To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As...To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As,Sn,Ba,Pb)in PM_(2.5)were monitored from December 2020 to November 2021 in a representative city,Xiamen.The concentrations of trace elements in Xiamen displayed an obvious seasonal variation and were dominated by K,Fe,Al,Ca and Zn.Based on Positive Matrix Factorization analysis,source appointment revealed that the major sources of trace elements in Xiamen were traffic,dust,biomass and firework combustion,industrial manufacture and shipping emission.According to health risk assessment combined with the source appointment results,it indicated that the average noncarcinogenic risk was below the threshold and cancer risk of four hazardous metals(Cr,Ni,As,Pb)exceeded the threshold(10^(-6)).Traffic-related source had almost half amount of contribution to the health risk induced by PM_(2.5)-bound trace elements.During the dust transport period or Spring Festival period,the health risks exceeded an acceptable threshold even an order of magnitude higher,suggesting that the serious health risks still existed in low PM_(2.5)environment at certain times.Health risk assessment reminded that the health risk reduction in PM_(2.5)at southeastern China should prioritize traffic-related hazardous trace elements and highlighted the importance of controlling vehicles emissions in the future.展开更多
The occurrence of missed appointments from online outpatient bookings significantly hinders the operational efficiency of outpatient services.This study aimed to investigate various factors influencing patients’misse...The occurrence of missed appointments from online outpatient bookings significantly hinders the operational efficiency of outpatient services.This study aimed to investigate various factors influencing patients’missed appointments from online outpatient bookings.Drawing on attribution theory,an empirical analysis was conducted using 382,004 authentic online outpatient appointments.The empirical findings revealed that appointment lead-time,appointment time,weekday appointments,online doctor rating,appointment doctor’s expertise,patient distance,and previous outpatient visit experience significantly influenced patients’missed appointment behaviors from online outpatient bookings.Importantly,previous outpatient experience positively moderated the relationship between the appointment doctor’s expertise and patients’missed-appointment behavior.This study provides insights into the factors influencing patients’missed-appointment behavior from online outpatient bookings.It further offers a theoretical foundation for medical institutions in China to mitigate the likelihood and adverse effects of patients’missed-appointment behavior from online outpatient bookings.展开更多
An appointment scheduling problem is studied with the consideration of customer impatience.On the assumption that both the time of leaving queue and the time of service are exponentially distributed,in order to minimi...An appointment scheduling problem is studied with the consideration of customer impatience.On the assumption that both the time of leaving queue and the time of service are exponentially distributed,in order to minimize the joint cost,the optimal appointment schedule of the fixed number of customers is studied.The joint cost function is composed of customers expected delay time and service availability time.The expected delay time of each customer in the queue is recursively computed in terms of customer interarrival time.Furthermore,the effect of impatience on the optimal schedule as well as the total operating cost is studied.The results show that as the impatience rate increases,the optimal interarrival time becomes shorter and the interarrival time of the last few customers gradually approaches that of the customers in the middle.In addition,impatient behaviors can increase the joint cost.展开更多
With the development of information and communication technologies,all public tertiary hospitals in China began to use online outpatient appointment systems.However,the phenomenon of patient no-shows in online outpati...With the development of information and communication technologies,all public tertiary hospitals in China began to use online outpatient appointment systems.However,the phenomenon of patient no-shows in online outpatient appointments is becoming more serious.The objective of this study is to design a prediction model for patient no-shows,thereby assisting hospitals in making relevant decisions,and reducing the probability of patient no-show behavior.We used 382,004 original online outpatient appointment records,and divided the data set into a training set(N_(1)=286,503),and a validation set(N_(2)=95,501).We used machine learning algorithms such as logistic regression,k-nearest neighbor(KNN),boosting,decision tree(DT),random forest(RF)and bagging to design prediction models for patient no-show in online outpatient appointments.The patient no-show rate of online outpatient appointment was 11.1%(N=42,224).From the validation set,bagging had the highest area under the ROC curve and AUC value,which was 0.990,followed by random forest and boosting models,which were 0.987 and 0.976,respectively.In contrast,compared with the previous prediction models,the area under ROC and AUC values of the logistic regression,decision tree,and k-nearest neighbors were lower at 0.597,0.499 and 0.843,respectively.This study demonstrates the possibility of using data from multiple sources to predict patient no-shows.The prediction model results can provide decision basis for hospitals to reduce medical resource waste,develop effective outpatient appointment policies,and optimize operations.展开更多
