model to examine the spatial spillover effects of resource misallocation on the impact of GTFP in agriculture. Existing studies have only considered resource misallocation to local regions or aggregate total factor productivity loss and have not yet focused on the spatial spillover effects of agricultural resource misallocation. Hao et al.  used a sThe remainder of the paper is organized as follows. The concept of “green total factor productivity” was first proposed by the United Nations Environment Programme , which rThe DEA method is widely used to calculate GTFP because it does not require a specific production function and can include multiple inputs and outputs (expected and unexpected outputs). This paper uses each city as a decision module (DMU) to construct the production frontier. Assuming each DMU uses estalova  and adopIn this paper, GTFP is further decomposed by Malmquist–Luenberger index:The GTFP is further decomposed into an efficiency change index  to obtain the spatial Durbin model (SDM).It should be noted that the use of OLS to estimate the spatial model will lead to bias and inefficiency. In order to avoid these problems, we refer to Lee  and use According to the theoretical model of Hsieh and Klenow  and othed Klenow  argue thSimilarly,Substituting Equations (13) and (14) into Equation (11), respectively, we can find:This paper assumes a high degree of substitutability of output between different cities within the same province. Thus, the output at the provincial level can be obtained by summing the output of cities.Thus, When Measuring GTFP requires the use of expected output, unexpected output and input variables, and the selection of relevant variables in this paper follows the existing literature.Agricultural output. Many scholars divide output into expected output (Y) and unexpected output (B). Expected output (Y): in this paper, total agricultural output is used to measure output and deflated using the 1978 price index of primary industry output. Unexpected output (B) mainly includes total phosphorus (TP), total nitrogen (TN) and chemical oxygen demand (COD). This paper refers to Chen et al. , Han et For the pollution production coefficient of chemical fertilizer : In this paper, the number of people employed in agriculture is used as labor input, but as the available statistics do not distinguish the data on agricultural employees from those employed in agriculture, forestry, and animal husbandry and fishery, the total agricultural output value as a proportion of the total agricultural output value of agriculture, forestry, and animal husbandry and fishery is used as the weight in this paper to separate out the number of people employed in agriculture. Land (L): In order to reflect the situation of replanting and replacing crops, this paper uses the total sown area of crops. Machinery (M): In this paper, the total power of agricultural machinery is used. Fertilizer (F): This paper expresses fertilizer input as the discounted amount of fertilizer applied to agricultural production each year, including nitrogen fertilizer, phosphate fertilizer, potash fertilizer and compound fertilizer.The control variables in this paper include: rural population proportion (RPP), per capita GDP (PGDP), population density (PD), environmental regulation (ER), technological innovation (Patent) and foreign direct investment (FDI).: FDI has a two-way impact on the green development of developing countries: On the one hand, FDI can use developing countries as “pollution haven”, thus worsening the environmental quality of the host country. On the other hand, FDI contributes to the improvement of GTFP in the host country through technology spillovers and relatively strict environmental standards, that is, the “pollution halo”. The variable definitions are shown in Rural population proportion (RPP): On the one hand, the shift of the rural population will ease the tense human–land relationship in the countryside and contribute to the increase in total factor productivity in agriculture. On the other hand, the rural population shift is only a result of China’s urbanization, and the encroachment of urban construction on agricultural land will lead farmers to applying large amounts of chemical fertilizer in order to increase food production on limited land, thus increasing agricultural surface pollution . Based ohttps://www.epsnet.com.cn/index.html#/Index, accessed on 1 May 2020). Considering the missing data of some cities, the following methods are used in this paper to ensure data coherence.The raw data in this paper come from the China Urban Statistical Yearbook, the China County Statistical Yearbook, the China Statistical Yearbook, the China Rural Statistical Yearbook and various local statistical yearbooks, and all of them can be found on the EPSDATA website ((1) Data at the county level were summed to the city level. (2) A linear fitting method was used to fill in the missing values. (3) The provincial data were decomposed to the city level based on the ratio of the city aggregate data to the province. (4) Samples that still had missing values were removed. In addition, as the DEA measurement of GTFP is more sensitive to abnormal data, this paper applies 1% tail reduction to the data before and after. Finally, in order to preserve as much sample size and data quality as possible, we obtain balanced panel data for a total of 6732 samples from 306 cities in China from 1996–2017. The descriptive statistics of this paper are shown in In order to avoid the spurious regression of the model due to the non-stationarity of the data, this paper first conducted a panel unit root test on each variable. In this paper, the IPS test  and FishThe Kao test , PedroniIn this paper, the model is also tested for multicollinearity using the variance inflation factor (VIF). The VIF is the ratio of the variance in the presence of multicollinearity between the explanatory variables to the variance in the absence of multicollinearity. When The existing studies generally use Moran’s I index to test for univariate spatial autocorrelation. According to You and Lv  and AnseThe Moran’s I test only describes the average level of spatial autocorrelation. If there is positive spatial autocorrelation in some regions and negative spatial autocorrelation in others, the two will cancel each other out, ultimately making the Moran’s I index an underestimate. Moran scatter map is used to further characterize the spatial autocorrelation between each region for the years 1996–2000, 2001–2005, 2006–2010 and 2011–2017. As can be seen from To determine the fixed effect form of the model, the LR test is carried out, according to Li et al. . As knowIn order to further determine which model is most suitable for SEM, SAR and SAREM, it is necessary to perform (robust) LM lag and (robust) LM error tests. On the basis of clearly adopting the SAREM model, it is also necessary to determine whether the SDM should be adopted according to the LR and Wald tests. It can be seen from The average annual growth rate of China’s agricultural GTFP from 1996 to 2017 was 0.58%, which is very close to the 0.49–0.63 measured by Chen et al.  and 0.55The period 1996–2003 was a stage of decay, with an average growth rate of −1.9%, mainly due to the significant deterioration in EFFCH and the lack of TECH. The reasons mainly come from three aspects: Firstly, this paper uses sequential DEA, which does not allow for technological decline and treats technological progress as a smooth process, thus attributing all the reasons for the decline and sharp fluctuations in GTFP to technical inefficiency and variability . SecondlIn (5)–(8), the coefficients of LnMis  are significantly negative, but the coefficients of In addition, we find that the control variables also have an impact on agricultural GTFP. The coefficients of u et al. , there iTo test the robustness of the estimation results, this paper uses a spatial weight matrix based on the square of the inverse of the geographical distance:It can be seen from The coefficients of the SDM do not directly reflect the marginal effects of the explanatory variables on the dependent variable  and needAs can be seen from The differences in the economic development, the marketisation and the climate are responsible for Chinese agricultural development’s obvious regional characteristics. In this paper, the sample is divided into three sub-sample groups according to the eastern, central and western parts of the country, in accordance with the usual practice of the academic community, and the regressions are conducted separately.As can be seen from In Additionally, this paper uses 300 km as the benchmark to construct a spatial distance weight matrix, and then measures the spatial spillover effect under different geographical distance thresholds according to the increasing distance of 300 km.As can be seen from This paper empirically examines the spatial spillover effects of resource misallocation affecting agricultural GTFP, based on balanced panel data from 306 cities in China from 1996–2017 using a spatial panel model. The main findings of this paper are summarized as follows.Firstly, Chinese agricultural GTFP is generally characterized by a “U” shaped change, with a decline (between 1996–2003) followed by an increase (between 2003–2017). Secondly, local resource misallocation hinders the achievement of green growth in agriculture, but labor misallocation in neighbor regions has a significant contribution to GTFP. The heterogeneity test results show that GTFP in the eastern region is more susceptible to negative spillovers from resource misallocation than in other regions, while the decline in GTFP in the central and western regions is noted to be affected by resource misallocation in the region. Finally, the negative effect of local resource misallocation on GTFP does not change depending on spatial geographical distance. In contrast, the indirect effect rises with increasing spatial distance, thus driving the total effect to also show an upward trend.Based on the above conclusions, the policy implications of this paper are as follows. (1) Chinese government should strengthen agricultural green technology innovation and diffusion. The empirical results show that Chinese agricultural technological progress has shown a continuous upward trend, but the technical efficiency has always been in a deteriorating trend, thus leading to the weak growth of Chinese agricultural GTFP. Therefore, while the Chinese government should increase the research and development of green technologies in agriculture, it should also strengthen the promotion of green technologies and enhance the training of farmers to apply the new technologies in agricultural production. (2) Chinese government should strengthen environmental regulation. In this paper, the excessive use of chemical fertilizer and improper disposal of agricultural straw are the main causes of environmental pollution. Tang et al.  argued t2 emissions by 2030 and carbon neutrality by 2060. Although industry is the source of greenhouse gases, rapid development of agriculture also plays an important role, and the carbon emissions caused each year should not be underestimated. In the future, we will consider the relationship between resource misallocation and agricultural carbon emissions.This paper has some limitations, which are as follows: Firstly, in the research sample, this study uses city data, which can directly reflect the temporal and spatial differences of agricultural resource misallocation and GTFP. However, the city data will smooth out the differences in farmers’ preference factors, and it is difficult to reveal the micro-mechanisms that the effect of resource misallocation will have on GTFP. In the future, sample data at the level of farmers or agricultural products can be used to explore in depth the micro-mechanism. Secondly, the Chinese government promises to strive to achieve peak CO


