基于SHA 2011的天津基层医疗卫生机构基本公共卫生服务开展情况分析

[目的]强化经常性卫生费用核算数据政策分析,为基本公共卫生服务项目后续开展提供依据。[方法]以天津市2016-2019年基层医疗卫生机构预防服务费用核算结果为基础,分析基层医疗卫生机构基本公共卫生服务项目开展情况和存在问题。[结果]2016-2019年,天津市基层医疗卫生机构预防服务费用呈逐年增长趋势,由2016年的14.25亿元增加至2019年的18.04亿元。预防服务费用主要流向预防接种项目、慢性病管理和老年人健康管理项目;预防服务费用筹资来源仍以政府筹资方案为主,但家庭卫生支出占比呈快速增长趋势,主要是由于二类疫苗接种费用的快速增长所致。[结论]天津市基层医疗卫生机构预防服务费用流向与其基本公共卫生工作重点一致,但基层医疗卫生机构传染病防控投入程度与其职能不匹配。基层医疗卫生机构二类疫苗接种服务家庭卫生支出负担过重。

2011年全球发现的新矿物种

在系统梳理2011年度全球发现并经国际矿物学协会(IMA)新矿物与矿物分类命名专业委员会(CNMNC)批准的122个新矿物种资料的基础上,从矿物名称、晶体化学式、晶系和空间群、晶胞参数、主要粉晶数据、物理性质、光学性质、产地与产状、与其他矿物种的关系、矿物名称来源、化学反应和光谱学特征等方面归纳总结了这些新矿物的重要矿物学特征。并按照中国新矿物及矿物命名专业委员会颁布的《矿物种汉名审订条例》,对122个新矿物种的中文名称进行了审订。通过适时公布国际新矿物工作的新进展和新成果,并逐步完善和规范矿物种中文译名体系,为我国新矿物的发现和研究提供有科学价值的参考和借鉴,不断推动矿物种中文译名规范化与标准化的进程。

优化职业教育类型定位,走好通往专业高职之路——基于ISCED2011及《前往专业行当的通道》评核报告的新视角

国际教育标准化分组2011通过职业专业与普通学术两种取向的划分,为国际层面更好地收集、比较和分析各国教育系统数据打开了一扇方便之门,很大程度上弥补了该分组1997版本在概念准确性和实践适切性方面的缺失。但囿于其对专业取向具体定义的悬而未决,仍让国际间数据收集、比较和分析工作无所适从,留下了进一步研究解读和实践探索的空间。OECD最新发布的职业教育与培训评核报告《前往专业行当的通道:理解高等职业与专业第三级教育系统》较好地回应了这一问题,找到了务实可行的进一步定义方案,是ISCED2011修订版发布以来的一项重大进展。该报告以相关国家系统数据及调查数据为基础,分析了专业教育计划的实际现状,阐释了技术变革时代经济社会对理想技能的新要求,在继承和发展ISCED2011的专业取向构念基础上,提出了专业第三级教育计划分组的架构与思考。该报告提出的关于聚焦专业取向教育计划的政策辩论意见、“三向度”高教分组中的“二向度”专业教育计划分组方案以及专业取向教育的独特性、增值性和高等性等理念,对于我国把握终生学习背景下的职教类型定位、专业第三级教育计划分组下的贯通衔接以及技能型社会的技能需求和专业技能系统的治理等有诸多新的启示。正确理解和积极吸收相关有益经验,有利于我们优化职业教育类型定位,走好通往中国式现代化的专业高职之路。

基于“SHA2011”的某省综合医院治疗费用分布维度分析

[目的]分析某省综合医院治疗费用分布维度,为相关政策的完善调整提供参考。[方法]以某省2018年综合医院数据为基础,应用卫生费用核算体系2011核算方法,对该省综合医院治疗费用在不同维度的分布以及分布维度、筹资方案的矩阵分析结果进行描述性分析。[结果]该省综合医院治疗费用依次来源于社会医疗保险、家庭个人卫生支出、自愿筹资。从疾病流向看,33.5%流向循环系统疾病和消化系统疾病;从年龄流向看,45.43%流向60岁及以上人群;从性别流向看,53%流向男性群体;从医疗机构级别流向看,73.8%流向省市级医疗机构。[结论]居民疾病经济负担较重,重点疾病、重点人群、高级别医院占用的治疗费用较高。

