In this study, a new four-parameter distribution called the Modi Exponentiated Exponential distribution was proposed and studied. The new distribution has three shape and one scale parameters. Its mathematical and sta...In this study, a new four-parameter distribution called the Modi Exponentiated Exponential distribution was proposed and studied. The new distribution has three shape and one scale parameters. Its mathematical and statistical properties were investigated. The parameters of the new model were estimated using the method of Maximum Likelihood Estimation. Monte Carlo simulation was used to evaluate the performance of the MLEs through average bias and RMSE. The flexibility and goodness-of-fit of the proposed distribution were demonstrated by applying it to two real data sets and comparing it with some existing distributions.展开更多
In this paper, a new distribution called Marshall-Olkin Exponentiated Fréchet distribution (MOEFr) is proposed. The goal is to increase the flexibility of the existing Exponentiated Fréchet distribution by i...In this paper, a new distribution called Marshall-Olkin Exponentiated Fréchet distribution (MOEFr) is proposed. The goal is to increase the flexibility of the existing Exponentiated Fréchet distribution by including an extra shape parameter, resulting into a more flexible distribution that can provide a better fit to various data sets than the baseline distribution. A generator method introduced by Marshall and Olkin is used to develop the new distribution. Some properties of the new distribution such as hazard rate function, survival function, reversed hazard rate function, cumulative hazard function, odds function, quantile function, moments and order statistics are derived. The maximum likelihood estimation is used to estimate the model parameters. Monte Carlo simulation is used to evaluate the behavior of the estimators through the average bias and root mean squared error. The new distribution is fitted and compared with some existing distributions such as the Exponentiated Fréchet (EFr), Marshall-Olkin Fréchet (MOFr), Beta Exponential Fréchet (BEFr), Beta Fréchet (BFr) and Fréchet (Fr) distributions, on three data sets, namely Bladder cancer, Carbone and Wheaton River data sets. Based on the goodness-of-fit statistics and information criteria values, it is demonstrated that the new distribution provides a better fit for the three data sets than the other distributions considered in the study.展开更多
Exponentiated Generalized Weibull distribution is a probability distribution which generalizes the Weibull distribution introducing two more shapes parameters to best adjust the non-monotonic shape. The parameters of ...Exponentiated Generalized Weibull distribution is a probability distribution which generalizes the Weibull distribution introducing two more shapes parameters to best adjust the non-monotonic shape. The parameters of the new probability distribution function are estimated by the maximum likelihood method under progressive type II censored data via expectation maximization algorithm.展开更多
In this paper, we introduce a new extension of the power Lindley distribution, called the exponentiated generalized power Lindley distribution. Several mathematical properties of the new model such as the shapes of th...In this paper, we introduce a new extension of the power Lindley distribution, called the exponentiated generalized power Lindley distribution. Several mathematical properties of the new model such as the shapes of the density and hazard rate functions, the quantile function, moments, mean deviations, Bonferroni and Lorenz curves and order statistics are derived. Moreover, we discuss the parameter estimation of the new distribution using the maximum likelihood and diagonally weighted least squares methods. A simulation study is performed to evaluate the estimators. We use two real data sets to illustrate the applicability of the new model. Empirical findings show that the proposed model provides better fits than some other well-known extensions of Lindley distributions.展开更多
Maximum product spacing for stress–strength model based on progressive Type-II hybrid censored samples with different cases has been obtained.This paper deals with estimation of the stress strength reliability model ...Maximum product spacing for stress–strength model based on progressive Type-II hybrid censored samples with different cases has been obtained.This paper deals with estimation of the stress strength reliability model R=P(Y<X)when the stress and strength are two independent exponentiated Gumbel distribution random variables with different shape parameters but having the same scale parameter.The stress–strength reliability model is estimated under progressive Type-II hybrid censoring samples.Two progressive Type-II