Although the “Internet+” technologies (big data and cloud computing) have been implemented in many industries, each industry involved in rural tourism economic information services has its own database, and there are still vast economic information resources that have not been exploited. Z travel agency through rural tourism enterprise third-party information services and mobile context-awareness-based Z travel has achieved good economic and social benefits by deep value mining and innovative application of the existing data of the enterprise through the third-party information service of rural tourism enterprises and mobile context-aware travel recommendation service. It clearly demonstrates that, in order to maximise the benefits of economic data, rural tourist businesses should focus not only on the application of new technologies and methodologies but also on the core of demand and data-driven and thoroughly investigate the potential value of current data. This paper mainly analyzes the problems related to how rural tourism can be upgraded under the smart tourism platform, with the aim of improving the development of China's rural tourism industry with the help of an integrated smart tourism platform, and proposes a hybrid cloud-based integrated system of smart scenic rural tourism information services, which can meet the actual use needs of rural tourism, with good shared service effect and platform application performance, and promote the development of rural tourism and resource utilization rate. The rise of the smart tourism model provides a new opportunity for rural tourism information construction, and the full integration of rural tourism information technology and smart tourism development is beneficial to the realization of rural tourism industry development systemic linkage, but also the future of rural tourism economic construction indispensable main content, to enhance the impact of rural tourism, has important significance –3.International rural tourism information technology started earlier, and in the late 1990s, some developed countries have formed the prototype of intelligent tourism. With the improvement of the level of information development and the popularization of intelligent technology, intelligent tourism development has become the main form of rural tourism development in some international developed countries.Among them, the customised service model , 5, whicChina and governments at all levels have deployed the rural revitalization strategy, and rural revitalization has become an important grasp of China's three agricultural works during the period of China's rural transformation and development. Economic revitalization is the foundation of rural revitalization, and rural tourism industry has become an important way to promote rural economic revitalization and industrial prosperity because of its diversified resource elements input requirements to integrate rural natural ecology and traditional culture and plays a pivotal role in the transformation of modern rural production mode and industrial structure. And with the development of modern technologies such as big data and Internet of Things, rural tourism development has advanced with the times, through the deep integration of technology and tourism, not only to achieve the systematic integration of tourism resources but also through the application of big data, cloud computing, artificial intelligence technology, etc. , 9, to iThe following is the paper's organization paragraph: There will very certainly be a lot of infrastructure rehabilitation and industrial development as part of the process of rejuvenating the countryside and boosting rural tourism. To avoid destroying the original rural landscape and cultural traditions during construction and development, intelligent tourism technology can be used to achieve sustainable utilization, such as using mapping and positioning technology in intelligent tourism, applying satellite remote sensing mapping, drone mapping, tilt photography technology, and Baidoo precise positioning technology in large regional project implementation monitors. In terms of monitoring regional project implementation, land resource protection, and use, as well as environmental protection of rural villages and restoration of ancient buildings, tourism development and utilization can be realized without changing the original rural landscape, and the authenticity of tourism resources can be protected as much as possible. For the intangible cultural heritage, mainly intangible cultural heritage, which is widely inherited in the countryside, big data technologies such as database, knowledge mapping, block chain, and other technologies in smart tourism can be used to achieve sustainable utilization of traditional rural culture. The purpose of wisdom tourism development for rural tourism system construction is to carry out scientific wisdom tourism development management layout according to the characteristics of rural tourism information development, promote the diversified design of wisdom tourism content –13, and The industry has progressed from simple computing virtualization to the cloud of the entire data center, employing a software-defined approach to automate and scale the administration of computing, network, and storage resources in the data center. A multi-AZ interoperable resource sharing paradigm has been adopted across various cloud data centers by large companies with numerous data centers. Today, an increasing number of businesses are combining clouds from various providers to solve specific business concerns. The evolution from traditional IT to the cloud has given birth to a large number of different cloud technologies see  19–21].–21.19–21At this stage, enterprises usually use three types of computing resources, namely, dedicated server resources running in enterprise data, virtual resource pools established on the basis of private clouds in enterprise data centers, and computing resources provided by public cloud providers . For theBoth public and private clouds offer infrastructure resources including processing, storage, and networking, as well as open APIs for consumers to employ. However, each cloud provider's APIs are distinct, and there is no consistent standard, which makes adapting heterogeneous clouds a difficult task for customers. Therefore, in this paper, we build independent Kubernetes container clusters in each cloud provider, such as public and private clouds, and then design and implement a unified global controller to manage and schedule the Kubernetes container clusters on each heterogeneous cloud at the upper layer. This ensures API homogeneity across the underlying heterogeneous clouds, as well as the simplicity of cross-cloud deployment, migration, and business elastic scalability. The hybrid cloud management platform mainly manages application publishing and resource scheduling of container clusters on the underlying heterogeneous cloud and contains four modules: API, scheduler, controller, and database. The API is mainly used to receive commands from the front-end, the scheduler is used to schedule Kubernetes clusters in the heterogeneous cloud, the controller is used to handle business logic, and the database is used to persistently store resource data managed by the platform. The underlying public or private cloud Kubernetes cluster mainly manages the scheduling and dispatching of resources of a single container cluster, including master and node nodes. Master mainly controls the resource scheduling of a single cluster, and node runs the actual business container as a working node.To deploy Kubernetes on each heterogeneous cloud infrastructure of the user, the upper global controller needs to add the platform address, port and Barberton of each Kubernetes cluster, etc. The upper controller makes calls through the standard API and the underlying Kubernetes. Namespaces of Kubernetes represent namespaces, which are mainly used to achieve resource isolation of tenants. Nodes represent host nodes in the cluster, which are the bearers of resource scheduling. Deployments are primarily used to manage the number of copies of applications. Pods are the smallest units for application operation and scheduling. Services are services that can expose access portals for back-end applications. N internal private cloud VMs, and all the initial invariant data is stored in a distributed manner. When there are M external public cloud VMs scaled to support N internal VMs for big data analytics tasks, the perception policy rescales the deployment of MapReduce applications and iterates the MapReduce-based big data analytics application on the generated hybrid cloud platform. For analysis, let the internal VMs have the same configuration capability as external VMs, and users can trace the historical state of the application or have access to the following MapReduce performance metrics: the total number of map/reduce tasks, denoted as PM and PR; the number of physical slots for performing map/reduce tasks, denoted as kM and kR; the average time to execute map, reduce, and scheduling tasks, denoted as AM, AR, and AS; and the average amount of scheduling data per execution of map, reduce, and scheduling tasks, denoted as