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Most influential countries in the international medical device trade: Network-based analysis.

ABSTRACT: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the international medical device trade has received extensive attention. To maintain the domestic supply of medical devices, some countries have sought multilateral trade cooperation or simply implemented export restrictions, which has exacerbated the instability and fragility of the global medical device market. It is crucial for government policymakers to identify the most influential countries in the international medical device trade and nip exports in the bud. However, few efforts have been made in previous studies to explore various countries' influence on the international medical device trade in light of their intricate trade relationships. To fill these research gaps, this study constructs a global medical device trade network (GMDTN) and explores the criticality of various countries from a network-based perspective. The evolution patterns and geographical distribution of influence among countries in the GMDTN are revealed. Details on the ways in which the influence of some crucial countries has formed are provided. The results show that the global medical device trade market is export oriented. The formation of some countries' strong influence may be due to their large number of trading partners or the deep dependence of some of those trading partners on that country (namely, breadth- or depth-based patterns). It is worth noting that the US has a dominant position in the international medical device trade in terms of both breadth and depth. In addition, some countries play a critical role as intermediate points in the influence formation process of other countries, although these countries are not critical direct trading partners. The findings of this study provide implications for policymakers seeking to understand the influence of countries on the international medical device trade and to proactively prepare responses to unexpected changes in this trade.

SUBMITTER: Bai X

PROVIDER: S-EPMC9250171 | biostudies-literature |

REPOSITORIES: biostudies-literature

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

Project description:BackgroundWikipedia, the multilingual encyclopedia, was founded in 2001 and is the world's largest and most visited online general reference website. It is widely used by health care professionals and students. The inclusion of journal articles in Wikipedia is of scholarly interest, but the time taken for a journal article to be included in Wikipedia, from the moment of its publication to its incorporation into Wikipedia, is unclear.ObjectiveWe aimed to determine the ranking of the most cited journals by their representation in the English-language medical pages of Wikipedia. In addition, we evaluated the number of days between publication of journal articles and their citation in Wikipedia medical pages, treating this measure as a proxy for the information-diffusion rate.MethodsWe retrieved the dates when articles were included in Wikipedia and the date of journal publication from Crossref by using an application programming interface.ResultsFrom 11,325 Wikipedia medical articles, we identified citations to 137,889 journal articles from over 15,000 journals. There was a large spike in the number of journal articles published in or after 2002 that were cited by Wikipedia. The higher the importance of a Wikipedia article, the higher was the mean number of journal citations it contained (top article, 48.13 [SD 33.67]; lowest article, 6.44 [SD 9.33]). However, the importance of the Wikipedia article did not affect the speed of reference addition. The Cochrane Database of Systematic Reviews was the most cited journal by Wikipedia, followed by The New England Journal of Medicine and The Lancet. The multidisciplinary journals Nature, Science, and the Proceedings of the National Academy of Sciences were among the top 10 journals with the highest Wikipedia medical article citations. For the top biomedical journal papers cited in Wikipedia's medical pages in 2016-2017, it took about 90 days (3 months) for the citation to be used in Wikipedia.ConclusionsWe found evidence of "recentism," which refers to preferential citation of recently published journal articles in Wikipedia. Traditional high-impact medical and multidisciplinary journals were extensively cited by Wikipedia, suggesting that Wikipedia medical articles have robust underpinnings. In keeping with the Wikipedia policy of citing reviews/secondary sources in preference to primary sources, the Cochrane Database of Systematic Reviews was the most referenced journal.

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Most influential countries in the international medical device trade: Network-based analysis.

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