We are very pleased to announce that we have invited Dr. Xue-Long JIANG to serve as the Associate Editor-in-Chief for Zoological Research （ZR）, effective from 1 March, 2016. Dr. JIANG, Professor and principle invest...We are very pleased to announce that we have invited Dr. Xue-Long JIANG to serve as the Associate Editor-in-Chief for Zoological Research （ZR）, effective from 1 March, 2016. Dr. JIANG, Professor and principle investigator from the Laboratory of Mammal Ecology and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, has worked with ZR since 2006 as a member of the editorial board and has played an active and important role in maintaining ZR as a respected academic publishing platform. Currently, he also works as the Associate Editor-in-Chief of Acta Thefiologica Sinica, Mammal Research and as a senior editorial board member of Biodiversity Science.展开更多
We are very pleased to announce that we have invited Dr. Wai-Yee Chan, Professor and Director of School of Biomedical Sciences, The Chinese University of Hong Kong, to serve as the Associate Editor- in-Chief for Zoolo...We are very pleased to announce that we have invited Dr. Wai-Yee Chan, Professor and Director of School of Biomedical Sciences, The Chinese University of Hong Kong, to serve as the Associate Editor- in-Chief for Zoological Research （ZR）, effective 1 September, 2016.展开更多
Suppose a practical scene that when two or more parties want to schedule anappointment, they need to share their calendars with each other in order to make itpossible. According to the present result the whole communi...Suppose a practical scene that when two or more parties want to schedule anappointment, they need to share their calendars with each other in order to make itpossible. According to the present result the whole communication cost to solve thisproblem should be their calendars’ length by using a classical algorithm. In this work, weinvestigate the appointment schedule issue made by N users and try to accomplish it inquantum information case. Our study shows that the total communication cost will bequadratic times smaller than the conventional case if we apply a quantum algorithm in theappointment-scheduling problem.展开更多
Background:Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV(PLHIV).PLHIV likelihood of missing clinic appointments is associated with direct and indirect e...Background:Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV(PLHIV).PLHIV likelihood of missing clinic appointments is associated with direct and indirect expenditures made while accessing HIV care.The objective of this study was to examine the relationship between out-of-pocket(OOP)health expenditures and the likelihood of missing appointments.Method:Totally 618 PLHIV older than 18 years attending two HIV care and treatment centres(CTC)in Northern Tanzania were enrolled in the study.Clinic attendance and clinical characteristics were abstracted from medical records.Information on OOP health expenditures,demographics,and socio-economic factors were self-reported by the participants.We used a hurdle model.The first part of the hurdle model assessed the marginal effect of a one Tanzanian Shillings(TZS)increase in OOP health expenditure on the probability of having a missed appointment and the second part assessed the probability of having missed appointments for those who had missed an appointment over the study period.Results:Among these 618 participants,242(39%)had at least one missed clinic appointment in the past year.OOP expenditure was not significantly associated with the number of missed clinic appointments.The median amount of OOP paid was 5100 TZS per visit,about 7%of the median monthly income.Participants who were separated from their partners(adjusted odds ratio[AOR]=1.83,95%confidence interval[CZ]:1.11-8.03)and those aged above 50 years(AOR=2.85,95%CI:1.01-8.03)were significantly associated with missing an appointment.For those who had at least one missed appointment over the study period,the probability of missing a clinic appointment was significantly associated with seeking care in a public CTC(P=0.49,95%CI:0.88-0.09)and aged between>25-35 years(P=0.90,95%CI:0.11-1.69).Conclusion:Interventions focused on improving compliance to clinic appointments should target public CTCs,PLHIV aged between>25-35 years,above 50 years of age and those who are separated from their partners.展开更多
Clinic Appointment Registration System is an important way to see a doctor, and it’s also a preliminary tool for storage and management of clinic medical records. This new system was developed using Visual Studio 200...Clinic Appointment Registration System is an important way to see a doctor, and it’s also a preliminary tool for storage and management of clinic medical records. This new system was developed using Visual Studio 2008 and C#.NET as the development environment and tools and Microsoft Access 2003 as the database to store the medical data based on Browse/Server (B/S) model. The system consists of several data operation functions including appointment registration, data management (e.g. addition, deletion and searching), data backup and recovery, etc., thus, achieve key research ob-jectives.展开更多
