Cardiovascular diseases(CVD)and their risk factors are exerting an increasingly significant impact on public health,and the incidence rate of CVD continues to rise.This article provides an interpretation of essentials...Cardiovascular diseases(CVD)and their risk factors are exerting an increasingly significant impact on public health,and the incidence rate of CVD continues to rise.This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China(2024),aiming to offer scientific evidence for CVD prevention,treatment,and the formulation of relevant policies.展开更多
IN the Shanghai Jewish Refugees Museum,a beautiful handbag is waiting for its owner in a display cabinet.The handbag belongs to a Jewish couple.When they sought refuge in Shanghai during World War II,they pawned the h...IN the Shanghai Jewish Refugees Museum,a beautiful handbag is waiting for its owner in a display cabinet.The handbag belongs to a Jewish couple.When they sought refuge in Shanghai during World War II,they pawned the handbag to Jin Wenzhen’s grandfather in exchange for their child’s medical expenses.He lent the couple the cash equivalent of one month’s revenue from his rice shop,but then never saw them again.展开更多
In recent years,surrogate models derived from genuine data samples have proven to be efficient in addressing optimization challenges that are costly or time⁃intensive.However,the individuals in the population become i...In recent years,surrogate models derived from genuine data samples have proven to be efficient in addressing optimization challenges that are costly or time⁃intensive.However,the individuals in the population become indistinguishable as the curse of dimensionality increases in the objective space and the accumulation of surrogate approximated errors.Therefore,in this paper,each objective function is modeled using a radial basis function approach,and the optimal solution set of the surrogate model is located by the multi⁃objective evolutionary algorithm of strengthened dominance relation.The original objective function values of the true evaluations are converted to two indicator values,and then the surrogate models are set up for the two performance indicators.Finally,an adaptive infill sampling strategy that relies on approximate performance indicators is proposed to assist in selecting individuals for real evaluations from the potential optimal solution set.The algorithm is contrasted against several advanced surrogate⁃assisted evolutionary algorithms on two suites of test cases,and the experimental findings prove that the approach is competitive in solving expensive many⁃objective optimization problems.展开更多
Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium...Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.展开更多
Formal credit is critical in agricultural production,allowing more expenditure and productive input,thereby improving farmers'welfare.In pastoral China,formal financial institutions are gradually increasing.Howeve...Formal credit is critical in agricultural production,allowing more expenditure and productive input,thereby improving farmers'welfare.In pastoral China,formal financial institutions are gradually increasing.However,a limited understanding remains of how formal credit affects herders'household expenses.Based on a survey of 544 herders from the Qinghai-Xizang Plateau of China,this study adopted the propensity score matching approach to identify the effect of formal credit on herders'total household expenses,daily expenses,and productive expenses.The results found that average age,grassland mortgage,and other variables significantly affected herders'participation in formal credit.Formal credit could significantly improve household expenses,especially productive expenses.A heterogeneity analysis showed that formal credit had a greater impact on the household total expense for those at higher levels of wealth;however,it significantly affected the productive expense of herders at lower wealth levels.Moreover,the mediating effect indicated that formal credit could affect herders'household income,thus influencing their household expenses.Finally,this study suggests that policies should improve herders'accessibility to formal credit.展开更多
