黄石无机盐厂含铬废水废渣的综合治理与利用方案设计

本文讨论了以黄石无机盐厂的废水、废渣为主，联合黄石另外几家大中型企业废水、废渣的综合利用，开发再生资源，获得更大的经济效益的方法与措施。     

石油、石化企业综合利用煤、油、气资源途径初探

近年来我国原油进口数量急剧增加。石油安全问题引起广泛关注。而我国煤炭与天然气资源相对比较丰富。统筹规划并合理利用煤、油、气资源，通过煤化工、石油炼制、石油化工3个行业技术上的互相借鉴，资源上的互相替代，产业链的互相补充，尽量减少石油的消耗，以减轻对进口原油的依赖。     

The Load Model: an alternative to QALY

Background: QALYs are widely used in health economic evaluation, but remain controversial, largely because they do not reflect how many people behave in practice. This paper presents a new conceptual model (Load Model) and illustrates it in comparison with the QALY model.

Methods: Load is the average annual weight attributed to morbidity and mortality over a defined period, using weightings based on preference judgements. Morbidity Load is attributed to states of illness, according to their perceived severity. When people are in full health, Load is zero (no morbidity). Death is treated as an event with negative consequences, incurred in the year following death. Deaths may be weighted equally, with a fixed negative weight such as ?100, or differ according to the context of death. After death, Load is zero. In a worked example, we use the standard gamble method to obtain a weighting for an illness state, for both Load and QALY models. A judge is indifferent between certainty of 1.5 years’ illness followed by death, or a 50/50 chance of 1.5 years’ full health or 1-year illness, each followed by death. The weightings calculated are applied to a hypothetical life, 72 years in full health followed by 3 years with illness then death, using both models. Three other hypothetical outcomes are also compared.

Results: For an example life, the relative size of the morbidity component compared with the mortality component is much higher in the Load model than in the QALY model. When comparing alternative outcomes, there are also substantial differences between the two models.

Conclusions: In the Load model the weight of morbidity, relative to mortality, is very different from that in the QALY model. Given the role of the QALYs in economic evaluation, the implications of an alternative, which generates very different results, warrant further exploration.     

北部湾城市群自然资本利用状况、空间分析与驱动因素

以北部湾城市群为例用三维生态足迹模型、偏最小二乘法、空间计量模型分析了其自然资本利用状况、空间相关性、驱动因素。结论:(1)城市群自然资本利用处于不可持续状态;(2)自然资本利用程度划分为低、中、高三类,城市也相应分成三类;(3)自然资本利用的主要驱动因素是人口因素、社会经济;(4)空间分析显示全局莫兰指数为正,空间集聚显著,表明自然资本利用存在空间正相关;空间误差模型拟合度最好,并证明自然资本存量占用与人口总量正相关,与GDP总额负相关。     

Healthcare costs of stroke and major bleeding in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants

Objective: To assess long-term healthcare costs related to ischemic stroke and systemic embolism (stroke/SE) and major bleeding (MB) events in patients with non-valvular atrial fibrillation (NVAF) treated with non-vitamin K antagonist oral anticoagulants (NOACs).

Materials and methods: Optum’s Clinformatics Data Mart database from 1/2009–12/2016 was analyzed. Adult patients with ≥1 stroke/SE hospitalization (index date) were matched 1:1 to patients without stroke/SE (random index date), based on propensity scores. Patients with an MB event were matched to patients without MB. All patients had an NOAC dispensing overlapping index date, ≥12?months of eligibility pre-index date, and ≥1 NVAF diagnosis. The observation period spanned from the index date until the earliest date of death, switch to warfarin, end of insurance coverage, or end of data availability. Mean costs were evaluated: (1) per-patient-per-year (PPPY) and (2) at 1, 2, 3, and 4?years using Lin's method.

Results: The cost differences were, respectively, $48,807 and $28,298 PPPY for NOAC users with stroke/SE (n?=?1,340) and those with MB (n?=?3,774) events compared to controls. Cost differences of patients with vs without stroke/SE were $49,876, $51,627, $57,822, and $60,691 at 1, 2, 3, and 4?years post-index, respectively (p?p?Limitations: Limitations include unobserved confounders, coding and/or billing inaccuracies, limited sample sizes over longer follow-up, and the under-reporting of mortality for deaths occurring after 2011.