In clinic＇s appointment scheduling system no-shows have been a significant and confirmed issue with a bad influence on patient accessibility and clinic efficiency. The problem of walk-in has often been seen as the op...In clinic＇s appointment scheduling system no-shows have been a significant and confirmed issue with a bad influence on patient accessibility and clinic efficiency. The problem of walk-in has often been seen as the opposite of no-show problem. In this work we revisit a walk-in admitting based approach to mitigate the bad influence of no-show without overbooking. First we establish a model which utilizes marginal benefit objective function to balance the interests of the clinic, the patient and the doctor, we prove that no-show and walk-in cancels out each other straightly has a bad property. Then we propose a new rule which is an extension of the well-known Bailey - Welch rule, the simulation results show that our rule has an improvement comparing with the common rule that cancels them out straightly.展开更多
Objective:Analyze the research hotspots and frontiers of shared outpatient service,and provide a reference for researchers in this field to carry out follow-up research.Methods:Search the Web of Science core collectio...Objective:Analyze the research hotspots and frontiers of shared outpatient service,and provide a reference for researchers in this field to carry out follow-up research.Methods:Search the Web of Science core collection database until 2022 and visually analyzekeywords in this field through CiteSpace5.8.R3 software,Results:A total of 261 iteratures were included.The research focuses mainly on advanced care planning,diabetes care,andgroup prenatal care,The research trend tends to be telemedicine and nursing provided by specialized nurses.Conclusion:Scholars can learn from the research hotspots of foreign shared medical appointments,pay attention to the research trend,expand its application scope in combination with China's national conditions,and further promote thedevelopment of shared medical appointments in China.展开更多
The reform and innovation of the personnel management system in government organs and institutions is to eliminate the shortcomings on the basis of the past human resources management, find the best human resources ma...The reform and innovation of the personnel management system in government organs and institutions is to eliminate the shortcomings on the basis of the past human resources management, find the best human resources management plan and create a positive personnel management system. Among the current personnel management systems in our country, the appointment system is the one chosen by many institutions. The appointment system can achieve the overall goal of human resources management. The influence and effectiveness of the appointment system are crucial to promote the sustainable development trend of government agencies and institutions. This paper analyzes the specific contents and functions of the reform and innovation of the appointment system and personnel management system in government institutions, and discusses the characteristics and practical significance of the reform and innovation of the appointment system in government institutions. The countermeasures for the reform and innovation of the personnel management system of the appointment system have been deeply and scientifically studied, which has certain practical value and promotes the long-term development of government organs and institutions.展开更多
Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivit...Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.展开更多
Ubiquitous contamination of the soil environment with volatile organic compounds(VOCs)has raised considerable concerns.However,there is still limited comprehensive surveying of soil VOCs on a national scale.Herein,65 ...Ubiquitous contamination of the soil environment with volatile organic compounds(VOCs)has raised considerable concerns.However,there is still limited comprehensive surveying of soil VOCs on a national scale.Herein,65 species of VOCswere simultaneously determined in surface soil samples collected from 63 chemical industrial parks(CIPs)across China.The results showed that the total VOC concentrations ranged from 7.15 to 1842 ng/g with a mean concentration of 326 ng/g(median:179 ng/g).Benzene homologs and halogenated hydrocarbons were identified as the dominant contaminant groups.Positive correlations between many VOC species indicated that these compounds probably originated from similar sources.Spatially,the hotspots of VOC pollution were located in eastern and southern China.Soils with higher clay content and a higher fraction of total organic carbon(TOC)content were significantly associated with higher soil VOC concentrations.Precipitation reduces the levels of highly water-soluble substances in surface soils.Both positive matrix factorization(PMF)and principal component analysis-multiple linear regression(PCA-MLR)identified a high proportion of industrial sources(PMF:59.2%and PCA-MLR:66.5%)and traffic emission sources(PMF:32.3%and PCA-MLR:33.5%).PMF,which had a higher R^(2) value(0.7892)than PCA-MLR(0.7683),was the preferred model for quantitative source analysis of soil VOCs.The health risk assessment indicated that the non-carcinogenic and carcinogenic risks of VOCs were at acceptable levels.Overall,this study provides valuable data on the occurrence of VOCs in soil from Chinese CIPs,which is essential for a comprehensive understanding of their environmental behavior.展开更多
