从技术移植到技术整合——来自南京奥特加的案例分析

本文阐述了南京奥特加冷机有限公司实施技术战略发展的基本过程,重点对其从技术移植到技术整合的技术创新过程中的基本做法进行了分析研究。在案例分析的基础上,得出了相关启示和借鉴。     

独立董事制度在普通法系国家(地区)的移植及其启示

1990年以后,许多普通法系国家(地区)引入了起源于美国的独立董事制度,以期加强公司治理,提高国家竞争力.这表明,在全球化背景下,不同国家的公司治理具有趋同的趋势.然而,从实施效果来看,这些国家(地区)的独立董事制度尚存在种种问题,其有效性与美国有一定差距.这又反映了公司治理制度移植以及全球趋同的困难性.     

Bias-corrected estimates of reduction of post-surgery length of stay and corresponding cost savings through the widespread national implementation of fast-tracking after liver transplantation: a quasi-experimental study

Background: Fast-tracking is an approach adopted by Mayo Clinic in Florida’s (MCF) liver transplant (LT) program, which consists of early tracheal extubation and transfer of patients to surgical ward, eliminating a stay in the intensive care unit in select patients. Since adopting this approach in 2002, MCF has successfully fast-tracked 54.3% of patients undergoing LT.

Objectives: This study evaluated the reduction in post-operative length of stay (LOS) that resulted from the fast-tracking protocol and assessed the potential cost saving in the case of nationwide implementation.

Methods: A propensity score for fast-tracking was generated based on MCF liver transplant databases during 2011–2013. Various propensity score matching algorithms were used to form control groups from the United Network of Organ Sharing Standard Analysis and Research (STAR) file that had comparable demographic characteristics and health status to the treatment group identified in MCF. Multiple regression and matching estimators were employed for evaluation of the post-surgery LOS. The algorithm generated from the analysis was also applied to the STAR data to determine the proportion of patients in the US who could potentially be candidates for fast-tracking, and the potential savings.

Results: The effect of the fast-tracking on the post-transplant LOS was estimated at approximately from 2.5 (p-value?=?0.001) to 3.2 (p-value?transplant patients was estimated to be at least $78 million during the 2-year period.

Conclusion: The fast-track program was found to be effective in reducing post-transplant LOS, although the reduction appeared to be less than previously reported. Nationwide implementation of fast-tracking could result in substantial cost savings without compromising the patient outcome.     

独立董事制度在普通法系国家（地区）篚移植及其启示

1990年以后,许多普通法系国家（地区）引入了起源于美国的独立董事制度,以期加强公司治理,提高国家竞争力。这表明,在全球化背景下,不同国家的公司治理具有趋同的趋势。然而,从实施效果来看,这些国家（地区）的独立董事制度尚存在种种问题,其有效性与美国有一定差距。这又反映了公司治理制度移植以及全球趋同的困难性。     

基于FPGA芯片的机载波形动态重构设计

针对机载综合射频传感器系统高度综合化的实际需求，基于部分可重构技术提出了一种机载传感器功能波形重构设计方法，以实现在现场可编程门阵列（Field Programmable Gate Array，FPGA）芯片局部区域上时分复用机载功能波形。该方法引入一种便于功能波形移植部署的FPGA平台设计，并在此平台上完成机载功能波形在FPGA芯片局部区域的可重构具体设计。工程应用表明，该设计能够灵活有效复用可编程逻辑器件资源，提高了综合射频传感器系统的功能波形集成度，具有较好的实践意义。     

Treatment patterns,healthcare resource utilization,and costs in patients with acute myeloid leukemia in commercially insured and Medicare populations

Objective: To describe the setting, duration, and costs of induction and consolidation chemotherapy for adults with newly-diagnosed acute myeloid leukemia (AML), who are candidates for standard induction chemotherapy, in the US.

Methods: Adults newly-diagnosed with AML who received standard induction chemotherapy in an inpatient setting were identified from the Truven Health Analytics MarketScan (2006–2015) and SEER-Medicare (2007–2011) databases. Patients were observed from induction therapy start to the first of hematopoietic stem cell transplant, 180 days after induction discharge, health plan enrollment/data availability end, or death. Induction and consolidation chemotherapy were identified using Diagnosis-Related Group codes (chemotherapy with acute leukemia) or procedure codes for AML chemotherapy administration. AML treatment episode setting (inpatient or outpatient), duration, and costs (2015 USD, payers’ perspective) were described for commercially insured patients and Medicare beneficiaries.

