Reevaluating health metrics:Unraveling the limitations of disabilityadjusted life years as an indicator in disease burden assessment

In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.

Determination of correlation of Adjusted Blood Requirement Index with outcome in patients presenting with acute variceal bleeding

AIM： To determine the correlation of Adjusted Blood Requirement Index （ABRI） with the 7th day outcome in patients presenting with acute variceal bleeding.METHODS： All patients presenting with acute variceal hemorrhage （AVH） were included. Patients with previous band ligation, sclerotherapy, gastrointestinal or hepatic malignancies were excluded. Patients were managed as per standard protocol for AVH with terlipressin and band ligation. ABRI scores were calculated using the formula outcome of alive or expired up to the 7th day after treatment. The correlation between ABRI and mortality was estimated and a receiver operative characteristic （ROC） curve was plotted.RESULTS： A total of 113 patients （76 male; 37 female） were included. On assessment, 18 were in Child＇s Pugh Class A, 82 in Class B and 13 were in Class C. The median number of blood units transfused ± inter-quartile range was 3.0 ± 2.0. The median ± inter-quartile range for ABRI was 1.3 ± 1.1. The ROC curve of ABRI for expiry showed a significantly large area of 0.848 （P 〈 0.0001; 95% CI： 0.75-0.95）. A significant correlation of log transformation of ABRI with an outcome of mortality was present （P 〈 0.0001）.

An adjusted energy-saving quantity calculation method for building energy-efficient retrofit

Aiming at a comprehensive assessment of energy-saving retrofitting effect on existing buildings,a calculation method is developed to adjust energy-saving quantity in standard condition for comparison under the same conditions. A mathematical model,method theory and calculation steps are given. Error analysis results show that this method can be applied accurately to practical engineering projects. In a case study of energy-saving quantity assessment before and after retrofitting on a certain hospital in Shanghai,with energy simulation software TRNSYS,detailed application of this method is introduced and analyzed. The method is applied to the case of energy-saving quantity assessment to a hospital in Shanghai before and after retrofitting with the energy simulation software TRNSYS.

Hydraulic impactor with impact energy and frequency adjusted independently and steplessly

Based on analysis of the present hydraulic impactor, a new hydraulic impactor with pressure feedback control was developed, whose structure and operation principle were introduced. The results show that the pressure of the impact system can be adjusted steplessly to change the impact energy of the impactor steplessly. By adjusting the oil flow of supply pump steplessly, the impact frequency will also be changed steplessly. So the impact energy and frequency of the new impactor can be adjusted independently and steplessly. In order to decrease the energy loss, a new kind of sleeve valve has been designed, which has features of little leakage, little pressure loss and low energy cost. The new type hydraulic impactor can be operated under various conditions with decreased energy consumption and improved operation efficiency.

IN 1997 SOME IMPORT AND EXPORT TARIFF RATES ADJUSTED

The General Customs Administration issued a circular statingthat,based upon a decision of the State Council,in 1997 someimport and export tariff rates would be adjusted.The major con-tents of the circular are the adjustment of the import tariff rates of 4tariff lines of commodities and items under 124 tariff lines;theelimination of the export tariffs for 14 tariff lines of commodities,addition of export tariff rates for 2 kinds of precious metals andimposition of provisional export tariff rates for 4 kinds of corn-

DFIG Voltage Control Based on Dynamically Adjusted Control Gains

The increasing penetration of wind power presents many technical challenges to power system operations. An important challenge is the need of voltage control to maintain the terminal voltage of a wind plant to make it a PV bus like conventional generators with excitation control. In the previous work for controlling wind plant, especially the Doubly Fed Induction Generator (DFIG) system, the proportional-integral (PI) controllers are popularly applied. These approaches usually need to tune the PI controllers to obtain control gains as a tradeoff or compromise among various operating conditions. In this paper, a new voltage control approach based on a different philosophy is presented. In the proposed approach, the PI control gains for the DFIG system are dynamically adjusted based on the dynamic, continuous sensitivity which essentially indicates the dynamic relationship between the change of control gains and the desired output voltage. Hence, this control approach does not require any good estimation of fixed control gains because it has the self-learning mechanism via the dynamic sensitivity. This also gives the plug-and-play feature of DFIG controllers to make it promising in utility practices. Simulation results verify that the proposed approach performs as expected under various operating conditions.

Improvement of the Algorithm for Computing Adjusted Structure Number for Determination of Backlog Maintenance

The pavement strength is very important for the evaluation of backlog maintenance. The current trend in many developing countries used pavement conditions index-PCI in estimating maintenance costs. The PCI can only justify periodic and routine recurrent maintenance. The condition strength is rarely determined in a flexible pavement creating an opportunity for back long maintenance. This paper reports the study conducted to develop and improve the algorithm for estimating the adjusted structure number to estimate the remaining thickness of the flexible pavement. The analysis of eight ways of computing structure numbers from FWD data ware analyzed and found that the improvement of the HDM 3 - 4 models can influence the usefulness of data collected from road asset management in Tanzania. The algorithm for estimating structural numbers from CBR was improved to compute adjusted structural numbers finally used to estimate the remaining life of the flexible pavement. The analysis of the network of about 6900 km including ST and AM was found that 64.72% were very good, 12% were Good, 10% were fair and 7.84% were poor and 5.4% were very poor.

