Integrated agronomic practice management decreases soil carbon emission and increases environmental ecological benefits of summer maize

Integrated agronomic practice management(IAPM)is an effective strategy for increasing nitrogen(N)use efficiency(NUE)and yield during crop production.Although various studies have evaluated the mechanism of a single agronomic management practice to increase yield and production efficiency and decrease environmental costs,few have investigated the effects of IAPM systems.A field experiment was conducted using four IAPM systems,a local smallholder farmers’practice system(T1),an improved management system(T2),a high-yield production system(T3),and an optimized management system(OMS),to study the annual yield,greenhouse gas(GHG)emissions,carbon(C)footprint(CF),and net environmental ecological benefit(NEEB)of summer maize.The results revealed that OMS was the most advantageous choice of IAPM,which increased yield and NUE and reduced GHG emissions and CF.Under OMS,yield and NUE were 42.6%and 88.1%higher,and N_(2)O,CO_(2),and CH4 emissions were on average 35.4%,5.8%,and 156.5%lower,respectively,than those under T1.Of the four IAPM systems,OMS resulted in the best soil quality,the lowest soil bulk density,the highest soil C/N ratio,and the highest soil total organic C content,which contributed to reduced GHG emissions.Carbon footprint and cost were the lowest under OMS,which decreased fertilizer input and GHG emissions.Optimized management system reduced CF and C cost by 5.9%and 33.9%,respectively,and increased NEEB by 111.4%compared to T1.Although T3 had the highest yield,it also had the highest GHG emissions and CF.In conclusion,OMS delivered a high yield and NUE while mitigating negative environmental impacts and increasing NEEB.Therefore,OMS is a suitable management system to increase the productivity and sustainability of summer maize.

Cassava Groundnut Intercropping: A Sustainable Land Management Practice for Increasing Crop Productivity and Organic Carbon Stock on Smallholder Farms

Cassava-groundnut intercropping is not a common practice among smallholder farmers in Sierra Leone even though both crops are well suited for intercropping. On-farm trials were conducted in three locations (Bai Largor, Bassah, and Njala Kanima) in the Moyamba district during the 2021 cropping season to investigate the efficacy of cassava-groundnut intercropping for increasing crop productivity and soil organic carbon stock on smallholder farms in the Moyamba district, Southern Sierra Leone. The experimental design was a randomized complete block design in three replications with treatments of sole groundnut, sole cassava and cassava-groundnut intercropping. Data on the yield and yield components of cassava and groundnut were analysed using the PROC MIXED procedure of SAS 9.4 and means were compared using the standard error of difference (SED). The above-ground biomass, number of roots per plant, and fresh root yield of cassava were not significantly (p > 0.05) affected by the cassava-based cropping system. Averaged across locations, intercropping cassava with groundnut decreased the above-ground biomass, the number of roots per plant, and fresh root yield of cassava by 17%, 11%, and 17%, respectively. The above-ground biomass, number of pods per plant and fresh pod yield of groundnut were significantly (p 1), the highest net revenue and benefit-cost ratio. The benefit-cost ratio was also favourable for the sole cassava (BCR > 1) but not favourable for the sole groundnut (BCR < 1). Averaged across locations, intercropping cassava with groundnut increased the benefit-cost ratio by 121% and 13% when compared to the sole groundnut and sole cassava. In the event of a 40% yield loss for the cassava and groundnut, the benefit-cost ratio was favourable (1.12) only for the cassava groundnut intercropping system. The net soil organic carbon stock was favourable only for the cassava-groundnut intercrop. Averaged across locations, the net soil organic carbon for the cassava-groundnut intercropping increased by 3.4% when compared to the baseline within one cropping cycle of the cassava (12 months). The results confirm that cassava-groundnut intercropping is a sustainable land management practice that could enhance crop productivity and soil organic carbon stock on smallholder farms.

Management of proximal humerus fractures in adults

The majority of proximal humerus fractures are lowenergy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures.Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each indi-vidual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes.

New Attempt for Building Rural Water Environment Management System Based on the Investigation and Analysis of Water Environment in Xianxia Town, Yudu County

Water environment is a part of ecological environment, and conservation of water environment has always been a focus of public attention in China, but water environment management in the vast countryside has been stuck in bottleneck. Based on the fi eld investigation in Xianxia Town, Yudu County, Ganzhou City, Jiangxi Province, this paper explored the current situation of local water environment and the management diffi culties, then introduced the holistic view to integrate the linkage of government, market and society, proposed the universality of the individual case, and the new attempt centering on urban-rural integrated water environment management system with public participation mechanism, management subjects' benefit balance and coordination system, marketing operation mechanism and economic incentive mechanism as the extension.