hybrid censoring schemes were used,Case I:A sample size of stress is the equal sample size of strength,and same time of hybrid censoring,the product of spacing function under progressive Type-II hybrid censoring schemes.Case II:The sample size of stress is a different sample size of strength,in which the life-testing experiment with a progressive censoring scheme is terminated at a random time T 2 e0;1T.The maximum likelihood estimation and maximum product spacing estimation methods under progressive Type-II hybrid censored samples for the stress strength model have been discussed.A comparison study with classical methods as the maximum likelihood estimation method is discussed.Furthermore,to compare the performance of various cases,Markov chain Monte Carlo simulation is conducted by using iterative procedures as Newton Raphson or conjugate-gradient procedures.Finally,two real datasets are analyzed for illustrative purposes,first data for the breaking strengths of jute fiber,and the second data for the waiting times before the service of the customers of two banks.展开更多
By exponentiating each of the components of a finite mixture of two exponential components model by a positive parameter, several shapes of hazard rate functions are obtained. Maximum likelihood and Bayes methods, bas...By exponentiating each of the components of a finite mixture of two exponential components model by a positive parameter, several shapes of hazard rate functions are obtained. Maximum likelihood and Bayes methods, based on square error loss function and objective prior, are used to obtain estimators based on balanced square error loss function for the parameters, survival and hazard rate functions of a mixture of two exponentiated exponential components model. Approximate interval estimators of the parameters of the model are obtained.展开更多
The reliability of a system is discussed when the strength of the system and the stress imposed on it are independent and non-identical exponentiated Pareto distributed random variables with progressively censored sch...The reliability of a system is discussed when the strength of the system and the stress imposed on it are independent and non-identical exponentiated Pareto distributed random variables with progressively censored scheme.Different interval estimations are proposed.The interval estimations obtained are exact,approximate and bootstrap confidence intervals.Different methods and the corresponding confidence intervals are compared using Monte-Carlo simulations.Simulation results show that the confidence intervals(CIs)of exact and approximate methods are really better than those of the bootstrap method.展开更多
Bayesian predictive probability density function is obtained when the underlying pop-ulation distribution is exponentiated and subjective prior is used. The corresponding predictive survival function is then obtained ...Bayesian predictive probability density function is obtained when the underlying pop-ulation distribution is exponentiated and subjective prior is used. The corresponding predictive survival function is then obtained and used in constructing 100(1 – ?)% predictive interval, using one- and two- sample schemes when the size of the future sample is fixed and random. In the random case, the size of the future sample is assumed to follow the truncated Poisson distribution with parameter λ. Special attention is paid to the exponentiated Burr type XII population, from which the data are drawn. Two illustrative examples are given, one of which uses simulated data and the other uses data that represent the breaking strength of 64 single carbon fibers of length 10, found in Lawless [40].展开更多
Maximum likelihood and Bayes estimators of the parameters, survival function (SF) and hazard rate function (HRF) are obtained for the three-parameter exponentiated Burr type XII distribution when sample is available f...Maximum likelihood and Bayes estimators of the parameters, survival function (SF) and hazard rate function (HRF) are obtained for the three-parameter exponentiated Burr type XII distribution when sample is available from type II censored scheme. Bayes estimators have been developed using the standard Bayes and MCMC methods under square error and LINEX loss functions, using informative type of priors for the parameters. Simulation comparison of various estimation methods is made when n = 20, 40, 60 and censored data. The Bayes estimates are found to be, generally, better than the maximum likelihood estimates against the proposed prior, in the sense of having smaller mean square errors. This is found to be true whether the data are complete or censored. Estimates improve by increasing sample size. Analysis is also carried out for real life data.展开更多