DM, DR, and DS. In addition, let the dynamic behavior of the big data analysis application at runtime be measurable; i.e., the first iteration process is known a priori, while the input data volume, newly generated data volume, and computational complexity during each subsequent MapReduce operation are independent of each other. The internal virtual machine performance evaluation metrics are used in the ith map operation, and the set of tasks with the number NumM,i is assigned to kM,i physical machines using a greedy allocation strategy. In this process, the task scheduling operation needs to be started first, so extra time is introduced and its time overhead needs to be considered separately, and its execution time is noted as 1T, whose value is related to the physical device performance and software system working mechanism, and can be considered as a constant. The theoretical lower bound on the execution time of subsequent task execution occurs in the case that the slowest task is scheduled to be executed last, while the previous NumR,i tasks have already been executed. Therefore, the theoretical maximum execution time of the ith map operation isτ is now the average execution time of the task and τmax is the slowest execution time of the task. Further, its minimum execution delay occurs when the workload is fully balanced, and all tasks are executed with normal efficiency. Therefore, the theoretical minimum execution time of the ith map operation asConsidering the economic cost and time cost, often different cloud service models are used to accomplish big data analysis. Therefore, the hybrid cloud platform should give the estimated computational resources and computation time to the user before the user submits the data with the target problem to determine the required virtual machine configuration. Initially, the MapReduce application is deployed on ith reduce operation areTR−max and TR−min are the theoretical upper and lower bounds of the execution time of the ith reduce operation, NumM,i is the number of tasks in the ith reduce operation, and kR,i is the number of physical machines in the ith reduce operation. In summary, for the ith iteration process, the lower bound on the time delay required to complete its execution can be estimated by the following equationSince the reduce and map operations in MapReduce are independent of each other but do not require task scheduling operations again, the minimum and maximum execution times for the I, the total completion time can be estimated by the following equation. For a big data analysis application with iteration N. The rating of the ith data in the list is (N − i + 1), so the first data in the retrieval result list with the highest rating can be obtained as N and the last data with the lowest rating. Assuming that a data appears more times in different retrieval result lists, the rating of the data can be expressed as the sum of the rating values of each retrieval queue. Then, the data that appears in all of the multiple retrieval result lists has a higher rating than the one that appears individually. The total score is obtained by first scoring each retrieval result data, and then, the data appearing in different retrieval result queues are summed into a list and sorted according to the weight value from largest to smallest. Let MM be the amount of data in the longest retrieval return list. In this paper, the longest retrieval chain is NC, i.e., MM = MO. For the j-th retrieval result list, let the rating base be Wj, and let the rating of the ith data in the j-th column be Wj∙(MM − i + 1). The relevance of the search term to its corresponding search category C and the amount of data in the retrieval queue will have an impact on the scoring base Wj. The retrieval queue scoring base Wj is shown as follows:C and retrieval keywords, rankC is 1. In the second rank,rankCis 0.5, and in the third rank,rankCis 0.25.simC is Sim, and numC indicates the number of data in the retrieval list. If a retrieval result list is not summed by retrieval category, rankC is 0.5 and simC is 0.1.Let the length of all retrieval result lists be A new private cloud data center is built off-site, and public cloud services are rented to form a “hybrid cloud” architecture. At the same time, the local data center of the health Bureau is used as the disaster recovery center, which eventually forms a “hybrid cloud” based two-location, three-center architecture. The existing hardware and network resources are fully protected, and under the cloud environment of the new data center, the appropriate level of protection is provided for each level of business, and the colocation and off-site disaster recovery of business and data backup are completed. The core key services of the new private cloud data center are built in 1 : 1 mode, which can realize business-level disaster recovery, and when the main system fails, the backup system takes over the business without losing business data. In addition, in order to avoid the hidden danger of data loss caused by natural disasters, the local server room of the health Bureau is used as the disaster recovery center, and a flexible deployment backup strategy is adopted, so that when the private cloud data center fails, no data can be lost, storage level disaster recovery can be realized, and the local data center has the ability to quickly resume business. The hybrid cloud disaster recovery solution is shown in train and matrix DCtrain are built using the method proposed in this paper, and the matrix DTtest and matrix DCtest are built according to the test set. Once the individual retrieval feature matrix M is constructed, the relevance of the retrieval categories in the DTtest matrix and DCtest matrix to the retrieval keywords is obtained, and the relevance score is performed. The experiments are from a travel information website, and the statistical results are shown in In order to verify the effectiveness of the algorithm proposed in this paper, cross-simulation tests are conducted. The user's rural tourism retrieval records were all divided into 10 subsets, each with the same number of tourism retrieval records. The retrieval algorithm was repeated 10 times for each different subset of data, and 9 of them were used as the training set. For the training set, the matrix DTn denotes the number of all retrieval categories related to the retrieved keywords, scoreci denotes the rating of the top three retrieval categories ci in terms of relevance. rankci denotes the ranking of retrieval categories ci, and ideal_rankci denotes the highest ranking that retrieval categories ci may receive. The feature matrix simulation experiments use the Rocchio algorithm and the Im-Rocchio algorithm proposed in this paper to calculate the user retrieval feature matrix M, respectively, and then, use the user retrieval feature matching algorithm to perform category matching and calculate the matching accuracy. From the results in For each user's retrieval, the algorithm feeds the user 3 categories with high relevance to the retrieved term, and the following equation is used to score the relevance of the retrieved category to the retrieved keyword. Feature matching simulation experiments are first conducted using the experimental dataset to compare user retrieval feature matching, generic retrieval feature matching, and 3 kinds of mixed feature threshold extraction matching, and the average accuracy of retrieval results is counted, as shown in N virtual machines deployed on the internal private cloud and M virtual machines deployed on the external public cloud as N-on-M-off. Let M = 0 denote the traditional single cloud storage scheme in the benchmark case, existing methods as a comparison, and M > 0 denote the proposed hybrid cloud storage scenario. The TestDFSIO experiments in the baseline and hybrid configuration scenarios are repeatedly executed 10 times, and these results are computed for the parameter β. In this experiment, the size of the input data volume used is 20 GB, and the size of the data volume processed by each mapping processor varies randomly, which equates to the number of mapping processors varying randomly. As a result, the following is the data sample creation process utilized to construct the random forest algorithm: First, HDFS is installed on three virtual machines in the internal virtual cloud and configured to generate data blocks using TestDFSIO. After the initial data is written, the HDFS deployed on the internal private cloud VMs can be further extended and deployed to the external public cloud VMs; second, during the load balancing phase, another TestDFSIO program is made to start at the same time. At the same time, at least one copy of each data block stored internally during the load balancing phase is moved to the externally deployed VMs. During the experimental run, the amount of data migrated to the external public cloud in the load balancing phase is recorded, thus forming a data sample containing different VM configuration scenarios and the performance of the corresponding algorithms. The proposed steps are then applied to construct a random forest. Denote the configuration scheme with The importance of rural tourism to rural revitalization is largely due to its high industrial correlation feature, which relates to transportation, accommodation, medical care, entertainment, catering, and a series of other supporting industries. Hybrid cloud platform has obvious technical and economic advantages because it combines the advantages of private cloud security and reliability and public cloud computing power. However, running intensive data businesses such as big data analytics under the hybrid cloud framework is still in its infancy, and there are difficulties in mismatching the underlying data storage with advanced applications and inaccurate application execution time prediction. The cloud platform is a new type of sharing infrastructure that employs cloud computing technology to gather a huge number of online resources and manages them automatically with software. The hybrid cloud-based integrated system of information services for rural tourism in smart scenic areas designed in this paper can use the hybrid cloud platform to get a large number of available resources in rural tourism and use software to manage them automatically. The test of this paper shows that the platform shares a relatively large number of resources and has comprehensive contents to meet the needs of users, and the rural tourism resources have good sharing application effects, which can improve the economic benefits of rural tourism.