Background:A better understanding of why HIV-exposed/infected children fail to attend their scheduled follow-up medical appointments for HIV-related care would allow for interventions to enhance the delivery of care.T...Background:A better understanding of why HIV-exposed/infected children fail to attend their scheduled follow-up medical appointments for HIV-related care would allow for interventions to enhance the delivery of care.The aim of this study was to determine characteristics of the caregiver-child dyad(CCD)associated with children’s non-adherence to scheduled follow-up medical appointments in HIV programs in Cameroon.Methods:We conducted a case-control analysis of the usual-care group of CCDs from the MORE CARE trial,in which the effect of mobile phone reminders for HIV-exposed/infected children in attending follow-up appointments was assessed from January to March 2013.For this study,the absence of a child at their appointment was considered a case and the presence of a child at their appointment was defined as a control.We used three multivariate binary logistic regression analyses.The best-fit model was the one which had the smallest chi-square value with the Hosmer-Lemeshow test(HLχ^(2)).Magnitudes of associations were expressed by odds ratio(OR),with a p-value<0.05 considered as statistically significant.Results:We included 30 cases and 31 controls.Our best-fit model which considered the sex of the adults and children separately(HLχ^(2)=3.5)showed that missing scheduled medical appointments was associated with:lack of formal education of the caregiver(OR 29.1,95%CI 1.1-777.0;p=0.044),prolonged time to the next appointment/follow-up(OR[1 week increase]1.4,95%CI 1.03-2.0;p=0.032),and being a female child(OR 5.2,95%CI 1.2-23.1;p=0.032).One model(HLχ^(2)=10.5)revealed that woman-boy pairs adhered less to medical appointments compared to woman-girl pairs(OR 4.9,95%CI 1.05-22.9;p=0.044).Another model(HLχ^(2)=11.1)revealed that man-boy pairs were more likely to attend appointments compared to woman-girl pairs(OR 0.23,95%CI 0.06-0.93;p=0.039).There were no statistical associations for the ages of the children or the caregivers,the study sites,or the HIV status(confirmed vs.suspected)of the children.Conclusion:The profile of children who would not attend follow-up medical appointments in an HIV program was:a female,with a caregiver who has had no formal education,and with a longer follow-up appointment interval.There is a possibility that female children are favored by female caregivers and that male children are favored by male caregivers when they come to medical care.展开更多
Appointment systems are used by health clinics to manage access to service providers.In such systems,a specified number of patients are scheduled in advance,but certain patients may not arrive or‘show up’to their ap...Appointment systems are used by health clinics to manage access to service providers.In such systems,a specified number of patients are scheduled in advance,but certain patients may not arrive or‘show up’to their appointments.The existence of no-show behaviour influences both the operational cost of the clinics and the waiting time of the patients.In this paper,we determine an optimal schedule that takes no-show behaviour into account to determine the time intervals between patients under the framework of the individual-block/variableinterval rule for minimising the overall cost of the patient waiting time,the practitioner idle time and overtime.Under the condition that the service time of each patient is exponentially distributed,we compare the results with a schedule designed for the same expected number of patients in the absence of no-shows and analyse the effect on the system performance from the perspectives of day-length,expected workload,no-show probability,ratio of overtime costs and no-golf policy.We extend our results to an equally-spaced appointment system,which is commonly used in practice.Our results show that not only do no-shows greatly affect the system performance compared with an appointment system with the same expected workload without no-shows,but they also affect the optimal scheduling behaviours in the dome-shaped distribution.In addition,overtime cannot be eliminated completely even if the day length is adequate for all patients because of the stochastic characteristic of service time.展开更多
In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:du...In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:during the decision-making stage of whether to choose appointed guardianship,the lack of professionalism and availability of appointed guardians can easily hinder the elderly from choosing to apply it;during the establishment stage of appointed guardianship,the limited rules related to the appointed guardianship agreement can easily lead to the frustration of the elderly’s subjective will;during the operation stage of appointed guardianship,the insufficient accountability mechanisms for appointed guardians can easily lead to the infringement of the personal or property rights of the elderly.By reflecting on its jurisprudential causes,it can be found that the current law largely ignores the orientation of appointed guardianship as a welfare for the elderly in social law,the concept of substantive equality in the appointed guardianship agreement,and the theoretical attributes of the appointed guardianship as a fiduciary relationship.Therefore,the appointed guardianship system in China should be systematically improved to fully release its institutional potential in the protection of the rights and interests of the elderly based on these jurisprudential principles.In particular,it is possible to consider actively promoting the“trust+appointed guardianship”model and cultivating a team of appointed guardians by the state based on the concept of elderly welfare;strengthening the protection of notarization procedures and the reasonable design of the appointed guardianship agreement based on the concept of substantive equality;and refining the fiduciary standards of appointed guardians and strengthening guardianship supervision based on the nature of fiduciary relationship.展开更多