Double Pressure on Power Grids——The demand for electricity is dropping while the electricity price is not adjusted properly

Since October 2008,China's social consumption of electricity had,for the first time,grown negatively compared to the same period of the previous year,and in November the negative growth range further expanded. The major pressure faced by the electricity industry has now turned from the contradiction between coal and electricity to electricity quantity. This is undoubtedly a true and new test to electricity enterprises which get used to high growth but are now suffering great losses. The reform of electricity system has already been in great difficulties and now is getting into a more serious situation. In order to help readers improve their knowledge and understanding of the current tough situation faced by the electricity industry and discuss how to alleviate and get through the difficulty resulted from the economic crisis "encountered once every one hundred years" by joint efforts of all parties concerned,a Seminar on Crisis and Countermeasures for Electricity Industry was held on November 20,2008. Here are some extracts from the speeches of four experts.

Tax Adjusted for Imported Equipment

Ministry of Finance,Central Administration of Customs,and State Administration of Taxation of P.R.of China jointly issued a"Notice on

Tentative tariff rate for partial import and export products adjusted

The tentative tariff rate for partial import and export products was adjusted since November 1^(st) of 2006.Total 58 imported commodities will be imposed lower tentative

Photoluminescence in fluorescent 4H-SiC single crystal adjusted by B,Al,and N ternary dopants

This paper reports the sensitive effect of photoluminescence peak intensity and transmittance affected by B, Al, and N dopants in fluorescent 4H-SiC single crystals. The crystalline type, doping concentration, photoluminescence spectra,and transmission spectra were characterized at room temperature. It is found that the doped 4H-SiC single crystal emits a warm white light covering a wide range from 460 nm to 720 nm, and the transmittance increases from ~10% to ~60%with the fluctuation of B, Al, and N ternary dopants. With a parameter of C_(D-A), defined by B, Al, and N concentration, the photoluminescence and transmittance properties can be adjusted by optimal doping regulation.

New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy:a diagnostic study

This study explored a new model of Prostate Imaging Reporting and Data System(PIRADS)and adjusted prostate-specific antigen density of peripheral zone(aPSADPZ)for predicting the occurrence of prostate cancer(PCa)and clinically significant prostate cancer(csPCa).The demographic and clinical characteristics of 853 patients were recorded.Prostate-specific antigen(PSA),PSA density(PSAD),PSAD of peripheral zone(PSADPZ),aPSADPZ,and peripheral zone volume ratio(PZ-ratio)were calculated and subjected to receiver operating characteristic(ROC)curve analysis.The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve(AUC).The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves.The AUCs of PSA,PSAD,PSADPZ,aPSADPZ,and PZ-ratio were 0.669,0.762,0.659,0.812,and 0.748 for PCa diagnosis,while 0.713,0.788,0.694,0.828,and 0.735 for csPCa diagnosis,respectively.All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa.The new model significantly improved the diagnostic accuracy of PCa(0.945 vs 0.830,P<0.01)and csPCa(0.937 vs 0.845,P<0.01)compared with the base model.In addition,the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold.This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators.Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.

An Adjusted Gray Map Technique for Constructing Large Four-Level Uniform Designs

A uniform experimental design(UED)is an extremely used powerful and efficient methodology for designing experiments with high-dimensional inputs,limited resources and unknown underlying models.A UED enjoys the following two significant advantages:(i)It is a robust design,since it does not require to specify a model before experimenters conduct their experiments;and(ii)it provides uniformly scatter design points in the experimental domain,thus it gives a good representation of this domain with fewer experimental trials(runs).Many real-life experiments involve hundreds or thousands of active factors and thus large UEDs are needed.Constructing large UEDs using the existing techniques is an NP-hard problem,an extremely time-consuming heuristic search process and a satisfactory result is not guaranteed.This paper presents a new effective and easy technique,adjusted Gray map technique(AGMT),for constructing(nearly)UEDs with large numbers of four-level factors and runs by converting designs with s two-level factors and n runs to(nearly)UEDs with 2^(t−1)s four-level factors and 2tn runs for any t≥0 using two simple transformation functions.Theoretical justifications for the uniformity of the resulting four-level designs are given,which provide some necessary and/or sufficient conditions for obtaining(nearly)uniform four-level designs.The results show that the AGMT is much easier and better than the existing widely used techniques and it can be effectively used to simply generate new recommended large(nearly)UEDs with four-level factors.