Although individual rare disorders are uncommon, it is estimated that, together, 6000+ known rare diseases affect more than 30 million people in Europe, and present a substantial public health burden. Together with the psychosocial burden on affected families, rare disorders frequently, if untreated, result in a low quality of life, disability and even premature death. Newborn screening (NBS) has the potential to detect a number of rare conditions in asymptomatic children, providing the possibility of early treatment and a significantly improved long-term outcome. Despite these clear benefits, the availability and conduct of NBS programmes varies considerably across Europe and, with the increasing potential of genomic testing, it is likely that these differences may become even more pronounced. To help improve the equity of provision of NBS and ensure that all children can be offered high-quality screening regardless of race, nationality and socio-economic status, a technical meeting, endorsed by the Slovenian Presidency of the Council of the European Union, was held in October 2021. In this article, we present experiences from individual EU countries, stakeholder initiatives and the meeting’s final conclusions, which can help countries attempting to establish new NBS programmes or expand existing provision. It has been estimated that among 750 million Europeans  are affected by one of over 6000 rare diseases [From Robert Guthrie’s first description of newborn screening (NBS) for the detection of phenylketonuria in the 1960s, to the widespread use, sixty years later, of tandem mass spectrometry (MS/MS), NBS has evolved from the detection of a single disease by the use of a specific test to approaches that can simultaneously detect more than 40 conditions . In the diseases .For some rare disorders, the early detection offered by NBS can be life-changing and is able to prevent long-term disability or even death . In the https://youtube.com/playlist?list=PLGrPQqFNXCItYEmEuM7MCrbZnYGd5yCMI, (accessed on 15 March 2022).To help understand and optimise the potential offered by NBS and the safeguards that must be in place to mitigate the unforeseen consequences of whole population screening programmes, the Slovenian Presidency of the Council of the European Union 2021 endorsed a technical meeting on “Achieving Equity and Innovation in Newborn Screening and in Familial Hypercholesterolemia Paediatric Screening across Europe” and listed it among its accompanying events. The technical meeting, that took place on the 11th of October 2021, brought together leaders in the field, patient representatives, members of the European Reference Networks for Rare Diseases and interested policymakers. The event was attended by more than 150 participants from more than 40 countries around the globe. As many could not attend the meeting, recordings of presentations have been made public at: The key objectives of the meeting were to: (i) understand and celebrate what has already been achieved within Europe in the field of NBS; (ii) understand the differences that exist in approaches to NBS and seek to improve the equity of provision between member states, taking care to respect national autonomy and subsidiarity; (iii) identify areas of good practice, helping to ensure that good practice becomes common practice; (iv) lay foundations for future development including the potential offered by genomic technologies both to detect and treat rare disorders; (v) propose the creation of a dedicated expert forum at EU level to bring together policy makers, patient group representatives and professionals able to share experience, explore the options and offer impartial advice.In the following article, we present an executive summary of the event and its conclusions. To begin, national representatives presented examples of best practice and achievements in the field of NBS, followed by the contributions from patient advocacy organisations and pan-European initiatives. The meeting concluded with a broad discussion about the topic, leading to conclusions for further action.While NBS is believed by parents to serve as reassurance that all is well, paradoxically, for a small group of parents the consequence of screening is that they are contacted unexpectedly to arrange a clinical referral following a positive NBS result. This can itself cause great shock. The way in which that clinical referral is arranged and conducted is crucially important to avoid lasting damage to the family, particularly if the result is subsequently found to be a false positive. It is clearly recognised that “all screening programmes do harm; some do good as well, and, of these some do more good than harm at reasonable cost” . It is tThe International Society for Neonatal Screening (ISNS) strives to promote well-organised and carefully monitored NBS programmes that are linked to carefully planned confirmatory testing, best practice treatment and the comprehensive assessment of long-term outcome. However, in this field, significant differences can be seen between European countries. Not only do countries differ in the number of conditions screened, but also in the pre-screening information and support offered to parents, the time of sample collection, the accreditation status of the laboratories conducting screening and the governance, regulation and monitoring of the NBS pathway . This vaWe are now progressing into a genetic era where genomics will help us diagnose rare disorders and also provide us with new treatment opportunities. Along with this new potential, it is important to reinforce the long-recognised importance of the Wilson and Jungner criteria ,15,16 anWhile the value of the Wilson and Jungner criteria has stood the test of time, it may be that these need to be interpreted differently with the additional information made available by genomic testing ,14,17. MAs new technologies are emerging, including genomic testing, we will need to be cautious and ensure that the public are involved during the planning and implementation. In addition, the current COVID pandemic, which affected most of the NBS programmes in Europe at least to some degree, has clearly exposed the need for better contingency planning and sharing of best practices among countries .Law mandate for NBSNBS infrastructure reorganizationSame-day, second-tier testing resultsNBS is considered an essential public health service and became mandatory by law in 1992 when only three disorders were screened for. With the introduction of MS/MS in 2016 and as new rare diseases were added, Italy began to cover approximately half of the neonatal population with expanded NBS. To improve accessibility, Italy structurally reorganized their strategy and reduced the number of screening centres from 32 to 15 to centralize diagnostic methods. Currently, the national programme includes 40 disorders, the coverage is 100% and the programme is financed by the government by Law 167/2016. To prevent parental anxiety arising from false-positive results, second-tier biochemical testing, where possible, is performed on the same day as the first screen-positive result.NBS mandated by lawClear hierarchical structure of advisory organs to the Ministry of HealthFrance began NBS in 1968. At present, France screens for six disorders as part of blood spot screening and clinically for hearing disability. NBS is mandatory, resulting in >99.5% coverage of newborns. The programme is performed in 17 NBS regional centres and monitored by a national coordinating centre. Two specialized commissions oversee the national organisation: an epidemiological commission which supervises the overall effectiveness of the NBS programme and a biological commission which defines the screening algorithms and proposes and monitors the biomarkers used and their cut-offs. Finally, a national steering committee in the French Ministry of Health provides the general policies for NBS. Recently, the French health technical agency recommended extending the NBS programme to include seven new inborn errors of metabolism and a new expansion is planned before the end of 2022 [Confirmatory testing with next generation sequencingNationwide IT system for NBSThe first major expansion of NBS in Slovenia was implemented in 2018 with the introduction of MS/MS, when 17 inborn errors of metabolism were added to phenylketonuria and congenital hypothyroidism. Next generation sequencing was introduced for confirmatory testing of positive first-tier results and proved to be feasible providing a reliable result. In addition, every Slovenian newborn is screened for hearing impairment by transient evoked otoacoustic emissions, optic media translucency and congenital hip dysplasia by an ultrasound. Law mandates NBS, and over 99% of newborns have their blood samples analysed in a single central laboratory. Following scientific advances, a second expansion of NBS is planned for 2022 and this will be able to detect more than 40 congenital diseases. To minimize the administrative burden and to achieve good traceability and rapid reporting of results, a national IT network was established for NBS together with a barcode system . SloveniEvaluation of feasibility of NBS extensions with pilot studiesLong-term observational studies of children with inherited metabolic diseasesNational cohorts for individual metabolic diseasesGermany began an NBS programme in 1969 and since then has successively extended the screening panel. Since 2005, the NBS programme has been coordinated through a national directive. At present, the disease panel includes 19 diseases. In addition, regional pilot studies on additional diseases are conducted to evaluate feasibility, diagnostic process quality, and potential health benefits ,24. In sNational biobank for dried blood spots storageNational registry for inborn errors of metabolism for prospective management of patientsSweden began newborn blood spot screening in 1965 and has, since 1975, stored all dried blood spots in a biobank which helps support quality control of the screening programme and provides a basis for research. At present, 25 disorders are included in the screening programme, for some a second-tier test is performed to improve the positive predictive value . At presNBS extension preceded by a pilot programmeDetermination of population-specific cut-offsCost-effectiveness analyses prior to implementationScreening for phenylketonuria began in the former Czechoslovakia in Czechia in 1975 and in Slovakia in 1980. The introduction of congenital hypothyroidism began in 1985. Subsequent expansions of the laboratory NBS programme took place in the independent Czech Republic in 2006, 2009 and 2016. These were each preceded by pilot programmes funded from competitive grant calls. The investigator-initiated pilots aimed at obtaining population distribution of the biomarkers, defining cut-off values and establishing patient care pathways and algorithms for patient care. The recommendations of these pilot projects together with estimation of costs of screening and therapy were mandated by the Ministry of Health and insurance companies prior to approving nationwide expansions. Currently, 15 inherited metabolic disorders, two endocrinopathies and cystic fibrosis are the primary target conditions; LC-MS/MS and molecular genetic techniques are used as second-tier tests for selected inborn errors of metabolism and cystic fibrosis, respectively. A new pilot programme for spinal muscular atrophy and severe combined immunodeficiency, initiated by policy makers, a patient organisation and healthcare professionals, began in January 2022.Generally underdeveloped NBS programmes compared to Western countriesNo NBS programmes in two countries in 2020Southeastern Europe comprises 14 diverse countries, 7 of