基金supported by the National Natural Science Foundation of China(No.U22A20578)the Science and Technology Department of Fujian Province(No.2022L3025)+3 种基金the Center for Excellence in Regional Atmospheric Environment Project(No.E0L1B20201)the Chaozhou Science and Technology Plan Project(No.2018GY03)Xiamen Atmospheric Environment Observation and Research Station of Fujian ProvinceFujian Key Laboratory of Atmospheric Ozone Pollution Prevention(Institute of Urban Environment,Chinese Academy of Sciences)。
文摘To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As,Sn,Ba,Pb)in PM_(2.5)were monitored from December 2020 to November 2021 in a representative city,Xiamen.The concentrations of trace elements in Xiamen displayed an obvious seasonal variation and were dominated by K,Fe,Al,Ca and Zn.Based on Positive Matrix Factorization analysis,source appointment revealed that the major sources of trace elements in Xiamen were traffic,dust,biomass and firework combustion,industrial manufacture and shipping emission.According to health risk assessment combined with the source appointment results,it indicated that the average noncarcinogenic risk was below the threshold and cancer risk of four hazardous metals(Cr,Ni,As,Pb)exceeded the threshold(10^(-6)).Traffic-related source had almost half amount of contribution to the health risk induced by PM_(2.5)-bound trace elements.During the dust transport period or Spring Festival period,the health risks exceeded an acceptable threshold even an order of magnitude higher,suggesting that the serious health risks still existed in low PM_(2.5)environment at certain times.Health risk assessment reminded that the health risk reduction in PM_(2.5)at southeastern China should prioritize traffic-related hazardous trace elements and highlighted the importance of controlling vehicles emissions in the future.
文摘The occurrence of missed appointments from online outpatient bookings significantly hinders the operational efficiency of outpatient services.This study aimed to investigate various factors influencing patients’missed appointments from online outpatient bookings.Drawing on attribution theory,an empirical analysis was conducted using 382,004 authentic online outpatient appointments.The empirical findings revealed that appointment lead-time,appointment time,weekday appointments,online doctor rating,appointment doctor’s expertise,patient distance,and previous outpatient visit experience significantly influenced patients’missed appointment behaviors from online outpatient bookings.Importantly,previous outpatient experience positively moderated the relationship between the appointment doctor’s expertise and patients’missed-appointment behavior.This study provides insights into the factors influencing patients’missed-appointment behavior from online outpatient bookings.It further offers a theoretical foundation for medical institutions in China to mitigate the likelihood and adverse effects of patients’missed-appointment behavior from online outpatient bookings.
基金The National Natural Science Foundation of China(No.71671036)the Scientific Innovation Research of Graduate Students in Jiangsu Province(No.KYLX_0211)
文摘An appointment scheduling problem is studied with the consideration of customer impatience.On the assumption that both the time of leaving queue and the time of service are exponentially distributed,in order to minimize the joint cost,the optimal appointment schedule of the fixed number of customers is studied.The joint cost function is composed of customers expected delay time and service availability time.The expected delay time of each customer in the queue is recursively computed in terms of customer interarrival time.Furthermore,the effect of impatience on the optimal schedule as well as the total operating cost is studied.The results show that as the impatience rate increases,the optimal interarrival time becomes shorter and the interarrival time of the last few customers gradually approaches that of the customers in the middle.In addition,impatient behaviors can increase the joint cost.
基金National Natural Science Foundation Program of China[No.71971092],[No.71671073]and[71810107003].
文摘With the development of information and communication technologies,all public tertiary hospitals in China began to use online outpatient appointment systems.However,the phenomenon of patient no-shows in online outpatient appointments is becoming more serious.The objective of this study is to design a prediction model for patient no-shows,thereby assisting hospitals in making relevant decisions,and reducing the probability of patient no-show behavior.We used 382,004 original online outpatient appointment records,and divided the data set into a training set(N_(1)=286,503),and a validation set(N_(2)=95,501).We used machine learning algorithms such as logistic regression,k-nearest neighbor(KNN),boosting,decision tree(DT),random forest(RF)and bagging to design prediction models for patient no-show in online outpatient appointments.The patient no-show rate of online outpatient appointment was 11.1%(N=42,224).From the validation set,bagging had the highest area under the ROC curve and AUC value,which was 0.990,followed by random forest and boosting models,which were 0.987 and 0.976,respectively.In contrast,compared with the previous prediction models,the area under ROC and AUC values of the logistic regression,decision tree,and k-nearest neighbors were lower at 0.597,0.499 and 0.843,respectively.This study demonstrates the possibility of using data from multiple sources to predict patient no-shows.The prediction model results can provide decision basis for hospitals to reduce medical resource waste,develop effective outpatient appointment policies,and optimize operations.