Evolutionary Decision-Making and Planning for Autonomous Driving Based on Safe and Rational Exploration and Exploitation

Decision-making and motion planning are extremely important in autonomous driving to ensure safe driving in a real-world environment.This study proposes an online evolutionary decision-making and motion planning framework for autonomous driving based on a hybrid data-and model-driven method.First,a data-driven decision-making module based on deep reinforcement learning(DRL)is developed to pursue a rational driving performance as much as possible.Then,model predictive control(MPC)is employed to execute both longitudinal and lateral motion planning tasks.Multiple constraints are defined according to the vehicle’s physical limit to meet the driving task requirements.Finally,two principles of safety and rationality for the self-evolution of autonomous driving are proposed.A motion envelope is established and embedded into a rational exploration and exploitation scheme,which filters out unreasonable experiences by masking unsafe actions so as to collect high-quality training data for the DRL agent.Experiments with a high-fidelity vehicle model and MATLAB/Simulink co-simulation environment are conducted,and the results show that the proposed online-evolution framework is able to generate safer,more rational,and more efficient driving action in a real-world environment.

Motion Planning for Autonomous Driving with Real Traffic Data Validation

Accurate trajectory prediction of surrounding road users is the fundamental input for motion planning,which enables safe autonomous driving on public roads.In this paper,a safe motion planning approach is proposed based on the deep learning-based trajectory prediction method.To begin with,a trajectory prediction model is established based on the graph neural network(GNN)that is trained utilizing the INTERACTION dataset.Then,the validated trajectory prediction model is used to predict the future trajectories of surrounding road users,including pedestrians and vehicles.In addition,a GNN prediction model-enabled motion planner is developed based on the model predictive control technique.Furthermore,two driving scenarios are extracted from the INTERACTION dataset to validate and evaluate the effectiveness of the proposed motion planning approach,i.e.,merging and roundabout scenarios.The results demonstrate that the proposed method can lower the risk and improve driving safety compared with the baseline method.

日本“3·11”震灾后文学中的“反核”书写——以《神明2011》《晚年样式集》为例

东日本大地震和由其引发的福岛核泄漏事故催生了以“3·11”大地震、核泄漏危机为主题的震灾后文学。本文基于川上弘美《神明2011》、大江健三郎《晚年样式集》这两部作品的分析,指出这两部作品在主题阐发上,分别通过新旧“神明观”的转变、过去侵入现在的历史书写,表达共同的反核主题,揭示了核危机下现代人共同的悲剧命运。

Selection of media tools for community planning:A study from the perspective of communicative planning

In community planning,due to the lack of evidence regarding the selection of media tools,this study examines how a common but differentiated ideal speech situation can be created as well as how more appropriate media tools can be defined and selected in the community planning process.First,this study describes the concept and theoretical basis of media used in community planning from the perspectives of the multiple effects of media evolution on communicative planning.Second,the classification criteria and typical characteristics of media tools used to support community planning are clarified from three dimensions:acceptability,cost effectiveness,and applicability.Third,strategies for applying media tools in the four phases of communicative planning-namely,state analysis,problem identification,contradictory solution and optimization-are described.Finally,trends in the development of media tools for community planning are explored in terms of multistakeholder engagement,supporting scientific decision-making and multiple-type media integration.The results provide a reference for developing more inclusive,effective,and appropriate media tools for enhancing decision-making capacity and modernizing governance in community planning and policy-making processes.