The Hum on Reforming China′s Railway Operating Cost Management System

This article introduces the historical evolution and the realities of china′s railway operating cost management system, then analyzes the various problems in it under current management system. And on the basis of the first two parts, the author gives proper design and advice, trying to be helpful to the great reform of the railway operating cost control system.

Cost-Benefit Analysis on Forest Certification for Forest Management and Forestry Industry Development in China

The paper is based on the summarization of forest certification development to analyze and describe how forest certification promotes and pushes the setup of forest resources management model, forest management level and collective forest tenure reform. In terms of breaking green trade barrier, upgrading international competitiveness of forest products, facilitating forestry enterprise growth, etc, it elaborated the role of forest certification in promoting forestry industry development. The authors also made an objective analysis on the costs and risks that China has to bear for conducting forest certification. Based on the comprehensive analysis on benefits and costs, the authors presented the specific recommendations on how China would conduct forest certification.

Cost-Benefit of Interface Management Improvement in Design-Manufacturing Chain

Design-manufacturing chain (D-MC) is the most important link of the supply chain with the greatest possibility in cost reduction. How to strengthen the effective management of interfacial relationship between designer and manufacturer and increase the effcency of interface management concerns the effciency of the whole supply chain. In order to evaluate and improve the impacts of D-MC interfacial relationship, first we should construct the evaluation index system and then we should analyze the total cost and benefit of the interfacial relationship betterment, including the cost of member units in D-MC, the opportunity cost of cooperation partners, and the market returns resulted from the interfacial relationship improvement, which will advance the whole supply chain effciency as well as enhance the management performance of D-MC.

全成本预算绩效管理的改革实践与未来展望

全成本预算绩效管理通过打开成本的“黑箱”,进一步增强了成本与产出之间的实质联系,是避免预算绩效管理流于形式的关键所在。本文针对预算管理实践中存在的成本核定不准确、预算投入不合理等问题,从理论机制和实践应用两个方面入手,深入剖析了全成本预算绩效管理区别于传统预算绩效管理的主要特征与关键优势。面对成本界定、成本分摊与成本效益信息运用中的诸多挑战,本文提出在考虑成本生成主体的基础之上,构建基于不同主体的成本核算机制,统一成本分摊标准,审慎考虑成本效益分析的实施项目与运用程度,实行绩效奖励与收入分成机制。本文希望为进一步深化预算绩效管理改革提供有效抓手。

绿色信贷政策会影响企业产品市场竞争力吗?——一个全面成本管理的视角

通过成本驱动效应,绿色信贷政策不仅会激励企业加强全面成本管理,还会激励企业进行研发创新,从而提升其产品市场竞争力。基于2009—2022年我国A股上市企业的数据,本文运用双重差分模型进行实证检验,结果表明绿色信贷政策的确能够显著提升企业产品市场竞争力。机制检验结果显示,绿色信贷政策通过降低全面成本管理成本和提高全要素生产率,对产品市场竞争力产生显著正面影响。异质性检验结果表明,在两职合一、民营企业和小规模的企业样本中,绿色信贷政策对企业的产品市场竞争力的影响更大。由此可见,绿色信贷政策能够助力企业实现绿色转型,有利于企业实现高质量可持续发展。

DIP支付模式下公立医院运营管理优化路径研究

随着公立医院综合改革进入深水区,粗放的运营管理已不符合高质量发展的需要。文章探讨了DIP支付模式下医院运营管理的现状问题,探索提出了优化路径及落地实践的要点,即以病种组合及分值为基础,实施预算绩效一体化闭环的资源配置策略、提升资源效能的成本管理机制、激发人员自生管理动力的绩效分配制度,并提出了建设管理信息系统的建议,进而为DIP支付模式下公立医院提升运营管理能力提供实践参考。