them are EU member states. NBS programmes in the region were generally underdeveloped when compared with western European countries in 2013. At the time, none of the countries had incorporated MS/MS in the programme, with the exception of Hungary in 2007. This was later followed by Croatia in 2017, and Slovenia in 2018. Nevertheless, it is a serious concern that two countries in the region currently do not have an NBS programme available for their population and that children in these countries are deprived of this life-changing intervention. Encouragingly, in the countries with existing NBS, the number of diseases screened and the proportion of newborns included has risen steadily. The main obstacles for programme expansion are the lack of financial resources, lack of organisation and staff ,31. The Screen4rare is a multi-stakeholder initiative launched by the International Patient Organisation for Primary Immunodeficiencies (IPOPI), the ISNS and the European Society for Immunodeficiencies. Screen4Rare recognises the need for autonomous national policy in member states and seeks to support those with that responsibility by the provision of unbiased scientific information, evidence, and comparative data to help ensure that the best decisions can be made on behalf of the populations served. The primary goal of Screen4Rare is to help promote ”The development of appropriate, well-organised and equitable NBS offered on a voluntary and informed basis to families, to help identify well-defined and treatable conditions where it is clear that their early asymptomatic detection and treatment during childhood results in significantly improved outcome.” To achieve this goal, Screen4Rare is striving to stimulate debate and support member states as they seek to improve existing screening programmes and, where appropriate, to introduce new forms of screening. Screen4Rare seeks to engage with physicians and scientists working in the field together with interested politicians, health policy makers and patient/parent groups with an interest. The EU Screen4rare initiative has achieved many important milestones including the support of 30 Members of the European Parliament and several organisations to a Call to Action on NBS for rare diseases . Screen4EURORDIS is a non-governmental, patient-driven alliance of patient organisations representing 988 rare disease patient organisations in 74 countries. In 2019, EURORDIS set up the Newborn Screening Working Group to review current policy and practice in the field of NBS and to develop principles for harmonious uptake/adoption of the NBS programmes across the Member States with a view to delivering maximum benefit and improving outcomes for babies born with rare diseases.After a consultation process involving experts, stakeholders as well as national alliances in the countries across Europe, European and international federations of rare diseases and members of EURORDIS, a position paper was published in January 2021 . The posThe principles make it clear that NBS should be organised as a system with clearly defined roles and responsibilities, as well as governance and accountability structures that are transparent and robust. The principles advocated by EURORDIS include, but are not limited to, treatable diseases, as this may improve the overall quality of life for newborns and their families. Crucially, it avoids the long journey to diagnosis that is so often faced, allows parents to also make decisions about treatments that can prevent or slow the onset of serious symptoms and gives them the option of making informed decisions about future pregnancies. Moreover, the principles promote appropriate psychological, social and economic support standards to be in place for families whose newborn is screened. In the position paper, it is also mentioned that healthcare professionals should receive thorough training, and the need for broader public awareness. Finally, the principles propose that Europe-wide standards are established to ensure that every parent in Europe can expect the same timing, collection methods, follow-up and information.In 2002, patients suffering from rare diseases reached out to the EC and raised awareness of rare diseases. This helped develop the concept of the European Reference Networks (ERNs) supported by Art. 12 in the Cross Border Directive 2011/24/EU. In 2017, twenty-four ERNs were established, involving about 300 health care providers of excellence and about 1000 specialized units, to which about 620 new units were added in November 2021. ERNs are present in all 27 EU Member States. “Share, Care, Cure” is the ERN’s motto, to promote equity of access to diagnosis, management and treatment for rare diseases in the EU. It is recognised that NBS has a key role in helping to achieve these goals and in turn, that the ERNs may have valuable expertise to inform how screening can be organized to ensure the best possible outcome for children and their families. Moreover, the ERNs seek to facilitate research and implementation of innovative therapies for rare diseases in EU. The ERNs are committed to promoting the concept that NBS should be considered as a system, not just a test, for this reason, this begins with information to couples during pregnancy and full counselling and care at the point of diagnosis . Equitable access to NBS—a life-changing and sometimes a lifesaving intervention—can be achieved by working together and the careful consideration of existing models of service delivery. We believe that it may be helpful to establish a time-limited NBS expert advisory committee (NBS-EAC), to help inform the EC and to act as a source for unbiased, evidence-based advice to support decision making at a national level. It is important that the group should include the voices of patient support organisations and be equipped to address the key issues of value to health-policy makers. The ERNs already have an established network of experts from different fields, connected to NBS, and as such provide an ideal platform for the formation of an NBS-EAC. Screen4Rare can also assist as a trusted repository for information about the NBS programmes across member states. The newly formed NBS-EAC would aim to develop unbiased information to support existing screening programmes and share information about new developments in all European countries.A key role for the NBS-EAC will also be to share experience from pilot schemes taking place in individual member states. It could play a valuable role in helping to co-ordinate work streams seeking to establish consistent case definitions for conditions included within NBS programmes and help ensure the interoperability of long-term outcome studies by supporting the ongoing development of existing disease registries in this area. It would also provide a means to share experience from around Europe of the governance arrangements, including a dictionary of key performance indicators, which can be employed to assess and monitor the quality of NBS programmes along with the standards which have been set by various member states to help monitor these. The key points that were identified in the stakeholders’ discussions are presented in As a product of this ongoing collaboration, a recent paper describes how NBS as a fully integrated system can enhance equity in NBS in Europe. This may need ten elements for the effective operation of NBS programmes, in part overlapping with initiatives mentioned below .(i)The formation of an NBS-EAC free from bias or national interests to provide trusted, high-quality information to support decision making at a national level;(ii)The need to progress specific work streams related to the documentation, identification and promotion of good practice in existing national NBS programmes so that these lessons may be shared more widely including through the Non-Communicable Diseases Group (SGPP) advising the EC;(iii)The need to collect, collate and develop key performance indicators that might help maintain and improve the quality of NBS programmes;(iv)The establishment of accepted ‘Case Definitions’ for the disorders currently screened and those under consideration;(v)The promotion of interoperable disease registries as a means to gather and understand outcomes to guide NBS strategy;(vi)The need for outputs from national pilot programmes in NBS to be shared more effectively to shorten the time needed to introduce new screening programmes or cease their development where these may be shown to be inappropriate;(vii)The consolidation of a NBS group within the existing ERNs, both those with a current involvement in NBS such as MetabERN and ERN-RITA (the immune deficiency ERN), and in those who have responsibility for conditions where patients may benefit from the early asymptomatic detection offered by NBS in the near future;(viii)The need for special consideration to be given to the rapid development of genomics to greatly alter the potential for diagnosis at birth and the ethical challenges and clinical opportunities that this brings.The most urgent initiatives, needed to stabilise the existing position and plan for a future which may see rapid expansion reflecting technological change, include the following: It was recognized at the meeting that NBS enjoys widespread acceptance among the public, professionals and policy makers and great care must be taken to preserve this public confidence in a society which no longer accepts medical practice without question. We need to be able to respond to those requesting improved access to screening while acting proportionately and ethically to protect the confidence which the public and parents with young children have placed in our existing programmes. To achieve this equitably on behalf of the community that we serve in the EU, we need to work together collaboratively across member states with the backing of the EC and the support of politicians, parents, professionals and the public. Additional initiatives are needed to promote good practice, address inequity and to ensure that the EU can maximise the scientific, clinical and economic benefits arising from NBS in the coming years.


Over the past few decades, we have been experiencing an increase in the incidence of multiple gestations, mostly due to the widespread use of assisted reproduction technologies. Multiple gestation encompasses 2–3% of all pregnancies, most of which are twin pregnancies . HoweverTwin pregnancies pose a significantly high risk for preterm birth. Approximately half of twins are born preterm (<37 weeks gestation), and 10% to 15% are born before the 34th week of gestation . WhereasAnother major obstetric controversy related to twin pregnancies is the delayed fetal growth observed in the third trimester. Whether this phenomenon should be considered as a normal physiologic characteristic of twins or a pathologic process that warrants special attention is currently unclear and has implications on the chart that should be used for the assessment of fetal growth and on the definition of fetal growth restriction ,11,12.Finally, there are complications that are specific to monochorionic placentation, which are associated with high risk of perinatal morbidity and mortality as compared to dichorionic twin gestations. Much progress was made over the last few decades in the management of those complications, mainly laser ablation of placental anastomoses. However, there is still much to achieve in tailoring the optimal treatment to each patient.In summary, twin pregnancies present unique challenges, and the optimal management of most of them is still unclear. Thus, it is important to continue with the conduction of clinical trials as well as basic-science research for the improvement of care and long-term outcomes of mothers and babies.