Influence of a diet meal plan on pepsinogen I and II,gastrin-17,and nutritional status in gastric ulcer patients

BACKGROUND Gastric ulcers(GUs)have a high risk of clinical morbidity and recurrence,and further exploration is needed for the prevention,diagnosis,and treatment of the disease.AIM To investigated the effects of a diet plan on pepsinogen(PG)I,PG II,gastrin-17(G-17)levels and nutritional status in patients with GUs.METHODS A total of 100 patients with GUs treated between May 2022 and May 2023 were enrolled,with 47 patients in the control group receiving routine nursing and 53 patients in the experimental group receiving dietary nursing intervention based on a diet plan.The study compared the two groups in terms of nursing efficacy,adverse events(vomiting,acid reflux,and celialgia),time to symptom improvement(burning sensation,acid reflux,and celialgia),gastric function(PG I,PG II,and G-17 levels),and nutritional status[prealbumin(PA)and albumin(ALB)levels].RESULTS The experimental group showed a markedly higher total effective rate of nursing,a significantly lower incidence of adverse events,and a shorter time to symptom improvement than the control group.Additionally,the experimental group’s post-intervention PG I,PG II,and G-17 levels were significantly lower than preintervention or control group levels,whereas PA and ALB levels were significantly higher.CONCLUSION The diet plan significantly reduced PG I,PG II,and G-17 levels in patients with GUs and significantly improved their nutritional status.

Optimal search path planning of UUV in battlefeld ambush scene

Aiming at the practical application of Unmanned Underwater Vehicle(UUV)in underwater combat,this paper proposes a battlefield ambush scene with UUV considering ocean current.Firstly,by establishing these mathematical models of ocean current environment,target movement,and sonar detection,the probability calculation methods of single UUV searching target and multiple UUV cooperatively searching target are given respectively.Then,based on the Hybrid Quantum-behaved Particle Swarm Optimization(HQPSO)algorithm,the path with the highest target search probability is found.Finally,through simulation calculations,the influence of different UUV parameters and target parameters on the target search probability is analyzed,and the minimum number of UUVs that need to be deployed to complete the ambush task is demonstrated,and the optimal search path scheme is obtained.The method proposed in this paper provides a theoretical basis for the practical application of UUV in the future combat.

Efficient Route Planning for Real-Time Demand-Responsive Transit

Demand Responsive Transit (DRT) responds to the dynamic users’ requests without any fixed routes and timetablesand determines the stop and the start according to the demands. This study explores the optimization of dynamicvehicle scheduling and real-time route planning in urban public transportation systems, with a focus on busservices. It addresses the limitations of current shared mobility routing algorithms, which are primarily designedfor simpler, single origin/destination scenarios, and do not meet the complex demands of bus transit systems. Theresearch introduces an route planning algorithm designed to dynamically accommodate passenger travel needsand enable real-time route modifications. Unlike traditional methods, this algorithm leverages a queue-based,multi-objective heuristic A∗ approach, offering a solution to the inflexibility and limited coverage of suburbanbus routes. Also, this study conducts a comparative analysis of the proposed algorithm with solutions based onGenetic Algorithm (GA) and Ant Colony Optimization Algorithm (ACO), focusing on calculation time, routelength, passenger waiting time, boarding time, and detour rate. The findings demonstrate that the proposedalgorithmsignificantly enhances route planning speed, achieving an 80–100-fold increase in efficiency over existingmodels, thereby supporting the real-time demands of Demand-Responsive Transportation (DRT) systems. Thestudy concludes that this algorithm not only optimizes route planning in bus transit but also presents a scalablesolution for improving urban mobility.

Exploration of Detailed Planning Practice of Chemical Industrial Parks under the Background of Territorial Space Planning

With the gradual completion of the overall planning of city and county land space,the detailed planning will be prepared according to the requirements of transmitting and refining the upper planning.Industrial parks are one of the“main forces”of local economic development,and the preparation of their detailed planning will escort their development.The key points of theControlIndicatorsofConstruction LandinIndustrialProjectsissued in 2008 and 2023 were compared,and the new requirements for detailed planning under the background of territorial space and the contradictions between the detailed planning of industrial parks and the overall planning of the upper territorial space were sorted out based on the summary of the existing problems in the development of chemical parks.It provides some ideas for the practice of detailed planning of chemical industrial parks under the background of territorial space.