Results: In total, 459 commercially insured patients and 563 Medicare beneficiaries (mean age?=?54 and 66 years; 53% and 54% male; respectively) were identified. For induction therapy, mean costs were $145,189 for commercially insured patients and $85,734 for Medicare beneficiaries, and median inpatient duration was 31 days (both). Following induction, 64% of commercially insured patients and 53% of Medicare beneficiaries had ≥1 consolidation cycle; 75% and 65% of consolidation cycles were in an inpatient setting, respectively. For consolidation cycles, in the inpatient setting, mean costs were $28,137 for commercially insured patients and $28,843 for Medicare beneficiaries, median cycle duration was 6 days (both); in the outpatient setting, mean costs were $11,271 for commercially insured patients and $5,803 Medicare beneficiaries, median duration was 5 days (both).

Limitations: Granular information on chemotherapy type administered was unavailable.

Conclusions: This is the first exploratory study providing a complete picture of recent AML treatment patterns and management costs among commercially insured patients and Medicare beneficiaries. There is substantial heterogeneity in the management and costs of AML.     

Healthcare utilization and costs with fixed-source versus variable-source tacrolimus in patients receiving a kidney transplant

Abstract

Aims: Switching drug manufacturers in transplant patients may require an increased intensity of therapeutic monitoring, leading to additional healthcare visits, associated laboratory tests, and perhaps hospitalizations. As real-world studies examining the interchangeability of tacrolimus from different manufacturers are limited, the purpose of this study was to examine the healthcare resource utilization (HRU) and economic impact of tacrolimus-switching in kidney transplantation.

Materials and methods: This cross-sectional, retrospective study examined HRU and healthcare costs (HCCs) among patients with a kidney transplant who were prescribed tacrolimus from fixed-source (FS) vs variable-source (VS) manufacturers using claims data from the large US health plan Humana from October 1, 2012, to December 31, 2013.

Results: Overall, 1,024 patients were identified (FS: n?=?674, 66%; VS: n?=?350, 34%). The number of therapeutic drug monitoring (TDM) events for the VS group was 13% greater than for the FS group after controlling for demographics, comorbidity score, and number of medications (incidence rate ratio?=?1.13, p?=?.033). Adjusted total HCCs were 9% lower for VS (US$28,054 vs US$30,823, p?=?.045). In the unadjusted analysis, VS had greater emergency department (ED) utilization (45% vs 35%, p?<?.002). In the VS group, the mean (standard deviation [SD]) number of days from manufacturer switch to first outpatient visit was 23.8 (33.6), and the number of days (SD) to first TDM event was 43.6 (56.2).

Limitations: Study limitations include the lack of availability of many transplant-specific variables within the Humana database, potential errors/omissions in claims coding, and restriction of cross-sectional data examination to a 1-year period.

Conclusions: VS patients had greater TDM and lower total HCCs. Further research is warranted to understand the drivers of ED use among the VS group, and to determine factors associated with delayed TDM after regimen modification. Opportunities may exist to improve the quality of care for patients receiving immunosuppressant treatment with tacrolimus.     

贯通古今，融会中西——读《寄簃文存》

《寄簃文存》是中国近代著名法学家、清末法制改革的倡导者沈家本的著作,它系统地表述了沈家本的法学思想。而贯通古今、融会中西是贯穿于其中的重要法律变革思想。关注这种思想,将对我们今天在加入WTO后面临的法律变革问题产生深刻的启示,而且将对在中西文化冲突中,中国传统文化的走向问题提供一种思维模式,即对传统法律文化的创造性转化的思路。     

浙商投资中部地区的特征和动因

该文归纳了浙商省外投资的三个主要特征,分析了浙企外迁的三个动因.认为浙江企业的集群外迁是产业梯度转移的强烈信号和重要标志.浙商投资重点选择江西有三个理由：发展态势好、制度成本低、邻域渗透快.     

Multi-objective design of an organ transplant network under uncertainty

We propose a novel multi-period location–allocation model for the design of an organ transplant transportation network under uncertainty. The model consists of a bi-objective mathematical programming model that minimizes total cost and time, including waiting time in the queue for the transplant operation, while considering organs’ priorities. A fuzzy multi-objective programming based approach is presented to solve the small and medium size problems to optimality. For larger problems, we propose two meta-heuristics based algorithms. Lower bounds, and several numerical examples with managerial insights are discussed. A real case-study is provided, and the existing and the proposed optimal solutions are compared.