文摘We are very pleased to announce that we have invited Dr. Xue-Long JIANG to serve as the Associate Editor-in-Chief for Zoological Research （ZR）, effective from 1 March, 2016. Dr. JIANG, Professor and principle investigator from the Laboratory of Mammal Ecology and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, has worked with ZR since 2006 as a member of the editorial board and has played an active and important role in maintaining ZR as a respected academic publishing platform. Currently, he also works as the Associate Editor-in-Chief of Acta Thefiologica Sinica, Mammal Research and as a senior editorial board member of Biodiversity Science.
文摘We are very pleased to announce that we have invited Dr. Wai-Yee Chan, Professor and Director of School of Biomedical Sciences, The Chinese University of Hong Kong, to serve as the Associate Editor- in-Chief for Zoological Research （ZR）, effective 1 September, 2016.
基金Supported by the National Natural Science Foundation of Chinaunder Grant Nos. 61501247, 61373131 and 61702277the Six Talent Peaks Project ofJiangsu Province (Grant No. 2015-XXRJ-013)+2 种基金Natural Science Foundation of JiangsuProvince (Grant No. BK20171458)he Natural Science Foundation of the HigherEducation Institutions of Jiangsu Province (China under Grant No. 16KJB520030)theNUIST Research Foundation for Talented Scholars under Grant No. 2015r014, PAPDand CICAEET funds.
文摘Suppose a practical scene that when two or more parties want to schedule anappointment, they need to share their calendars with each other in order to make itpossible. According to the present result the whole communication cost to solve thisproblem should be their calendars’ length by using a classical algorithm. In this work, weinvestigate the appointment schedule issue made by N users and try to accomplish it inquantum information case. Our study shows that the total communication cost will bequadratic times smaller than the conventional case if we apply a quantum algorithm in theappointment-scheduling problem.
基金support from the US National Institutes of Health D43 TW009595 and P30 AI064518 programsCharles Muiruri was supported by the National Heart,Lung,And Blood Institute of the National Institutes of Health trader Award U01HL142099.
文摘Background:Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV(PLHIV).PLHIV likelihood of missing clinic appointments is associated with direct and indirect expenditures made while accessing HIV care.The objective of this study was to examine the relationship between out-of-pocket(OOP)health expenditures and the likelihood of missing appointments.Method:Totally 618 PLHIV older than 18 years attending two HIV care and treatment centres(CTC)in Northern Tanzania were enrolled in the study.Clinic attendance and clinical characteristics were abstracted from medical records.Information on OOP health expenditures,demographics,and socio-economic factors were self-reported by the participants.We used a hurdle model.The first part of the hurdle model assessed the marginal effect of a one Tanzanian Shillings(TZS)increase in OOP health expenditure on the probability of having a missed appointment and the second part assessed the probability of having missed appointments for those who had missed an appointment over the study period.Results:Among these 618 participants,242(39%)had at least one missed clinic appointment in the past year.OOP expenditure was not significantly associated with the number of missed clinic appointments.The median amount of OOP paid was 5100 TZS per visit,about 7%of the median monthly income.Participants who were separated from their partners(adjusted odds ratio[AOR]=1.83,95%confidence interval[CZ]:1.11-8.03)and those aged above 50 years(AOR=2.85,95%CI:1.01-8.03)were significantly associated with missing an appointment.For those who had at least one missed appointment over the study period,the probability of missing a clinic appointment was significantly associated with seeking care in a public CTC(P=0.49,95%CI:0.88-0.09)and aged between>25-35 years(P=0.90,95%CI:0.11-1.69).Conclusion:Interventions focused on improving compliance to clinic appointments should target public CTCs,PLHIV aged between>25-35 years,above 50 years of age and those who are separated from their partners.
文摘Clinic Appointment Registration System is an important way to see a doctor, and it’s also a preliminary tool for storage and management of clinic medical records. This new system was developed using Visual Studio 2008 and C#.NET as the development environment and tools and Microsoft Access 2003 as the database to store the medical data based on Browse/Server (B/S) model. The system consists of several data operation functions including appointment registration, data management (e.g. addition, deletion and searching), data backup and recovery, etc., thus, achieve key research ob-jectives.