This study aims to investigate the antecedents and consequences of relationship quality in the Jordanian pharmaceutical industry. A convenience sampling technique was used to select a representative sample of physicians working in the public healthcare sector in Jordan. Particularly, 500 questionnaires were distributed and 374 questionnaires were used in the analyses. Structural Equation Modeling was used to test the research hypotheses. Results revealed that the relationship quality was affected positively by the following antecedent variables  while similarities had no significant effect on the relationship quality. The findings also revealed that the anticipation of future interaction between the physicians and medical representatives was affected positively by relationship quality. This study is the first that adequately examined the relationship quality and the anticipation of future interaction in the Jordanian pharmaceutical sector. Relationship marketing is generally concerned with how organizations create, build and maintain productive relationships with customers for long-term profitability . BesidesOne driver of relationship effectiveness and success relates to the concept of relationship quality , 5, whicIn general, in a B2B setting, firms must understand the nature and conditions of their targeted clients because of their unique characteristics and consider that B2B customers purchase larger quantities and have more specialized needs . ConsequIn this paper, section one examines the previous literature on pharmaceutical marketing. Afterward, the study model, hypotheses development, and a review of related previous literature on the impact of relationship quality on customer loyalty are discussed. Section three presents the study’s methodology including the population and sample, measures, data collection instrument and response rate, validity constructs and composite reliability. The fourth section illustrates the empirical results, followed by the discussion. The final section includes the conclusion, study limitations, and recommendations.The literature of pharmaceutical marketing has recently shifted its focus to examine the impact of social media on pharmaceutical firms –20. GeneOverall, this trend identified factors affecting prescription behavior such as scientific information by public authorities , serviceWhile the majority of the literature focused on these two main research themes, limited research attention has been given to the antecedents and consequences of relationship quality and its impact on pharmaceutical firms. Pharmaceutical marketing varies from most customer marketing activities in many aspects. Aside from the heavy use of patent protection of products and the increasing incentives for research and development . In the Relationship quality has a critically important role in relationship marketing and is mainly recognized as a central construct . Even thTrust refers to the “perceived credibility and benevolence of a target of trust” , and sevFinally, relationship commitment is considered as an attitude, where the main assumption is that the relationship is worth the effort to be maintained . 60] de de60] deBehaviors of medical representatives are treated as a critical element in building long-term relationships. The way a medical representative reacts to different elements within the sale encounters with a specific physician can predict the future possibilities of the relationship , 27, 66.Relationship selling behaviors emerged as a construct of three elements, namely, mutual disclosure, contact intensity, and cooperative intentions where these three-elements are a part of the relationship quality model that aims to show structural characteristics of long-term sales relationships in service selling , 69. ConThe contact intensity, on the other hand, refers to the frequency in which the medical representative communicates (face-to-face or indirectly) with the physician either for personal or business purposes. It reflects an effort on the part of the salesperson to keep the communication channels open with the customer and exhibit a commitment to the relationship . RelatioFinally, the cooperative intentions refer to the positive attitude towards sharing information or problem solving within a collaborative relationship. These intentions, or goals, provide an active behavioral outcome rather than mere willingness . CooperaH1. Relational selling behavior has a significant effect on relationship quality.A crucial part of the antecedent variables of relationship quality relates to the similarities between the medical representative and physician. The general presumption here is that salespeople are more likely to be successful if they have some characteristics in common with their prospects , 78–80. H2. Similarities between medical representatives and physicians have a significant effect on relationship quality.Expertise is defined by  as “the H3. Expertise has a significant effect on relationship quality.Ethical behavior plays an important role in securing relationship quality , 91, 92.H4. Ethical medical representative behavior has a significant effect on relationship quality.The anticipation of future interaction is identified by  as “an oRelationship quality serves as an indicator of the health and future wellbeing of long-term service sales relationships, thus, confronts the uncertainty that is often present in a business to business context . RelatioH5. Relationship quality has a significant effect on the anticipation of future interaction.The model used in this research is shown in To test for causal relationships between the variables of our model, a quantitative approach was adopted . ConsequThe reasons for choosing physicians in the public healthcare sector relate to the assumption that physicians are considered the key customers for pharmaceutical companies as they played a relevant role in the B2B buying process as initiators, deciders and users for the pharmaceutical product . ConsequConcerning the measures used, As seen in A Confirmatory Factor Analysis (CFA) was also employed to assess the construct validity of the study instrument as seen in Structural Equation Modeling (SEM) was employed to test the research hypotheses. The research model described in Furthermore, the results of the hypothesis testing are presented in Using a sample of (N = 374) physicians in Jordan, this study aimed to investigate the antecedents and consequences of relationship quality in the pharmaceutical Industry. Aside from the similarities’ influence on relationship quality, all the proposed hypotheses generated by this study were supported, so that the developed model was tested and validated. Generally, this study sheds some light on the importance of developing and improving a quality relationship between physicians in the public healthcare sector, on the one side, and the medical representative of pharmaceutical companies, on the other. Consequently, this study contributes to the literature by filling the gap that exists in linking the antecedents of relationship quality and relationship quality with the anticipation of future interaction in the Jordanian pharmaceutical industry.Regarding the antecedents of relationship quality, the results showed that relationship quality was affected positively by relational selling behaviors, which implied that relational selling behaviors were considered an effective factor for maintaining a good relationship quality. This finding is supported by previous findings in the literature , 70, 72,Regarding the relationship between similarities and relationship quality, the results of this study revealed that there were no significant relationships between these variables. This could indicate that similarities between medical representatives and physicians were not a predictor of the quality of long-term relationships in this context. This result fosters the previous findings in the literature  while thFurthermore, the findings of this study documented that relationship quality was also affected positively by the medical representative’s expertise, which indicated that physicians within the sample took into account the medical representatives’ expertise level when considering the relationship quality. Furthermore, pharmaceutical firms with a high level of medical representative expertise should enjoy the benefits of high relationship quality, which would reflect positively on future interactions. These results might be attributed to the essential role of knowledge and expertise in the healthcare sector, and the importance of accuracy in this field as well as the consequences of inaccuracy . Thus, iThis issue was confirmed by  who studRegarding the ethical dimension, the result of this study also pointed out that the quality of the relationship was affected positively by the medical representatives’ ethical behavior. This finding suggested that the ethics of the medical representative was a predictor of relationship quality as previously demonstrated by the literature. Besides, pharmaceutical companies with a high level of medical representative ethical behavior enjoyed the benefits of favorable relationship quality, which reflected positively the future interaction when compared to pharmaceutical companies with a low level of medical representative ethical behavior . This fiAccordingly, it could be argued that physicians should take into consideration the level of ethics in determining their relationships with medical representatives. For example, the ethical level of medical representatives would be determined by factors such as never lying about the competitor to make sales, not exaggerating the features and benefits of their products, not passing the blame for something they had done wrong to someone else, caring about patient interests and never selling dangerous products. These ethical attributes would result in good relationship quality with physicians and thus lead to long-term business relationships . This ouFinally, similar to previous studies, for example, , 95, 111Based on the finding of this research, various managerial implications can be derived and used by sales and marketing managers in pharmaceutical companies in Jordan to increase relationship quality with their customers. Thus, managers should develop services marketing strategies that deepen and enhance long term customer relationships, meantime they can secure a sustainable competitive advantage that will enhance the opportunities for future business and facilitate interaction in the future. Also, managers can utilize the connection between relational selling behaviors  and relationship quality . When hiring a medical representative, marketing and sales managers can screen for the social skills that facilitate establishing a quality relationship, which leads to maintaining long-term interpersonal relationships. This screening can be done via role-plays within the interview. Furthermore, managers could use the positive effect of ethical behavior on the quality of relationships through training programs that focus on learning the impact of ethics on relationships, draw attention to potential ethical issues, and greater awareness of the complications that follow unethical behaviors. Finally, owing to the impact of expertise on relationship quality, managers should focus on training courses and continuous learning programs for the medical representatives, especially the latest updates and pharmaceutical product studies. These studies would also reflect positively on relationship quality.For theoretical implications, the general purpose of this investigation for researchers was to explore the antecedents of relationship quality as well the effect of relationship quality on the future interaction for the pharmaceutical context, from the customer perspective (i.e. physicians’ perspective). Using a quantitative research method, self- administrated questionnaire, and SEM analysis technique to test the hypotheses, the overall results provide strong support for the relationship quality model  which inAs with all social science studies, some limitations exist that could provide fruitful avenues for future research. First, the research population was compromised to the physicians in the public healthcare sector and thus physicians from private healthcare sector were not included, due to the differences in buying process of these businesses, future studies could examine the study model on physicians from the private healthcare sector, also, future studies could consider the perspectives of medical representatives or both physician and medical representatives. Second, while this study examines the impact of relationship quality on the anticipation of future interaction, future research could examine the influence of relationship quality on the actual retention rates. Finally, considering that the majority of studies examine pharmaceutical marketing issues in the traditional brick and mortar context, future research could employ this model in the online context and examine the influence of social media on the work of pharmaceutical firms.S1 Data(SAV)Click here for additional data file.S1 File(DOCX)Click here for additional data file.