To address the challenges of high-dimensional constrained optimization problems with expensive simulation models,a Surrogate-Assisted Differential Evolution using Manifold Learning-based Sampling(SADE-MLS)is proposed....To address the challenges of high-dimensional constrained optimization problems with expensive simulation models,a Surrogate-Assisted Differential Evolution using Manifold Learning-based Sampling(SADE-MLS)is proposed.In SADE-MLS,differential evolution operators are executed to generate numerous high-dimensional candidate points.To alleviate the curse of dimensionality,a Manifold Learning-based Sampling(MLS)mechanism is developed to explore the high-dimensional design space effectively.In MLS,the intrinsic dimensionality of the candidate points is determined by a maximum likelihood estimator.Then,the candidate points are mapped into a low-dimensional space using the dimensionality reduction technique,which can avoid significant information loss during dimensionality reduction.Thus,Kriging surrogates are constructed in the low-dimensional space to predict the responses of the mapped candidate points.The candidate points with high constrained expected improvement values are selected for global exploration.Moreover,the local search process assisted by radial basis function and differential evolution is performed to exploit the design space efficiently.Several numerical benchmarks are tested to compare SADE-MLS with other algorithms.Finally,SADE-MLS is successfully applied to a solid rocket motor multidisciplinary optimization problem and a re-entry vehicle aerodynamic optimization problem,with the total impulse and lift to drag ratio being increased by 32.7%and 35.5%,respec-tively.The optimization results demonstrate the practicality and effectiveness of the proposed method in real engineering practices.展开更多
We have shown that cornerstone articles considering effects of corporate debt on the firm value and constituting the basis of the trade-off theory of capital structure are wrong.Their main mistake is in ignoring the b...We have shown that cornerstone articles considering effects of corporate debt on the firm value and constituting the basis of the trade-off theory of capital structure are wrong.Their main mistake is in ignoring the business securing expenses(BSEs).In the framework of the extended Merton model(EMM),we consider the cumulative effect of debt and corporate taxes on the firm value and its survival,in other words,we revisit Modigliani-Miller Proposition 3(MMP3).We show that(1)debt affects the firm value and its survival,(2)this effect is negative,diminishing the firm value and its chances to survive,(3)the pressure increases as the debt grows provoking the firm’s default,(4)the main factors depressing the levered firm are its debt payments added to the BSEs of the identical unlevered firm and the length of debt maturity,(5)corporate taxes cause development of positive skewness in the asset distribution,but do not affect the location of this distribution in the asset axis.The presented model helps estimate the consequences of choosing this or that level of debt in the presence of corporate taxes and can make a useful instrument for practicing financial managers.展开更多
Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei Universit...Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei University.Methods:The hospitalization information of patients with AKI from January 2020 to January 2023 was collected and sorted through the hospital charging system and the factors affecting the total hospitalization cost were analyzed by multiple linear regression.Results:Univariate analysis showed that age,occupation,marriage,length of hospitalization,recovery of renal function,and stage of AKI had significant effects on hospitalization cost(P<0.05).The result of the multiple linear regression analysis model showed that age(t=4.11,P<0.0001),length of hospitalization(t=16.10,P<0.0001),recovery of renal function(t=3.26,P<0.0001),AKI stage(t=5.23,P=0.002)are factors affecting the economic burden of patients with AKI.Conclusion:AKI patients should be managed according to age stratification to effectively control the progression of the disease and improve the quality of the medical services provided.This will reduce the economic burden of patients.展开更多
Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospit...Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.展开更多
Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing ...Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.展开更多
Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put fo...Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.展开更多
沿革为了刺激技术创新,美国很早就制定颁布了相应的税收优惠制度。1954年美国《国内税收法典》就确立了研发费用扣除制度(174节)。但是令人遗憾的是,研发费用扣除制度没有带来预想的效果。数据显示,研发投资与国民生产总值的比例从1968...沿革为了刺激技术创新,美国很早就制定颁布了相应的税收优惠制度。1954年美国《国内税收法典》就确立了研发费用扣除制度(174节)。但是令人遗憾的是,研发费用扣除制度没有带来预想的效果。数据显示,研发投资与国民生产总值的比例从1968年的2.01%下降到1975年的1.58%。更重要的是,美国将其大部分研发投资都用于国防工业。与其他发达国家相比,它的非国防研发支出(civilian research expense)是比较少的。1970-1980年间,美国的研发投入与GDP的比例始终在1.5%到2%之间徘徊。而在同时段的德国和日本,这一比例从来没有低过1.9%。展开更多
英汉语均广泛使用比较级,但英语用比较级更广泛些,花样也多些。因此,相对说来,英译汉困难多些。其实汉译英也不易,只是一般采用平铺直叙的译法,不常采用英语丰富多采的表达方式来翻译。例如下面提到的“绝不坏”,一般就译为“not bat at...英汉语均广泛使用比较级,但英语用比较级更广泛些,花样也多些。因此,相对说来,英译汉困难多些。其实汉译英也不易,只是一般采用平铺直叙的译法,不常采用英语丰富多采的表达方式来翻译。例如下面提到的“绝不坏”,一般就译为“not bat at all”,“not absolutely bad”或“quite good”,很少译为“no less good”。又如“这种布由于很漂亮,也就不算贵了”,一般直译为“This展开更多
有报道称,中国财富性别差距日益扩大,女性不仅被＂剩下＂,而且被＂无视＂。
Shang Wen,a single 32-year-old,a three-year-old’s mother,is a rarity1in China,mainly because her parents helped her purchase her own house in 20...有报道称,中国财富性别差距日益扩大,女性不仅被＂剩下＂,而且被＂无视＂。
Shang Wen,a single 32-year-old,a three-year-old’s mother,is a rarity1in China,mainly because her parents helped her purchase her own house in 2004.＂Property was not too expensive then,and my parents had no idea that the market would take off2,＂says Shang.Little did she know that this investment could end up paying off years later,展开更多
目的评价药品集中带量采购对糖尿病患者住院总费用及各类构成费用的影响。方法基于研究医院的9852份糖尿病患者病案首页数据,整理患者基本信息、医疗服务利用信息及各项医疗费用信息,综合运用普通最小二乘法(ordinary least square,OLS...目的评价药品集中带量采购对糖尿病患者住院总费用及各类构成费用的影响。方法基于研究医院的9852份糖尿病患者病案首页数据,整理患者基本信息、医疗服务利用信息及各项医疗费用信息,综合运用普通最小二乘法(ordinary least square,OLS)和倾向性得分匹配法(propensity score matching,PSM)进行数据分析。结果集中带量采购政策确实能够降低糖尿病住院患者的药品费用(t=-2.27,P<0.05),但是对住院总费用、医疗服务性费用影响不显著。OLS回归低估了药品集中带量采购对患者检查化验耗材费用的增费效应(t=2.26,P<0.05)。结论在进一步加强宣传教育的同时,要有序扩大药品集中带量采购,系统推动医药领域集约式改革,持续放大改革红利,实现患者总体医疗负担减轻,让政策福利遍及更多患者。展开更多
Modern engineering design optimization often relies on computer simulations to evaluate candidate designs, a setup which results in expensive black-box optimization problems. Such problems introduce unique challenges,...Modern engineering design optimization often relies on computer simulations to evaluate candidate designs, a setup which results in expensive black-box optimization problems. Such problems introduce unique challenges, which has motivated the application of metamodel-assisted computational intelligence algorithms to solve them. Such algorithms combine a computational intelligence optimizer which employs a population of candidate solutions, with a metamodel which is a computationally cheaper approximation of the expensive computer simulation. However, although a variety of metamodels and optimizers have been proposed, the optimal types to employ are problem dependant. Therefore, a priori prescribing the type of metamodel and optimizer to be used may degrade its effectiveness. Leveraging on this issue, this study proposes a new computational intelligence algorithm which autonomously adapts the type of the metamodel and optimizer during the search by selecting the most suitable types out of a family of candidates at each stage. Performance analysis using a set of test functions demonstrates the effectiveness of the proposed algorithm, and highlights the merit of the proposed adaptation approach.展开更多
文摘Cardiovascular diseases(CVD)and their risk factors are exerting an increasingly significant impact on public health,and the incidence rate of CVD continues to rise.This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China(2024),aiming to offer scientific evidence for CVD prevention,treatment,and the formulation of relevant policies.