文摘In clinic＇s appointment scheduling system no-shows have been a significant and confirmed issue with a bad influence on patient accessibility and clinic efficiency. The problem of walk-in has often been seen as the opposite of no-show problem. In this work we revisit a walk-in admitting based approach to mitigate the bad influence of no-show without overbooking. First we establish a model which utilizes marginal benefit objective function to balance the interests of the clinic, the patient and the doctor, we prove that no-show and walk-in cancels out each other straightly has a bad property. Then we propose a new rule which is an extension of the well-known Bailey - Welch rule, the simulation results show that our rule has an improvement comparing with the common rule that cancels them out straightly.
文摘Objective:Analyze the research hotspots and frontiers of shared outpatient service,and provide a reference for researchers in this field to carry out follow-up research.Methods:Search the Web of Science core collection database until 2022 and visually analyzekeywords in this field through CiteSpace5.8.R3 software,Results:A total of 261 iteratures were included.The research focuses mainly on advanced care planning,diabetes care,andgroup prenatal care,The research trend tends to be telemedicine and nursing provided by specialized nurses.Conclusion:Scholars can learn from the research hotspots of foreign shared medical appointments,pay attention to the research trend,expand its application scope in combination with China's national conditions,and further promote thedevelopment of shared medical appointments in China.
文摘The reform and innovation of the personnel management system in government organs and institutions is to eliminate the shortcomings on the basis of the past human resources management, find the best human resources management plan and create a positive personnel management system. Among the current personnel management systems in our country, the appointment system is the one chosen by many institutions. The appointment system can achieve the overall goal of human resources management. The influence and effectiveness of the appointment system are crucial to promote the sustainable development trend of government agencies and institutions. This paper analyzes the specific contents and functions of the reform and innovation of the appointment system and personnel management system in government institutions, and discusses the characteristics and practical significance of the reform and innovation of the appointment system in government institutions. The countermeasures for the reform and innovation of the personnel management system of the appointment system have been deeply and scientifically studied, which has certain practical value and promotes the long-term development of government organs and institutions.
文摘Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.
基金supported by the Medical and Health Projects in Zhejiang Province(No.2022PY049)the Basic Scientific Research Project of Hangzhou Medical College(No.YS2021006)Key Discipline of Zhejiang Province in Public Health and Preventive Medicine(First Class,Category A),Hangzhou Medical College.
文摘Ubiquitous contamination of the soil environment with volatile organic compounds(VOCs)has raised considerable concerns.However,there is still limited comprehensive surveying of soil VOCs on a national scale.Herein,65 species of VOCswere simultaneously determined in surface soil samples collected from 63 chemical industrial parks(CIPs)across China.The results showed that the total VOC concentrations ranged from 7.15 to 1842 ng/g with a mean concentration of 326 ng/g(median:179 ng/g).Benzene homologs and halogenated hydrocarbons were identified as the dominant contaminant groups.Positive correlations between many VOC species indicated that these compounds probably originated from similar sources.Spatially,the hotspots of VOC pollution were located in eastern and southern China.Soils with higher clay content and a higher fraction of total organic carbon(TOC)content were significantly associated with higher soil VOC concentrations.Precipitation reduces the levels of highly water-soluble substances in surface soils.Both positive matrix factorization(PMF)and principal component analysis-multiple linear regression(PCA-MLR)identified a high proportion of industrial sources(PMF:59.2%and PCA-MLR:66.5%)and traffic emission sources(PMF:32.3%and PCA-MLR:33.5%).PMF,which had a higher R^(2) value(0.7892)than PCA-MLR(0.7683),was the preferred model for quantitative source analysis of soil VOCs.The health risk assessment indicated that the non-carcinogenic and carcinogenic risks of VOCs were at acceptable levels.Overall,this study provides valuable data on the occurrence of VOCs in soil from Chinese CIPs,which is essential for a comprehensive understanding of their environmental behavior.