Transportation plays a significant role in the global economy and society and takes part in a lot of different processes such as mass transportation and the supply chain. Therefore, it is crucial to introduce modern technologies in this area of the economy in the context of Industry 4.0. The main scope of this study is to develop a model that supports analyzing last-mile logistics modern solutions using the latest technologies such as road autonomous delivery robots (RADRs), civil drones, or smart bikes, and compare them to conventional solutions (delivery vehicles). Multi-criteria decision analysis (MCDA) was applied to build a formal comparison model that scores the solutions and weights different criteria according to decision-makers and placeholders, to rank the solutions from the most crucial option to the weakest in a predetermined scenario with set parameters and conditions (three varied scenarios were included in the present investigation). The results of the model were in favor of using civil drones or smart bicycles to perform light deliveries in small urban areas (these key findings support the assumptions that are often manifested in speech in the context of the use of new technologies). The modern solutions scored almost 40–80% higher in total in the conglomeration of assessment criteria  than the conventional solution, which indicates the importance of studying the implementation of such technologies. An interesting result of the study is the operational cost reduction by ca. 60–74% in favor of autonomous delivery robots, 89–93% in favor of civil delivery drones, and 87–90% in favor of smart bikes vs. conventional delivery trucks/vans. Yet, it should be underlined that the results may vary with different assumptions within the MCDA method. Since ancient times, people have transported goods from one location to another using different means of transport. The economy and society have traditionally placed a high value on transportation, which continues to play a vital role in many applications including mass transit, public and private transportation, and supply chain and logistics procedures. Therefore, it is necessary to implement modern technology in the transportation industry. The more advanced the logistics and transportation systems are, the more advantages they accrue to societies and economies throughout the world. To identify knowledge gaps and development possibilities that keep transportation and logistics in sync with the growth of other industries, it is important to thoroughly study, investigate and assess the introduction of modern technology in the predefined context. This context is presented in How significant is the advancement of logistics and transportation for humanity? New technologies have been introduced, tested, and utilized to create more dependable, efficient, and environmentally friendly means of transport since the emergence of transportation networks to allow the transfer of people and freight. Logistics and transportation are two different yet closely related terms. While logistics is described as the administration and planning of the manufacturing of freight (logistics management), handling and storing it, and then moving it to the end user (logistics engineering), transportation is the movement of passengers and freight by various branches and modes in a variety of environments including land, water, and air . The defIn an era of massive use of fossil fuels, it is of utmost importance that these new technologies are designed to be powered by alternative energy sources and their operations controlled by appropriate sensors. While this is not the immediate focus of this study, it is also worth considering this aspect in the selection of means of transport applied to transportation and logistics processes. To make this selection rational, it is necessary to analyze which of the means of transport and equipment, developed in recent years, are worthy of further development based on their technological, economic, and financial benefits. As both logistics and transportation are continually enriched with new, supportive technologies, it is necessary to investigate and compare conventional and modern technologies. Consequently, it is obligatory to compare them to each other to evaluate the wisdom of replacing conventional technologies with modern ones. This paper presents an investigation of conventional delivery trucks/vans with modern devices and means of transport equipped with sensors such as autonomous delivery robots, civil delivery drones, and smart bikes.The structure of the paper is as follows: Firstly, a review of the literature on conventional and modern technologies applied in certain transport processes and operations is finalized with the specification of research gaps. Secondly, the assessment method and three scenarios are briefly described. They are applied to obtain the results given in The growth in demand for freight transportation over the past few decades is what gives the development of transportation and logistics such significance in the context of modern technologies application. The European Environment Agency (EEA) reports that since 2000, the demand for freight transportation has increased by 14% for road transportation and by about 11.5% for rail transportation ,4 in 201Germany, one of the top nations for manufacturing, coined the phrase “Industrie 4.0” , which pThe logistics sector is one of the most significant businesses that will profit from the usage of autonomous vehicles in its transportation operations. The use of autonomous vehicles for freight transportation can reduce crashes and use 10 to 15% less energy ,10. AddiPlatooning: A method of driving in which several trucks employ autonomous capabilities to follow a leading vehicle. Only under specific circumstances do the trailing truck drivers assume control.Human–drone platooning: A scenario that closely resembles the first, except that the trailing trucks are driverless autonomous vehicles. With autonomous capabilities that allow them to make judgments in certain situations, the trailing trucks precisely mimic the behaviors of a leading vehicle that is piloted by a person.Exit-to-exit autonomous trucks with remote operation: In this scenario, autonomous vehicles are remotely controlled by operation centers in challenging environments such as small cities. However, trucks employ their autonomous technology to move freight unassisted on smooth surfaces such as motorways. This situation may present several difficulties, such as a loss of connections.Autopilot scenario: The American Trucking Association (ATA) prefers the scenario in which a driver and a vehicle alternately handle the driving process utilizing autonomous autopilot capabilities that regulate the speed and position of a truck in its lane.Exit-to-exit autonomous trucks: In this scenario, level 4 fully autonomous trucks are employed in transportation on interstates or highways without drivers. Only while moving cargo to and from these autonomous vehicles in urban and rural locations do human drivers interfere.Facility-to-facility trucking: In this scenario, driverless autonomous trucks handle all aspects of facility-to-facility transportation. Without human assistance, trucks should be able to maneuver through small spaces.Many delivery or manufacturing companies, particularly those strongly related to logistics, may benefit from the implementation of autonomous vehicles coupled with other modern technologies, investigated in this paper. With the introduction of new technologies in the framework of Industry 4.0, logistics has significantly advanced in recent years. Due to demand from customers who expect prompt and same-day deliveries, novel technologies such as autonomous vehicles and robotics have been the subject of investigation. There are various scenarios that academics and specialists in the logistics sector have presented that serve to make the process of implementing autonomous trucks more understandable. Viscelli presented six scenarios for the use of autonomous trucks in 2018 :PlatooniEach of the scenarios has different technological requirements, benefits, and drawbacks since it has a significant influence on businesses and the employment of drivers. Logistics companies should carefully consider each scenario before implementation.To place the following technologies, it should be mentioned what exactly is an autonomous vehicle. A vehicle that uses modern technology to adapt to its environment and make the same decisions as a human driver is known as an autonomous  vehicle. When a robotic vehicle is listed, it is worth mentioning that an autonomous robot (autonomous delivery robot) is designed and engineered to operate autonomously in its surroundings and for lengthy periods without human intervention. It must not only carry out its delivery mission well but also assesses the numerous circumstances that are changing around it and behave accordingly . A certaAutonomous robotic systems have the potential to significantly improve operational safety and efficiency. Because of the explosive expansion of e-commerce, providing quicker, more inexpensive, and sustainable last-mile delivery becomes increasingly vital. Many challenges, such as reduced capacity, driver shortages, damaged and stolen merchandise, unsuccessful delivery efforts, increased traffic congestion, and so on, can be handled with autonomous delivery robots (autonomous delivery devices) .On the other hand, unmanned aerial vehicles (UAVs) that may be used for civil purposes such as freight delivery are known as civil delivery drones. With the evolution of technology and the right programming, drones may be fully autonomous and accomplish tasks without human involvement. Drones employ sensors and technologies that enable human control. Civil drones were first used in the logistics industry to support the control of inventory in warehouses ,18,19. HDrone delivery is also becoming more popular in industries such as healthcare, food, postal service, and shipping. The ability of drones to fly into rural or otherwise inaccessible places more readily and quickly than other modes of transportation is perhaps their most significant advantage for healthcare delivery (therefore this technology can contribute to leveling off freight transport poverty) . AnotherRecently, typical coupling of technology consists of truck-based/van-based drone delivery systems such as the examples presented in ,32. To fWith the usage of drones, same-day delivery and environmentally friendly transportation will be very much viable and more prevalent in the nearest future. Since drones move in the air, delivery would not be hampered by difficult terrain or heavy traffic. Additionally, drones will be able to function without direct surveillance of people, properly delivering goods to the end user, owing to technologies such as the Internet of Things, machine learning, and location sensors.Some concerns have been voiced about the usage of drone delivery services, especially the necessity to relocate or establish additional distribution centers closer to customers . A recenTo address some of the present urban logistical challenges, cargo bikes have been recommended as an alternative to diesel vehicles for parcel delivery. These bikes are known as smart bicycles and are fully equipped with a set of sensors . AdditioThe authors of  presenteWhen last-mile logistics of small-goods deliveries is considered, bicycles cannot be omitted, especially smart bicycles. These vehicles are being