文摘IN the Shanghai Jewish Refugees Museum,a beautiful handbag is waiting for its owner in a display cabinet.The handbag belongs to a Jewish couple.When they sought refuge in Shanghai during World War II,they pawned the handbag to Jin Wenzhen’s grandfather in exchange for their child’s medical expenses.He lent the couple the cash equivalent of one month’s revenue from his rice shop,but then never saw them again.
基金Sponsored by Scientific and Technological Innovation Programs of Higher Education Institutions in Shanxi(Grant No.2022L294)Taiyuan University of Science and Technology Scientific Research Initial Funding(Grant Nos.W2022018,W20242012)Foundamental Research Program of Shanxi Province(Grant No.202403021212170).
文摘In recent years,surrogate models derived from genuine data samples have proven to be efficient in addressing optimization challenges that are costly or time⁃intensive.However,the individuals in the population become indistinguishable as the curse of dimensionality increases in the objective space and the accumulation of surrogate approximated errors.Therefore,in this paper,each objective function is modeled using a radial basis function approach,and the optimal solution set of the surrogate model is located by the multi⁃objective evolutionary algorithm of strengthened dominance relation.The original objective function values of the true evaluations are converted to two indicator values,and then the surrogate models are set up for the two performance indicators.Finally,an adaptive infill sampling strategy that relies on approximate performance indicators is proposed to assist in selecting individuals for real evaluations from the potential optimal solution set.The algorithm is contrasted against several advanced surrogate⁃assisted evolutionary algorithms on two suites of test cases,and the experimental findings prove that the approach is competitive in solving expensive many⁃objective optimization problems.
文摘Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.
基金funding from the National Natural Science Foundation of China (72303086)the Leading Scientist Project of Qinghai Province, China (2023-NK-147)+1 种基金the Consulting Project of Chinese Academy of Engineering (2023-XY-28,2022-XY-139)the Fundamental Research Funds for the Central Universities, China (lzujbky-2022-sp13)
文摘Formal credit is critical in agricultural production,allowing more expenditure and productive input,thereby improving farmers'welfare.In pastoral China,formal financial institutions are gradually increasing.However,a limited understanding remains of how formal credit affects herders'household expenses.Based on a survey of 544 herders from the Qinghai-Xizang Plateau of China,this study adopted the propensity score matching approach to identify the effect of formal credit on herders'total household expenses,daily expenses,and productive expenses.The results found that average age,grassland mortgage,and other variables significantly affected herders'participation in formal credit.Formal credit could significantly improve household expenses,especially productive expenses.A heterogeneity analysis showed that formal credit had a greater impact on the household total expense for those at higher levels of wealth;however,it significantly affected the productive expense of herders at lower wealth levels.Moreover,the mediating effect indicated that formal credit could affect herders'household income,thus influencing their household expenses.Finally,this study suggests that policies should improve herders'accessibility to formal credit.
基金co-supported by the National Natural Science Foundation of China(Nos.52272360,52232014,52005288,52201327)Beijing Natural Science Foundation,China(No.3222019)+1 种基金Beijing Institute of Technology Research Fund Program for Young Scholars,China(No.XSQD-202101006)BIT Research and Innovation Promoting Project(No.2022YCXZ017).
文摘To address the challenges of high-dimensional constrained optimization problems with expensive simulation models,a Surrogate-Assisted Differential Evolution using Manifold Learning-based Sampling(SADE-MLS)is proposed.In SADE-MLS,differential evolution operators are executed to generate numerous high-dimensional candidate points.To alleviate the curse of dimensionality,a Manifold Learning-based Sampling(MLS)mechanism is developed to explore the high-dimensional design space effectively.In MLS,the intrinsic dimensionality of the candidate points is determined by a maximum likelihood estimator.Then,the candidate points are mapped into a low-dimensional space using the dimensionality reduction technique,which can avoid significant information loss during dimensionality reduction.Thus,Kriging surrogates are constructed in the low-dimensional space to predict the responses of the mapped candidate points.The candidate points with high constrained expected improvement values are selected for global exploration.Moreover,the local search process assisted by radial basis function and differential evolution is performed to exploit the design space efficiently.Several numerical benchmarks are tested to compare SADE-MLS with other algorithms.Finally,SADE-MLS is successfully applied to a solid rocket motor multidisciplinary optimization problem and a re-entry vehicle aerodynamic optimization problem,with the total impulse and lift to drag ratio being increased by 32.7%and 35.5%,respec-tively.The optimization results demonstrate the practicality and effectiveness of the proposed method in real engineering practices.