Postpartum Family Planning at the Timbuktu Hospital in Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

Stochastic programming based coordinated expansion planning of generation,transmission,demand side resources,and energy storage considering the DC transmission system

With the increasing penetration of wind and solar energies,the accompanying uncertainty that propagates in the system places higher requirements on the expansion planning of power systems.A source-grid-load-storage coordinated expansion planning model based on stochastic programming was proposed to suppress the impact of wind and solar energy fluctuations.Multiple types of system components,including demand response service entities,converter stations,DC transmission systems,cascade hydropower stations,and other traditional components,have been extensively modeled.Moreover,energy storage systems are considered to improve the accommodation level of renewable energy and alleviate the influence of intermittence.Demand-response service entities from the load side are used to reduce and move the demand during peak load periods.The uncertainties in wind,solar energy,and loads were simulated using stochastic programming.Finally,the effectiveness of the proposed model is verified through numerical simulations.

Correlates of Mistimed Pregnancy and Unmet Need for Family Planning among Women of Reproductive Age in Sandema, Ghana

Background: Globally, an estimated 80 million unintended pregnancies comprising both mistimed and unwanted pregnancies are recorded yearly. Yet only half of the women at risk of mistimed pregnancy use contraceptives. In developing countries, over 100 million females have unmet need, and national surveys in Ghana indicate 23% unmet need rate. Methods: Using a cross-sectional community-based approach, a sample size of 300 women of reproductive age were selected using multi-step cluster sampling techniques. The study was quantitative, using structured interviewer-administered questionnaires. Results: Two-third (66%) of the women in reproductive age still had unmet need, 71% were currently pregnant, and more than a third (36%) confirmed ever having a mistimed pregnancy. Fifty-three percent (53%) of the women confirmed never communicating with their partners on family planning issues, a little below half (45%) took their own health care decisions. Seventy nine percent (79%) ever received family planning services from a health professional. Factors related to unmet needs included mistimed pregnancy, level of education, preferred birth/pregnancy interval, communication between partners and the autonomy to spend self-earnings. Conclusion: Considering that high rates of unmet need results in mistimed pregnancy, improved policies around the influence of unmet need on mistimed pregnancies are needed.

A Reverse Path Planning Approach for Enhanced Performance of Multi-Degree-of-Freedom Industrial Manipulators

In the domain of autonomous industrial manipulators,precise positioning and appropriate posture selection in path planning are pivotal for tasks involving obstacle avoidance,such as handling,heat sealing,and stacking.While Multi-Degree-of-Freedom(MDOF)manipulators offer kinematic redundancy,aiding in the derivation of optimal inverse kinematic solutions to meet position and posture requisites,their path planning entails intricate multiobjective optimization,encompassing path,posture,and joint motion optimization.Achieving satisfactory results in practical scenarios remains challenging.In response,this study introduces a novel Reverse Path Planning(RPP)methodology tailored for industrial manipulators.The approach commences by conceptualizing the manipulator’s end-effector as an agent within a reinforcement learning(RL)framework,wherein the state space,action set,and reward function are precisely defined to expedite the search for an initial collision-free path.To enhance convergence speed,the Q-learning algorithm in RL is augmented with Dyna-Q.Additionally,we formulate the cylindrical bounding box of the manipulator based on its Denavit-Hartenberg(DH)parameters and propose a swift collision detection technique.Furthermore,the motion performance of the end-effector is refined through a bidirectional search,and joint weighting coefficients are introduced to mitigate motion in high-power joints.The efficacy of the proposed RPP methodology is rigorously examined through extensive simulations conducted on a six-degree-of-freedom(6-DOF)manipulator encountering two distinct obstacle configurations and target positions.Experimental results substantiate that the RPP method adeptly orchestrates the computation of the shortest collision-free path while adhering to specific posture constraints at the target point.Moreover,itminimizes both posture angle deviations and joint motion,showcasing its prowess in enhancing the operational performance of MDOF industrial manipulators.