equipped with collision-free warning systems, mostly applied by using accelerometers/gyroscopes, LIDAR, sensors, and networking communication, as the authors of a recent review paper reported . Such syDespite the popularity of novel technologies’ considerations and applications in logistics and transportation, the authors have not found any in-depth study in the research literature that would provide a comparison of the aforementioned technologies with those conventionally applied in the delivery process. Some exceptions can be observed in the popular science press   was developed to assess the technological expansion of modern solutions applied in transportation and logistics and compare them with conventional solutions. The model is based on a decision theory, specifically, multi-criteria decision analysis , to give a score for the solutions based on different criteria ,49,50. TThe solutions used as input technologies to the model were civil drones, road autonomous delivery robots (RADRs), and smart bicycles, as modern types of technologies applied in the novel delivery process. These solutions use modern technology development in the context of Industry 4.0 and Logistics 4.0. Moreover, a traditional technology such as conventional vans applied for the delivery process  was the final solution implemented in the model to compare it to the modern solutions in terms of how differently they operate in freight transport. The authors assumed a delivery process occurring in urban areas in the case of any assessed technology.Apart from MCDA application in the study, the scenario technique was applied as well ,57. The Logistics processes of delivery are investigated for a small urban area.The US laws and regulations are applied in the scenarios.Using American manufacturers of modern technologies.The logistics processes have the purpose of delivering 10 or 20 small packages at a time with an average weight of 1.5 kgs per package and traveling 16 km or 45 km.The scenarios used for the implementation of the model have the purpose of finding out the best solution to be applied in last-mile logistics ,59,60. LRQ1: Which of the preliminary defined optimization criteria given in  support RQ2: How do the experts’ opinions influence the results of MCDA application?The MCDA uses a set of criteria to score solutions based on the mentioned scenarios. The weight of each criterion depends significantly on the decision-makers (four independent experts investigated and assessed the presented technologies) according to the criterion’s importance, and therefore the scenarios were required to test the model. Moreover, as experts’ opinions may be case-specific, it is worth developing a sensitivity analysis depending on experts’ opinions , and the assessment itself is also developed.Economy: Capital spending for the technologies used in the modern solutions, energy consumption costs, and delivery costs are all expenses that are very important to take into account when comparing modern solutions vs. conventional ones (the symbol of this criterion is K2) ,64,65,66Time for delivery: Time taken to deliver packages in last-mile logistics can be critical to the operator and the end user nowadays when competition is rising, and speed is an important pillar to the success of the business (symbol K4) ,34,67.Payload: The payload of the solution can affect the properties of the packages to be delivered and their amount, and therefore the number of returns the means of transport has to make to the logistics operator (symbol K6) ,33,68,69Laws and regulations: Complying with local laws is always a must for all kind of businesses and can be challenging for modern solutions that might have an unclear position in the current laws and regulations (symbol K3) ,71.Safety: Safety is always a great concern for modern solutions in all industries and is very important to take into consideration (symbol K1) ,72,73,74Environment: Last-mile logistics contribute 25–30% of greenhouse gas emissions in the sector of transportation and that creates the need for modern solutions to reduce emissions (symbol K5) ,76,77,78Criteria that fit the scenarios discussed in Collecting large amounts of data can be very supportive in the scoring process for the solution as it becomes indicative and informative about the different aspects of modern technologies under discussion in this paper. These data were applied to score modern solutions in this model according to each criterion. Most of the data collected for this model are qualitative since these solutions use modern technologies that are still being under testing and development. The Likert scale mentioned in the methodology is used in this process .The parameters, described in Second scenario (S2)—20 package deliveries per day for one year and a distance per package of 16 km (scenario is set with double the deliveries to be satisfied at the same distance).Third scenario (S3)—10 package deliveries per day for one year and a distance per package of 45 km  considers deliveries of 10 packages per day for one year and a distance/package of 16 km. Two more scenarios were developed :TCD—total cost of delivery;ACP—average cost per package;ECM—energy cost per kilometer;i—distance of a delivery (16 km);j—number of packages in a delivery (10 packages);k—total duration of deliveries (365 days);CC—capital costs;CE—cost of equipment;MC—maintenance costs per year;EC—economy costs.The total cost of each scenario operation is examined with Equation (1).k-criterion given in Equations (4) and (5)). The analysis and evaluation of variants characterized by decision variables of different types and units, such as those presented in the discussion so far, requires the unification and normalization of the results. For this purpose, one of the methods of zero standardization was applied. These methods are characterized by the adoption of a certain uniform point of reference , which iThe solutions for each criterion were given scores after ranking the criteria in accordance with the needs of the business. The decision-makers assigned weights to the criteria based on their requirements. As previously mentioned, there are various approaches to weighting a criterion. The formulas used in both the rank sum method and point distribution method are described in The rank sum and point distribution strategies are applied in this model. The criteria weights are presented in To attribute a total score to each analyzed technology and assist the decision-maker in selecting the best course of action, the scores and weights of the various criteria are combined at this stage. Following Equation (6), the weights are multiplied by the scores and then added together. Consequently, a total score is obtained.The combination of the scores and weights utilizing both types of weighting criteria are shown in K1 = 10, then, K2 = K3 = K4 = K5 = 5 and K6 = 70. The values of the weights together with the point method application for general assessment of all the solutions, namely autonomous delivery robots, civil delivery drones, conventional delivery trucks/vans, and smart bicycles are given in Methods based on experts’ opinion such as the rank sum or rank allocation method are subjective; therefore, the sensitivity of changes depending on the weights of certain criteria is worth analyzing (it is based on S1 solely). The assumption was made that each successive criterion would be analyzed incrementally, in five-point increments, while keeping the other four criteria constant and topping up the scores to 100 in total for criterion K6 (there was no particular reason for choosing this criterion as a top-up) in correlation to K1 weight increases and the values of the weights of the other criteria  remain constant (K2 weights results in similar behavior of the model as in the case of K1 (The greatest susceptibility to change (and consequently sensitivity) occurs as the value of the criterion constant . Safety se of K1 .K3. Such heterogeneity is primarily related to the uncertainty regarding the legal regulation of modern, unmanned means of transport. However, in practical applications, the high weighting values for this criterion are not expected  or with less traditional means of transport such as RADRs.A simplified mathematical model built on MCDA was developed to evaluate the solutions and compare them, providing logistics companies with the chance to select the most fitting option that would best meet their requirements. It should be underlined that any development of MCDA was not the aim of this study—the importance of this investigation was the selection of data for the method in such a way that the results were meaningful and in line with reality. Moreover, the given set of criteria is unique, and not applied in any other study according to our review of the scientific literature.The model was then applied to a scenario with predetermined parameters and conditions to determine which of conventional vehicles, civil drones, smart bicycles, andRADRs would be an effective choice in line with the assumptions and decision-making criteria. According to the model, given the information and criteria specified in the scenarios, the usage of civil drones, autonomous robots, or smart bicycles can be around 40–80% better than that of conventional vehicles . More siIt should be underlined, following ,121, thaHowever, it should be underlined that in the currently presented assessment, more criteria than costs were incorporated into the model, which is progressive compared with other research results. These results are promising enough that a significant reshaping of the existing business models of delivery companies can be expected soon, which will benefit from the advantages of multimodal transportation, i.e., the transportation of goods, using two or more modes of transport. Moreover, this study proved the validity of the application of modern devices and means of transport such as autonomous delivery robots or civil delivery drones within the transportation and logistics process. As these devices and means of transport are equipped with sensors and actuators, it is worth focusing on their technical development to improve their current abilities even more.While researching the topic and developing the mathematical model, there were some limitations in terms of resources and data. Since the technologies mentioned in the context of Industry 4.0 and Logistics 4.0 are very recent, there are still limited data and resources providing extensive details and information that covers all aspects related to these technologies. For future research on similar topics, it is advised to collect more data with high accuracy that would provide an output from the model with high reliability; another recommendation would be using other weighting methods for the criteria analysis to make sure the results are consistent. In future research, an analysis based on a wider range of means of transport will be carried out , and at the same time it will be possible to conduct analyses under real conditions—validation of the obtained results will be carried out. At the same time, this research demands varying the scenarios with different determinants in the number of packages, their weight, and alternative distances. Moreover, comparative analysis can also be provided for different domains such as medical supply, Internet of Things, general logistics systems, etc.—nevertheless, this is a complex and very wide-ranging problem worth devoting experimental research to. It is a matter of future research as well.