Conclusions: The incremental healthcare costs incurred by patients with vs without stroke/SE was nearly twice as high as those of patients with vs without MB. Moreover, each additional year up to 4?years after the first event was associated with an incremental cost for patients with a stroke/SE or MB event compared to those without an event.     

The Influence of Vested Interests on Healthcare Legislation in the USA, 2009–2010

Collective lobbying organizations and some big companies acted as cautious partners in the design of the Affordable Care Act of the Obama Administration. In addition to being consulted by government executives, these entities intensively lobbied legislators. The qualitative and statistical analysis I conduct here shows a positive impact of healthcare lobbying. Collective lobbying organizations have a significant impact on lawmaking and complementary lobbying enhances their impact. However, not all (disjointed) lobbying is successful. Perspective-based distortion might explain why organizations lobby on issues against all odds of ever being effective.     

山区城市打造区域职业教育中心的分析及建议

本文在分析永安市开展职业教育工作优势和劣势的基础上,就山区城市如何打造区域职业教育中心提出了合理化建议。     

Comparing post-operative resource consumption following transcatheter aortic valve implantation (TAVI) and conventional aortic valve replacement in the UK

Objective:

To define the in-hospital and 6-month post-discharge resource use, following Transcatheter Aortic Valve Implantation (TAVI) and conventional Aortic Valve Replacement (AVR) surgery within a single UK hospital.

Methods:

A local service evaluation of patients undergoing TAVI or AVR between January 2011 and May 2012 captured data until 6-months post-procedure, collected from hospital records and via a General Practitioner questionnaire. The main end-points were mortality, time in ITU/HDU, hospital length of stay (LoS), discharge destination, re-admission, and post-discharge primary/secondary care resource use. Sub-group analyses were performed for AVR patients aged ≥80 (AVR?≥?80) and with EuroSCORE of ≥10 (AVR ES?≥?10) to allow more direct comparison with ‘TAVI type’ patients.

Results:

Results are given as means (standard deviation) for TAVI (n?=?51), AVR (n?=?188), AVR?≥?80 (n?=?48), and AVR ES?≥?10 (n?=?47), respectively, unless otherwise stated. Age in years was 83.0 (8.1), 71.2 (13.1), 84.1 (2.7), 79.4 (7.1); EuroSCORE was 24.7 (11.9), 8.1 (6.4), 12.0 (6.0), and 16.5 (6.6); post-operative LoS (days) was 11.5 (11.2), 10.9 (10.8), 14.3 (16.7), and 15.2 (17.7). For discharged patients, 0%, 7%, 13%, and 9% had unplanned cardiac-related re-admissions within 30-days of discharge. Time to first readmission was 74.6 (34.0), 35.0 (34.2), 20.8 (9.7), and 22.6 (14.3) days.

Limitations:

This was a single-center retrospective evaluation, not prospectively powered to confirm differences in outcomes.

Conclusions:

Despite TAVI being performed in an older, higher risk population, LoS was similar to AVR. Most strikingly there were no cardiac-related re-admissions within 30-days for TAVI and time to first re-admission was significantly longer. This evaluation suggests that TAVI is clinically appropriate and provides economic advantages in both the hospital and post-discharge setting in this high risk group. Many patients undergoing TAVI are considered unfit for surgery and, hence, TAVI offers a treatment that delivers similar results to traditional AVR without the high risk associated with surgery.     

新型个人信息保护体系构建研究

大数据时代,传统的以“信息收集”规制为着力点的个人信息保护出现适法性困境,以“知情同意”为框架的机理失灵,个人信息的利用对象从直接个人信息逐渐向间接个人信息过渡,其财产价值凸显,新型个人信息财产权呼之欲出。立法应顺应数字经济的发展,构建合理新型个人信息体系。具体而言:纵向层面,以“宽进+删除权”为具体保护策略;横向层面,在信息主体和信息产业者之间合理配置权利,即信息主体享有个人信息权和个人信息财产权,信息产业者享有信息资产权。     

Normal utilization rate in the Sraffa framework

This paper deals with the normal utilization rate in the Sraffa framework. It further presents two arguments about the utilization controversy surrounding the neo-Kaleckian theory of growth and distribution: First, it shows that the normal utilization rate is generally not independent of demand and the growth rate, and this result does not rely on the neo-classical production function and other restrictive assumptions. Second, it argues that endogenizing the normal utilization rate is not a general solution for the utilization controversy.