文摘Background:A better understanding of why HIV-exposed/infected children fail to attend their scheduled follow-up medical appointments for HIV-related care would allow for interventions to enhance the delivery of care.The aim of this study was to determine characteristics of the caregiver-child dyad(CCD)associated with children’s non-adherence to scheduled follow-up medical appointments in HIV programs in Cameroon.Methods:We conducted a case-control analysis of the usual-care group of CCDs from the MORE CARE trial,in which the effect of mobile phone reminders for HIV-exposed/infected children in attending follow-up appointments was assessed from January to March 2013.For this study,the absence of a child at their appointment was considered a case and the presence of a child at their appointment was defined as a control.We used three multivariate binary logistic regression analyses.The best-fit model was the one which had the smallest chi-square value with the Hosmer-Lemeshow test(HLχ^(2)).Magnitudes of associations were expressed by odds ratio(OR),with a p-value<0.05 considered as statistically significant.Results:We included 30 cases and 31 controls.Our best-fit model which considered the sex of the adults and children separately(HLχ^(2)=3.5)showed that missing scheduled medical appointments was associated with:lack of formal education of the caregiver(OR 29.1,95%CI 1.1-777.0;p=0.044),prolonged time to the next appointment/follow-up(OR[1 week increase]1.4,95%CI 1.03-2.0;p=0.032),and being a female child(OR 5.2,95%CI 1.2-23.1;p=0.032).One model(HLχ^(2)=10.5)revealed that woman-boy pairs adhered less to medical appointments compared to woman-girl pairs(OR 4.9,95%CI 1.05-22.9;p=0.044).Another model(HLχ^(2)=11.1)revealed that man-boy pairs were more likely to attend appointments compared to woman-girl pairs(OR 0.23,95%CI 0.06-0.93;p=0.039).There were no statistical associations for the ages of the children or the caregivers,the study sites,or the HIV status(confirmed vs.suspected)of the children.Conclusion:The profile of children who would not attend follow-up medical appointments in an HIV program was:a female,with a caregiver who has had no formal education,and with a longer follow-up appointment interval.There is a possibility that female children are favored by female caregivers and that male children are favored by male caregivers when they come to medical care.
基金This paper was financially supported by National Natural Science Foundation of China(71021061,61273204).
文摘Appointment systems are used by health clinics to manage access to service providers.In such systems,a specified number of patients are scheduled in advance,but certain patients may not arrive or‘show up’to their appointments.The existence of no-show behaviour influences both the operational cost of the clinics and the waiting time of the patients.In this paper,we determine an optimal schedule that takes no-show behaviour into account to determine the time intervals between patients under the framework of the individual-block/variableinterval rule for minimising the overall cost of the patient waiting time,the practitioner idle time and overtime.Under the condition that the service time of each patient is exponentially distributed,we compare the results with a schedule designed for the same expected number of patients in the absence of no-shows and analyse the effect on the system performance from the perspectives of day-length,expected workload,no-show probability,ratio of overtime costs and no-golf policy.We extend our results to an equally-spaced appointment system,which is commonly used in practice.Our results show that not only do no-shows greatly affect the system performance compared with an appointment system with the same expected workload without no-shows,but they also affect the optimal scheduling behaviours in the dome-shaped distribution.In addition,overtime cannot be eliminated completely even if the day length is adequate for all patients because of the stochastic characteristic of service time.
基金the National Social Science Fund of China Youth Project“Research on the Application Dilemma and Solutions of the Appointed Guardianship Clauses in the Civil Code”(Project Approval Number 20CFX075).
文摘In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:during the decision-making stage of whether to choose appointed guardianship,the lack of professionalism and availability of appointed guardians can easily hinder the elderly from choosing to apply it;during the establishment stage of appointed guardianship,the limited rules related to the appointed guardianship agreement can easily lead to the frustration of the elderly’s subjective will;during the operation stage of appointed guardianship,the insufficient accountability mechanisms for appointed guardians can easily lead to the infringement of the personal or property rights of the elderly.By reflecting on its jurisprudential causes,it can be found that the current law largely ignores the orientation of appointed guardianship as a welfare for the elderly in social law,the concept of substantive equality in the appointed guardianship agreement,and the theoretical attributes of the appointed guardianship as a fiduciary relationship.Therefore,the appointed guardianship system in China should be systematically improved to fully release its institutional potential in the protection of the rights and interests of the elderly based on these jurisprudential principles.In particular,it is possible to consider actively promoting the“trust+appointed guardianship”model and cultivating a team of appointed guardians by the state based on the concept of elderly welfare;strengthening the protection of notarization procedures and the reasonable design of the appointed guardianship agreement based on the concept of substantive equality;and refining the fiduciary standards of appointed guardians and strengthening guardianship supervision based on the nature of fiduciary relationship.