文摘We have shown that cornerstone articles considering effects of corporate debt on the firm value and constituting the basis of the trade-off theory of capital structure are wrong.Their main mistake is in ignoring the business securing expenses(BSEs).In the framework of the extended Merton model(EMM),we consider the cumulative effect of debt and corporate taxes on the firm value and its survival,in other words,we revisit Modigliani-Miller Proposition 3(MMP3).We show that(1)debt affects the firm value and its survival,(2)this effect is negative,diminishing the firm value and its chances to survive,(3)the pressure increases as the debt grows provoking the firm’s default,(4)the main factors depressing the levered firm are its debt payments added to the BSEs of the identical unlevered firm and the length of debt maturity,(5)corporate taxes cause development of positive skewness in the asset distribution,but do not affect the location of this distribution in the asset axis.The presented model helps estimate the consequences of choosing this or that level of debt in the presence of corporate taxes and can make a useful instrument for practicing financial managers.
文摘Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei University.Methods:The hospitalization information of patients with AKI from January 2020 to January 2023 was collected and sorted through the hospital charging system and the factors affecting the total hospitalization cost were analyzed by multiple linear regression.Results:Univariate analysis showed that age,occupation,marriage,length of hospitalization,recovery of renal function,and stage of AKI had significant effects on hospitalization cost(P<0.05).The result of the multiple linear regression analysis model showed that age(t=4.11,P<0.0001),length of hospitalization(t=16.10,P<0.0001),recovery of renal function(t=3.26,P<0.0001),AKI stage(t=5.23,P=0.002)are factors affecting the economic burden of patients with AKI.Conclusion:AKI patients should be managed according to age stratification to effectively control the progression of the disease and improve the quality of the medical services provided.This will reduce the economic burden of patients.
文摘Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.
文摘Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.
文摘Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.
文摘沿革为了刺激技术创新,美国很早就制定颁布了相应的税收优惠制度。1954年美国《国内税收法典》就确立了研发费用扣除制度(174节)。但是令人遗憾的是,研发费用扣除制度没有带来预想的效果。数据显示,研发投资与国民生产总值的比例从1968年的2.01%下降到1975年的1.58%。更重要的是,美国将其大部分研发投资都用于国防工业。与其他发达国家相比,它的非国防研发支出(civilian research expense)是比较少的。1970-1980年间,美国的研发投入与GDP的比例始终在1.5%到2%之间徘徊。而在同时段的德国和日本,这一比例从来没有低过1.9%。
文摘英汉语均广泛使用比较级,但英语用比较级更广泛些,花样也多些。因此,相对说来,英译汉困难多些。其实汉译英也不易,只是一般采用平铺直叙的译法,不常采用英语丰富多采的表达方式来翻译。例如下面提到的“绝不坏”,一般就译为“not bat at all”,“not absolutely bad”或“quite good”,很少译为“no less good”。又如“这种布由于很漂亮,也就不算贵了”,一般直译为“This
