Comparison of the Length of Stay and Medical Expenditures among Japanese Hospitals for Type 2 Diabetes Treatments: The Box-Cox Transformation Model under Heteroscedasticity

In this paper, we analyzed length of stay (LOS) in hospitals and medical expenditures for type 2 diabetes patients. LOS was analyzed by the power Box-Cox transformation model when variances differed among hospitals. We proposed a new test and consistent estimator. We rejected the ho-moscedasticity of variances among hospitals, and then analyzed the LOS of 12,666 type 2 diabetes patients hospitalized for regular medical treatments collected from 60 general hospitals in Japan. The variables found to affect LOS were age, number of comorbidities and complications, introduced by another hospital, one-week hospitalization, 2010 revision, specific-hospitalization-period (SHP), and principal diseases E11.5, E11.6 and E11.7. There were surprisingly large differences in ALOS among hospitals even after eliminating the influence of characteristics and conditions of patients. We then analyzed daily medical expenditure (DME) by the ordinary least squares methods. The variables that affected DME were LOS, number of comorbidities and complications, acute hospitalization, hospital’s own outpatient, season, introduced by another hospital, one-week hospitalization, 2010 revision, SHP, time trend, and principal diseases E11.2, E11.4 and E117. The DME did not decrease after the SHP. After eliminating the influences of characteristics and conditions of patients, the differences among hospitals were relatively small, 12% of the overall average. LOS is the main determinant of medical expenditures, and new incentives to reduce LOS are needed to control Japanese medical expenditures. Since at least 99% of patients require medical care after leaving the hospital, systems that take proper care of patients for long periods of time after hospitalization are absolutely necessary for efficient treatment of diabetes.

10kV箱变改造为发电机转子护环感应加热电源的研究与应用

在某核电站汽轮发电机转子首次检修和绕组发生绝缘缺陷时,需要采用感应加热法拆除转子护环进行检查与处理。本文结合电站实际情况及护环拆装需求,经过分析与计算,按照最优的单绕组供电方案将工程建设期退役的10kV箱式变电站改造成拆装发电机转子护环所需的感应加热电源,并在两台百万千瓦级汽轮发电机的首次大修和转子绝缘缺陷处理中实现成功应用,有效保障了核电站发电机大修工期,节约了大修成本。

基于物联网的箱式变电站远程监控系统的设计

箱式变电站是电力系统中的关键环节,承担着用户侧降压和电力分配工作。为保证变电站可靠稳定运行的同时降低人工运营成本,以STM32单片机为核心控制单元,结合温湿度传感器、烟雾浓度传感器、人体红外感应传感器和电压电流功率计传感器等设计了一套远程监控系统。采集影响箱式变电站安全运行的环境信息数据如温度、湿度、输出电压电流值和烟雾浓度等,并通过WiFi模块将采集的数据实时与手机APP进行通信。同时在手机端可以设置可预知的危险阈值范围来判断预警信息,并且可以通过ESP32CAM摄像头模块视频监控变电站现场,方便后台运维人员进行安全管控。通过模拟实物的制作并进行测试,运行结果表明,该系统能够实时监测箱式变电站运行环境信息,拥有简单易操作、稳定可靠、成本低等优点,具有一定的实用性。

箱式变电站外围恒温网络入侵的动态检测研究

变电站外围恒温网络节点关联较弱,易受外界入侵。为此,提出基于深度信念网络(DBN)的箱式变电站外围恒温网络入侵动态检测方法。首先,对恒温网络数据实施类型转换和归一化处理,将Nominal类型转换为Numeric类型,以避免转换数据维度变高。然后,利用非线性迭代偏最小二乘法对恒温网络数据实施特征提取和分类处理,以增强入侵信号的聚类。最后,结合DBN模型并利用核极限学习机(KELM)分类算法,对恒温网络的入侵数据实施检测。试验结果表明,该方法的模型训练准确率最高为90%;当迭代次数达到200次时,训练时间为10.35 s;网络入侵检测效率高且检测结果误差分数小,平均误差分数为1%。该方法对各样本的网络入侵检测率稳定,有利于网络入侵检测的实际应用。