A Planning Method for Operational Test of UAV Swarm Based on Mission Reliability

The unmanned aerial vehicle(UAV)swarm plays an increasingly important role in the modern battlefield,and the UAV swarm operational test is a vital means to validate the combat effectiveness of the UAV swarm.Due to the high cost and long duration of operational tests,it is essential to plan the test in advance.To solve the problem of planning UAV swarm operational test,this study considers the multi-stage feature of a UAV swarm mission,composed of launch,flight and combat stages,and proposes a method to find test plans that can maximize mission reliability.Therefore,a multi-stage mission reliability model for a UAV swarm is proposed to ensure successful implementation of the mission.A multi-objective integer optimization method that considers both mission reliability and cost is then formulated to obtain the optimal test plans.This study first constructs a mission reliability model for the UAV swarm in the combat stage.Then,the launch stage and flight stage are integrated to develop a complete PMS(Phased Mission Systems)reliability model.Finally,the Binary Decision Diagrams(BDD)and Multi Objective Quantum Particle Swarm Optimization(MOQPSO)methods are proposed to solve the model.The optimal plans considering both reliability and cost are obtained.The proposed model supports the planning of UAV swarm operational tests and represents a meaningful exploration of UAV swarm test planning.

Heuristic Expanding Disconnected Graph:A Rapid Path Planning Method for Mobile Robots

Existing mobile robots mostly use graph search algorithms for path planning,which suffer from relatively low planning efficiency owing to high redundancy and large computational complexity.Due to the limitations of the neighborhood search strategy,the robots could hardly obtain the most optimal global path.A global path planning algorithm,denoted as EDG*,is proposed by expanding nodes using a well-designed expanding disconnected graph operator(EDG)in this paper.Firstly,all obstacles are marked and their corners are located through the map pre-processing.Then,the EDG operator is designed to find points in non-obstruction areas to complete the rapid expansion of disconnected nodes.Finally,the EDG*heuristic iterative algorithm is proposed.It selects the candidate node through a specific valuation function and realizes the node expansion while avoiding collision with a minimum offset.Path planning experiments were conducted in a typical indoor environment and on the public dataset CSM.The result shows that the proposed EDG*reduced the planning time by more than 90%and total length of paths reduced by more than 4.6%.Compared to A*,Dijkstra and JPS,EDG*does not show an exponential explosion effect in map size.The EDG*showed better performance in terms of path smoothness,and collision avoidance.This shows that the EDG*algorithm proposed in this paper can improve the efficiency of path planning and enhance path quality.

Ground threat prediction-based path planning of unmanned autonomous helicopter using hybrid enhanced artificial bee colony algorithm

Unmanned autonomous helicopter(UAH)path planning problem is an important component of the UAH mission planning system.Aiming to reduce the influence of non-complete ground threat information on UAH path planning,a ground threat prediction-based path planning method is proposed based on artificial bee colony(ABC)algorithm by collaborative thinking strategy.Firstly,a dynamic threat distribution probability model is developed based on the characteristics of typical ground threats.The dynamic no-fly zone of the UAH is simulated and established by calculating the distribution probability of ground threats in real time.Then,a dynamic path planning method for UAH is designed in complex environment based on the real-time prediction of ground threats.By adding the collision warning mechanism to the path planning model,the flight path could be dynamically adjusted according to changing no-fly zones.Furthermore,a hybrid enhanced ABC algorithm is proposed based on collaborative thinking strategy.The proposed algorithm applies the leader-member thinking mechanism to guide the direction of population evolution,and reduces the negative impact of local optimal solutions caused by collaborative learning update strategy,which makes the optimization performance of ABC algorithm more controllable and efficient.Finally,simulation results verify the feasibility and effectiveness of the proposed ground threat prediction path planning method.

Trajectory planning for multi-robot coordinated towing system based on stability

Given the unconstrained characteristics of the multi-robot coordinated towing system,the rope can only provide a unidirectional constraint force to the suspended object,which leads to the weak ability of the system to resist external disturbances and makes it difficult to control the trajectory of the suspended object.Based on the kinematics and statics of the multi-robot coordinated towing system with fixed base,the dynamic model of the system is established by using the Newton-Euler equations and the Udwadia-Kalaba equations.To plan the trajectories with high stability and strong control,trajectory planning is performed by combining the dynamics and stability of the towing system.Based on the dynamic stability of the motion trajectory of the suspended object,the stability of the suspended object is effectively improved through online real-time planning and offline manual adjustment.The effectiveness of the proposed method is verified by comparing the motion stability of the suspended object before and after planning.The results provide a foundation for the motion planning and coordinated control of the towing system.