文摘目的基于上海市近年结核病诊疗费用减免政策,探索耐多药结核病(multidrug resistant tuberculosis,MDR-TB)患者疾病经济负担及其影响因素,为优化MDR-TB诊疗费用减免政策和综合管理模式提供依据。方法收集上海市2017—2019年确诊MDR-TB患者情况和诊疗费用减免情况数据,开展针对疾病经济负担的问卷调查,建立涵盖患者人口和社会经济情况、临床特征、疾病经济负担和诊疗费用减免情况数据库,明确患者疾病经济负担和灾难性卫生支出(catastrophic health expenditure)发生情况。以多元线性回归法分析可能影响患者疾病经济负担的因素,以多因素logistic回归法分析不同比例下灾难性卫生支出发生的影响因素。结果196例纳入研究分析的MDR-TB患者平均年龄为(44±16)岁,男性139例(占70.9%),上海户籍占46.4%,49%的患者为家庭主要劳动力。治疗期间,患者自付诊疗费用中位数为4.0(四分位数区间2.0~6.5)万元。113例患者获得减免诊疗,减免费用中位数为2.6(四分位数区间1.3~4.9)万元。若自付费用占家庭年收入的40%及以上,有47.8%的患者会发生灾难性支出;若不考虑减免政策,有59.8%的患者发生灾难性卫生支出。上海户籍(OR=0.3,95%CI为0.1~1.0)、更低家庭收入水平(P_(trend)=0.002)、医疗保险类型[(农村合作医疗保险/外来人口综合保险(OR=13.3,95%CI为1.0~171.2),无医疗保险(OR=17.5,95%CI为2.7~113.0)]和既往结核病治疗史(OR=3.3,95%CI为1.1~10.0)可能影响灾难性卫生支出的发生。结论上海市MDR-TB患者的自付诊疗费用较高。医疗保障力度较小和家庭经济情况不佳的患者更易发生高额自付费用,导致灾难性卫生支出。上海市MDR-TB诊疗费用减免政策有效降低了患者的经济负担。
文摘有报道称,中国财富性别差距日益扩大,女性不仅被＂剩下＂,而且被＂无视＂。
Shang Wen,a single 32-year-old,a three-year-old’s mother,is a rarity1in China,mainly because her parents helped her purchase her own house in 2004.＂Property was not too expensive then,and my parents had no idea that the market would take off2,＂says Shang.Little did she know that this investment could end up paying off years later,
文摘目的评价药品集中带量采购对糖尿病患者住院总费用及各类构成费用的影响。方法基于研究医院的9852份糖尿病患者病案首页数据,整理患者基本信息、医疗服务利用信息及各项医疗费用信息,综合运用普通最小二乘法(ordinary least square,OLS)和倾向性得分匹配法(propensity score matching,PSM)进行数据分析。结果集中带量采购政策确实能够降低糖尿病住院患者的药品费用(t=-2.27,P<0.05),但是对住院总费用、医疗服务性费用影响不显著。OLS回归低估了药品集中带量采购对患者检查化验耗材费用的增费效应(t=2.26,P<0.05)。结论在进一步加强宣传教育的同时,要有序扩大药品集中带量采购,系统推动医药领域集约式改革,持续放大改革红利,实现患者总体医疗负担减轻,让政策福利遍及更多患者。
文摘Modern engineering design optimization often relies on computer simulations to evaluate candidate designs, a setup which results in expensive black-box optimization problems. Such problems introduce unique challenges, which has motivated the application of metamodel-assisted computational intelligence algorithms to solve them. Such algorithms combine a computational intelligence optimizer which employs a population of candidate solutions, with a metamodel which is a computationally cheaper approximation of the expensive computer simulation. However, although a variety of metamodels and optimizers have been proposed, the optimal types to employ are problem dependant. Therefore, a priori prescribing the type of metamodel and optimizer to be used may degrade its effectiveness. Leveraging on this issue, this study proposes a new computational intelligence algorithm which autonomously adapts the type of the metamodel and optimizer during the search by selecting the most suitable types out of a family of candidates at each stage. Performance analysis using a set of test functions demonstrates the effectiveness of the proposed algorithm, and highlights the merit of the proposed adaptation approach.