Robust variance estimation for covariate-adjusted unconditional treatment effect in randomized clinical trials with binary outcomes

To improve the precision of estimation and power of testing hypothesis for an unconditional treatment effect in randomized clinical trials with binary outcomes,researchers and regulatory agencies recommend using g computation as a reliable method of covariate adjustment.How-ever,the practical application of g-computation is hindered by the lack of an explicit robust variance formula that can be used for different unconditional treatment effects of interest.To fill this gap,we provide explicit and robust variance estimators for g-computation estimators and demonstrate through simulations that the variance estimators can be reliably applied in practice.

Calixarenes enabling well-adjusted organic-inorganic interface for inverted organic solar cells with 18.25%efficiency and multifold improved photostability under max power point tracking

Compared with organic solar cells(OSCs) adopting conventional architecture,inverted OSCs have offered generally better stability,where Zn O is the most widely used electron transporting layer(ETL) material.For ZnO-based inverted OSCs,a welltuned interface of organic(active layer)-inorganic(Zn O film) with matched surface energy(γS) is critical for both high performance and high stability.In this work,two typical calixarenes,C4A and Bu C4A,were employed as the tuning agents to adjust this organic-inorganic interface for ZnO-based inverted OSCs.As a result,with PM6:L8-BO as the active layer,significantly promoted power conversion efficiencies(PCEs) from 17.14%(for ZnO) to 18.25%(for ZnO/C4A) and 17.80%(for ZnO/Bu C4A) were achieved.Photodynamic studies indicate that the enhanced performance is due to the faster charge extraction process,the suppressed recombination and more ideal internal electric field in ZnO/calixarene-based devices.In addition,wellmatched interface energy and more ordered molecular aggregation in active layer effectively improved photostability and thermal stability for ZnO/calixarene-based devices.These results indicate that calixarenes could act as effective modifying agents of ZnO to improve inverted OSCs’ performance and stability simultaneously,and likely also stimulate calixarenes’ and other macromolecules’ broader studies in other organic electronic devices.

Accelerating Oxygen Electrocatalysis Kinetics on Metal-Organic Frameworks via Bond Length Optimization

Metal-organic frameworks(MOFs)have been developed as an ideal platform for exploration of the relationship between intrinsic structure and catalytic activity,but the limited catalytic activity and stability has hampered their practical use in water splitting.Herein,we develop a bond length adjustment strategy for optimizing naphthalene-based MOFs that synthesized by acid etching Co-naphthalenedicarboxylic acid-based MOFs(donated as AE-CoNDA)to serve as efficient catalyst for water splitting.AE-CoNDA exhibits a low overpotential of 260 mV to reach 10 mA cm^(−2)and a small Tafel slope of 62 mV dec^(−1)with excellent stability over 100 h.After integrated AE-CoNDA onto BiVO_(4),photocurrent density of 4.3 mA cm^(−2)is achieved at 1.23 V.Experimental investigations demonstrate that the stretched Co-O bond length was found to optimize the orbitals hybridization of Co 3d and O 2p,which accounts for the fast kinetics and high activity.Theoretical calculations reveal that the stretched Co-O bond length strengthens the adsorption of oxygen-contained intermediates at the Co active sites for highly efficient water splitting.

一种基于CatBoost优化的光伏阵列故障诊断模型

大部分光伏电站地处偏僻、地形复杂的区域,受到外界环境的影响,易发生各种故障.而传统的光伏阵列故障诊断方法存在精度不高以及光伏数据利用率低等问题.针对以上问题,本文先是通过引入Levy飞行策略和步长因子动态调整策略改进麻雀搜索算法(Sparrow Search Algorithm,SSA),降低SSA算法陷入局部最优的风险,提升SSA算法的寻优能力.然后采用改进的Levy步长调整麻雀搜索算法(Levy Adjustment Sparrow Search Algorithm,LASSA)对CatBoost模型关键超参数进行寻优,提出了一种基于CatBoost并以LASSA为优化策略的光伏阵列故障诊断模型LASSA-CatBoost,以实现光伏阵列的短路、开路、老化和阴影遮挡故障的精确诊断.实验结果表明,LASSA-CatBoost模型的故障诊断准确率为99.7%,相较于优化前的CatBoost模型,准确率提高了3.6%.与现有的光伏阵列故障诊断模型相比,LASSA-CatBoost模型的准确性和稳定性更高.

Phosphorous Enrichment in Molten Adjusted Converter Slag: Part I Effect of Adjusting Technological Conditions

The effects of adjusting technological conditions on the phosphorous enrichment of adjusted converter slag were investigated. The results showed that the phosphorus could he effectively enriched to 2CaO · SiO2 and 2CaO · SiO2-3CaO· P2O5 solid solution （SS, namely phosphorus-rich phase） to be formed with the decreasing of basicity and cooling rate. Moreover, the morphology of the phosphorus-rich phase changed from granular for the original converter slag with higher basicity to the coexistence of granular shape and rod-like for the adjusted slag with lower basicity. P2 05 content in phosphorus-rich phase exceeded 30° while the hasicity was 1.3 at the cooling rate of 1.0 ℃/min.