湖区平原风电场风电机组平面布置探究

湖区平原风电场受土地利用性质的影响,风机的布置空间受到限制,水渠及水塘成为湖区风电场建设最大的潜在可利用场地。因此,水渠及水塘内风电机组布置的研究探讨,对湖区平原风电场的发展具有重要意义。结合风电场项目建设实例,对水渠内风机基础及箱变的平面布置进行探讨,通过已投运项目的验证,风机基础及箱变平面布置方案合理。

基于地埋液压的可夜视升降安全围栏杆的研究

针对变电站大型检修时,运行人员在布置安全措施过程中,面临耗时长、遮拦安装及拆卸耗费人力的现实问题,提出了一种户外地埋液压可夜视升降安全围栏,采用预埋筒将可伸缩液压栏杆预制在变电站内,当需要布置安全措施时只需要按动按钮,伸缩套杆将会从预埋筒中伸出,通过液压弹簧作用固定至要求高度,并用夜间发光材质对栏杆表面进行涂刷,起到对现场工作人员的警示作用。从根本上解决了运维人员搬运金属支撑杆这一繁琐步骤,有效提高了变电站人员布置安全措施的效率,缩短检修停电时间,保障电力的可靠供应。

城市道路电力箱体“三化”要求背景下箱式变电站的研制与应用

针对北京市现有电力箱体尺寸过大、数量过多、位置不合适等问题,研制多种满足“隐形化、小型化、景观化”要求的箱式变电站(简称“箱变”)。通过实地调研,提出了多种具体的满足“三化”要求的解决方案。通过研制多款标准型、沉箱型和半地埋型等3种类型的箱变,满足了胡同、公园、临街店铺、行道树间和隔离带等多种场景下“三化”的需求。文章给出了箱变结构设计的具体方案,并展示了这些新型箱变在实际场景中的应用效果。

基于红外图像处理的箱式变压器组件检测研究

为解决高原风电箱变巡视问题,减少巡视工作量,提高设备运行稳定性,针对基于红外图像处理的箱式变压器组件检测技术展开研究。构建YOLOv8模型作为本文实验的主要算法,在红外图像基础上,通过特征提取、目标检测头部网络、位置预测等步骤,设计检测算法,配置实验参数,训练模型。最后的实验结果表明,YOLOv8n模型mAP达到95.1%,在实验设备上识别速度达到0.35 s,与YOLOv3识别速度相比提升了74%,证明了YOLOv8算法在实际运用中可行性和有效性。

箱式变电站及组合式变压器温升试验系统设计应用

随着我国电力行业的快速发展,箱式变电站及组合式变压器因其紧凑性、高效性和可靠性的特点而在我国电力系统中得到了广泛的应用。然而,它们的温升问题一直是影响其性能和寿命的关键因素。该文主要研究了箱式变电站及组合式变压器的温升试验系统,并通过实际应用验证了该系统满足试验要求,具备有效性和可行性,所研究内容可为优化设计提供理论支撑。

箱式变电站的影响温升试验判定因素探究

箱变的温升试验是检测箱变的运行过程中组成箱变的各个电力设备可靠性的一项重要的测试试验,温升试验判定的有效性显得尤为重要。温升试验是否合格分为温升试验过程和温升结果数据两个阶段的判定,以常见欧式箱变内用油浸式变压器为例,用2个独立电源分别在高压侧和低压侧进行连续通电,采用短路法达到热平衡。本文针对这两个阶段影响判定结果的因素进行分析。

箱式变电站运行维护中常见隐患及应对措施

作为配电网中的重要组成部分,箱式变电站的稳定运行对减少用户停电、提高供电可靠性具有重要作用。重点阐述了在日常运行维护中,箱式变电站常见的隐患及隐患产生的原因,并针对出现的隐患提出了相应的应对措施。

S11-5000/35型箱变相间短路事故分析

以某风电场S11-5000/35型箱变发生的相间短路故障为例,对事故原因进行分析与排查,最终确定为相间短路放电,进而提出相应的处理方案和防范措施。

海上风场风电机组箱式变压器控制柜散热优化设计

海上环境复杂,风电机组箱式变压器控制柜散热难度大。为此,文章对海上风场风电机组箱式变压器控制柜进行散热优化设计,通过增设散热装置、引入强制冷风技术、优化主变室进风口与出风口、优化控制柜结构,增强箱式变压器控制柜的散热能力和稳定性。实验结果表明,所提出的优化方法能够显著提高控制柜的散热效率,保证箱式变压器控制柜稳定工作。