基于闭环双向对标管理模式的医疗设备临床配置路径优化研究

目的:基于双闭环工作路径构建闭环双向对标管理模式,提高医疗设备临床配置水平。方法:构建招标采购和临床使用的闭环双向对标管理指标体系,采用奇异值分解算法选取标杆,形成双向对标管理模式。选取2018年6月至2022年5月解放军总医院采购的357台医疗设备,包括医用电子仪器、手术室设备、医学检验仪器、生命支持设备、医学影像设备及其他医疗设备,分别采用专家论证管理模式(165台)和闭环双向对标管理模式(192台)进行设备临床配置管理,对比两种配置管理模式的医疗设备临床配置管理效果。结果:采用闭环双向对标管理模式的医用电子仪器、手术室设备、医学检验仪器、生命支持设备、医学影像设备及其他医疗设备的临床配置管理评估值分别为(0.86±0.07)、(0.87±0.05)、(0.88±0.05)、(0.84±0.07)、(0.87±0.04)和(0.85±0.05),均高于专家论证管理模式,其差异有统计学意义(t=2.564、3.228、4.641、2.719、2.774、3.490,P<0.05);医疗设备采购失败率和管理成本增幅分别为(2.78±1.97)%和(0.98±0.70)%,低于专家论证管理模式,其差异有统计学意义(t=3.322、2.538,P<0.05);医疗设备验收通过率和开机运转率分别为(98.10±2.68)%和(91.54±4.76)%,均高于专家论证管理模式,其差异有统计学意义(t=3.470、2.125,P<0.05)。医院设备采购及使用相关工作人员对采用闭环双向对标管理模式的医疗设备配置流程合理性、制度规范性和质量有效性满意度分别为98.75%、93.75%和100%,均高于专家论证管理模式,其差异有统计学意义(x^(2)=5.769、4.006、6.234,P<0.05)。结论:闭环双向对标管理模式能够使配置的医疗设备更好地满足临床科室需求,最大化地应用于疾病诊疗和科研教学,提高招标采购和运行管理的规范性。

基于关联性风险分析的过程管理策略对医疗设备运行效益的影响研究

目的:基于医疗设备关联性风险分析,制定过程性管理策略,提高医疗设备临床运行效益。方法:制定医疗设备管理对策,从主体、质量、环境、制度和诊疗角度进行风险矩阵评估,建立关联性风险综合评估模型。选取2021年4月至2022年3月上海市第八人民医院临床在用的400台医疗设备,采用数表法将其分为对照组和观察组,每组200台,对照组采用个体化风险分析法进行过程性管理,观察组采用关联性风险分析法进行过程性管理。对比分析两组医疗设备的风险等级和运行效益。结果:观察组医学影像诊断及辅助设备、手术治疗设备、生命支持与急救设备、体外循环及血液处理设备和健康监测及康复设备的高危险占比分别为17.39%(4/23)、14.58%(7/48)、12.24%(6/49)、5.55%(1/18)和5.06%(5/62),均低于对照组,其差异有统计学意义(x^(2)=4.132、4.009、6.275、4.833、4.859,P<0.05);观察组医疗设备的成本效益、社会效益、诊疗效益和发展效益评分分别为(91.37±6.15)分、(92.78±3.80)分、(95.25±2.09)分和(90.51±3.82)分,均高于对照组,其差异有统计学意义(t=2.392、3.877、4.841、2.504,P<0.05)。结论:关联性风险分析方法可降低医疗设备安全风险发生概率和危害程度,提高医疗设备临床运行效益,过程管理策略符合医疗设备全生命周期管理的实际需要。

考虑环境成本综合效益的泾河流域最佳管理措施评价与筛选

基于土壤和水评估工具(SWAT)评估9种单一最佳管理措施(BMPs)及其不同组合共计103种BMPs情景布设对非点源污染的消减效率,并基于信息熵的多属性决策方法评估泾河流域BMPs实施成本和非点源控制有效性之间的权衡.研究发现,SWAT模型在泾河流域非点源污染模拟中适用性较好,不同的BMPs对非点源污染负荷削减量存在较大差异,组合BMPs比单一BMPs在降低非点源污染负荷方面表现更好.在农业耕作过程中减少化肥50%的施用量、将坡度大于25°的农田退耕还草以及在河道进行植草水道措施建设是泾河流域具有最大环境成本综合效益值的优选组合BMPs.

实施DRG收付费对房颤射频消融术费用影响的研究

目的探讨疾病诊断相关分组(diagnosis related group,DRG)收付费实施对房颤射频消融术费用的影响。方法采用回顾性分析与描述性分析相结合的方法,导出福建省立医院2021年1—6月(实施前)326例,2022年1—6月(实施后)363例进行分析对比。分析DRG实施前后房颤射频消融术各种费用指标(住院天数、药品费、手术费、医务性收入、耗材费、麻醉费、检查化验费)的变化情况。采用多元线性回归分析住院总费用的影响因素,采用方差分析并发症对患者住院总费用的影响。结果DRG收付费实施后住院天数短于实施前,药品费、耗材费、手术费均低于实施前,医务性收入高于实施前,差异有统计学意义(P<0.05);DRG收付费实施前后检查化验费、麻醉费比较,差异无统计学意义(P>0.05)。耗材费、药品费是影响医保支付金额的主要因素(P<0.05);无并发症组的住院总费用为(78290.320±5020.166)元,1个并发症组的住院总费用为(84669.870±20566.278)元,2个并发症组的住院总费用为(84881.250±20369.003)元,3个并发症组的住院总费用为(93440.170±28814.175)元,患者住院总费用比较,差异有统计学意义(P<0.05),并发症越多,患者住院总费用越高。结论DRG收付费制度对优化医疗费用结构有一定作用,实施DRG能有效降低医疗费用,减少居民医疗服务支出,提高医疗服务质量,对推进我国DRG收付费的实施具有重大意义,为进一步推动完善DRG收付费改革提供理论依据,对于遏制医疗费用不合理增长、推动公立医院加强自身运营能力建设具有重要的理论与现实意义,但仍存在一些问题需要完善。