大功率直流充电系统设计及短路保护分析

为满足大容量电池动力船舶以及超级电容动力船舶充电需求,通过设计2.5 MW船舶充电系统,包含:船岸连接的电压电制、充电系统设备,其中包括箱变电源以及船岸连接部件等方面,同时考虑船岸两端,进行短路电流计算及分析。通过多方案的比较及实船配套验证,采用大功率直流充电系统具有容量大、充电快、操作安全、使用方便等特点,为新能源渡船大功率充电系统提供有效的解决方案。

基于临时移动电源应用的低压侧短时停电的箱式变压器更换方法

当箱式变压器作为唯一电源,以辐射状结构向低压终端用户供电时,若上级进线电源需更换、检修和迁移,低压终端用户需要陪同停电,居民群众用户用电满意度则会受到严重影响。针对这一现状,提出一种基于临时移动电源应用的低压侧短时停电的箱式变压器更换方法,极大地降低了低压陪停电时户数损失,有效提高了供电可靠性和电力营商环境。重点介绍了该方法的实施过程和应用优势。

箱式变压器完全不停电更换方法探究

当箱式变压器作为唯一电源,以辐射状结构向低压终端用户供电时,如果上级进线电源需更换、检修和迁移,低压终端用户就要陪同停电,居民群众用户用电满意度将受到严重影响。特别是对于某些重要用户,亟需一种能够实现完全不停电的箱式变压器更换方法。针对这一现状,提出了一种基于临时移动电源应用的低压侧完全不停电的箱式变压器更换方法,消除了低压陪停电时户数损失,有效提高了供电可靠性和改善了电力营商环境。重点介绍了该方法的实施过程和应用优势。

Evaluation of Length of Hospital Stay Joining Educational Programs for Type 2 Diabetes Mellitus Patients: Can We Control Medical Costs in Japan?

Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.

Financial Sustainability of the Japanese Medical Payment System: Analysis of the Japanese Medical Expenditure for Educational Hospitalization of Patients with Type 2 Diabetes

Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we analyzed the medical expenditures for educational hospitalization of patients with type 2 diabetes. A dataset of 6173 patients from 36 hospitals was used in the analysis. The sample period was from July 2008 to March 2012. We analyzed the medical expenditures in two ways. First, we analyzed the length of hospital stay (LOS). Next, we analyzed the daily expenditure per patient. The Box-Cox transformation model was used in the first analysis and the ordinary least squares method in the second. Comorbidities and complications prolonged LOS and increased daily expenditures. The LOS was significantly different among hospitals. On the other hand, the differences in daily expenditures among hospitals were relatively small, such that LOS was the main determinant of medical expenditures. Previous studies suggested that LOS could be shortened without degradation of medical quality. Moreover, LOS could be controlled by introducing proper critical paths and improving and standardizing educational programs. Hence, it would be possible to control the medical expenditures for this disease.

风电场箱式变电站设计选型要点分析

为统一风电场箱式变电站变压器及箱变低压侧动力电缆的设计原则,形成标准化的设计方案,文章梳理并分析相关设计标准与规程规范,针对变压器的型式、容量和能效,以及箱变低压侧动力电缆的材料、根数和截面积,提出了设计方案与选型计算的依据,通过工程实例验证了标准设计方案的合理性与适用性,最后提出风电场箱变选型的注意事项。

基于大数据的凝露控制系统研究

针对当前变电站电力箱凝露控制器的控制策略过于单一,设置门槛值启动加热属于事后型,没有预测功能,效果不理想。介绍了凝露控制系统的原理与构成,利用数据采集器采集变电站电力箱内外温湿度等状态,依据天气预报、历史数据、相邻设备情况等大数据分析提前启动加热器防凝露,同时阐述了凝露控制系统的辅助功能,电力箱状态可通过GPRS网络上传手机或远程电脑,实现对电力箱的远程集中监控。