电池热管理对城市客车能耗的影响

先介绍了电池热管理技术(即电池冷却系统)的重要性,并以电池液冷系统作为研究对象,以国内某地区在营运的城市客车的数据为例,结合电池液冷系统的零部件结构和工作原理,分析了电池液冷系统对纯电动客车能耗的影响,以及由于能耗的增加对单车运营成本的影响。

降低社会物流成本研究

物流是实体经济的“筋络”,连接生产与消费、内贸与外贸。有效降低社会物流成本是增强产业核心竞争力、提升经济运行效率的重要举措。当前我国社会物流成本较高,这是我国经济结构、物流业水平、供应链水平、市场效率等因素综合作用的结果:一方面,我国服务业占比低,工业占比高,且多数产品附加值较低,不利于物流费用的降低和产品所对应GDP的增加,影响社会物流总费用与GDP比率的降低;另一方面,我国综合运输体系尚未完全建立,社会库存量大周转慢,物流基础设施不完善且投入不足,物流服务运作主体仍有缺陷,税费高且不统一,产学研一体化体系尚未形成,行业协会合作欠缺,不利于科技赋能和物流业水平、供应链水平、市场效率提升,导致保管和管理费用居高不下,影响社会物流总费用与GDP比率的降低。社会物流成本是国家经济社会发展成本重要的组成部分,通常包括运输成本、保管成本、管理成本三个部分。降低社会物流成本是一项系统工程,切忌单纯从物流看物流,要着眼国民经济全局,通过发展新质生产力、改造物流供应链、推动物流业数智化转型、提升产业链供应链现代化水平、深化市场化改革,着力降低经济结构性物流成本、组织模式性物流成本、运行性物流成本、管理制度性物流成本,四者缺一不可。其中,发展新质生产力、推动物流业进行供应链改造和数智化升级,是降低社会物流成本的必由之路;打造创新力更强、附加值更高、更安全可靠的产业链供应链,是降低物流成本的根本之策;促进物流与供应链制度型开放、深化供给侧结构性改革、构建物流统一大市场,是降低物流成本的制度性保障。此外,还要加强物流与供应链绩效考核,增强物流成本核算意识。

价值链视角下公立医院手术室成本管理难点及策略研究

在公立医院高质量发展和DRG/DIP支付方式改革的双轮驱动下,公立医院运营模式急需转向“降本增效”的集约模式。手术室作为医院业务运转的枢纽和资源融合的重要中心,其精益化管理影响着公立医院实现“三转变、三提高”高质量发展目标。基于价值链视角,从作业成本动因、执行性成本动因和结构性成本动因3个方面探讨公立医院手术室成本管理的难点,并提出管理策略,以促进手术室精益化管理,助力公立医院加强成本管控和提高运营效率。

网格化管理在医疗监护设备质量控制管理中的应用价值分析

目的 研究网格化管理在医疗设备质量控制管理中的应用价值,为提高医疗设备管理质量提供参考。方法 广西中医药大学第一附属医院于2023年1月起对院内所有监护设备实施网格化质控管理,2022年9—12月对539台监护设备进行常规质控管理,设置为对照组,2023年1—3月对539台监护设备在常规质量控制管理基础上采取网格化管理,设置为研究组,比较两组在管理质量、运行质量、成本效益等方面的差异性。结果 研究组监护设备日常维护管理数据中临床操作、信息数据、质量控制检测、维护维修、报废处理维度管理质量评分均显著高于对照组(P<0.05)。研究组监护设备使用年限指数、运行利润均显著高于对照组,工程师维护费用支出显著低于对照组(P<0.05)。研究组监护设备开机率、设备功能完好率、设备运转率均显著高于对照组(P<0.05)。结论 网格化管理在医疗监护设备质量控制管理中的运用,有效提高了医疗设备的临床服务收益,且在提升监护设备运行质量及管理水平方面发挥了重要作用,值得推广。