A new generalized exponentiated Weibull model called Gumbel-exponentiated </span><span style="font-family:Verdana;">Weibull</span><span style="font-family:""> </span...A new generalized exponentiated Weibull model called Gumbel-exponentiated </span><span style="font-family:Verdana;">Weibull</span><span style="font-family:""> </span><span style="font-family:Verdana;">{Logistic} distribution is introduced and studied. The new distribution extends the exponentiated Weibull distribution with additional parameters and bimodal densities. Some new and earlier distributions formed the sub-models of the proposed distribution. The mathematical properties of the new distribution including expressions for the hazard function, survival function, moments, order statistics, mean deviation and absolute mean deviation from the mean, and entropy were derived. Monte Carlo simulation study was carried out to assess the finite sample behavior of the parameter estimates by maximum likelihood estimation approach. The superiority of the new generalized exponentiated Weibull distribution over some competing distributions was proved empirically using the fitted results from </span><span style="font-family:Verdana;">three</span><span style="font-family:Verdana;"> real life datasets.展开更多
In this work,we propose a low-regularity Fourier integrator with almost mass conservation to solve the Davey-StewartsonⅡsystem(hyperbolic-elliptic case).Arbitrary order mass convergence could be achieved by the suita...In this work,we propose a low-regularity Fourier integrator with almost mass conservation to solve the Davey-StewartsonⅡsystem(hyperbolic-elliptic case).Arbitrary order mass convergence could be achieved by the suitable addition of correction terms,while keeping the first order accuracy in H~γ×H^(γ+1)for initial data in H^(γ+1)×H^(γ+1)withγ>1.The main theorem is that,up to some fixed time T,there exist constantsτ_(0)and C depending only on T and‖u‖_(L^(∞)((0,T);H^(γ+1)))such that,for any 0<τ≤τ_(0),we have that‖u(t_(n),·)-u^(n)‖H_γ≤C_(τ),‖v(t_(n),·)-v^(n)‖_(Hγ+1)≤C_(τ),where u^(n)and v^(n)denote the numerical solutions at t_(n)=nτ.Moreover,the mass of the numerical solution M(u^(n))satisfies that|M(u^(n))-M(u_0)|≤Cτ~5.展开更多
A prototype cleanroom for hazardous testing and handling of satellites prior to launcher encapsulation,satisfying the ISO8 standard has been designed and analyzed in terms of performances.Unsteady Reynolds Averaged Na...A prototype cleanroom for hazardous testing and handling of satellites prior to launcher encapsulation,satisfying the ISO8 standard has been designed and analyzed in terms of performances.Unsteady Reynolds Averaged Navier-Stokes(URANS)models have been used to study the related flow field and particulate matter(PM)dispersion.The outcomes of the URANS models have been validated through comparison with equivalent large-eddy simulations.Special attention has been paid to the location and shape of the air intakes and their orientation in space,in order to balance the PM convection and diffusion inside the cleanroom.Forming a cyclone-type flow pattern inside the cleanroom is a key to maintaining a high ventilation efficiency.展开更多
This paper is concerned with a third order in time linear Moore-Gibson-Thompson equation which describes the acoustic velocity potential in ultrasound wave program.Influenced by the work of Kaltenbacher,Lasiecka and M...This paper is concerned with a third order in time linear Moore-Gibson-Thompson equation which describes the acoustic velocity potential in ultrasound wave program.Influenced by the work of Kaltenbacher,Lasiecka and Marchand(Control Cybernet.2011,40:971-988),we establish an observability inequality of the conservative problem,and then discuss the equivalence between the exponential stabilization of a dissipative system and the internal observational inequality of the corresponding conservative system.展开更多
In differentiable search architecture search methods,a more efficient search space design can significantly improve the performance of the searched architecture,thus requiring people to carefully define the search spa...In differentiable search architecture search methods,a more efficient search space design can significantly improve the performance of the searched architecture,thus requiring people to carefully define the search space with different complexity according to various operations.Meanwhile rationalizing the search strategies to explore the well-defined search space will further improve the speed and efficiency of architecture search.With this in mind,we propose a faster and more efficient differentiable architecture search method,AllegroNAS.Firstly,we introduce a more efficient search space enriched by the introduction of two redefined convolution modules.Secondly,we utilize a more efficient architectural parameter regularization method,mitigating the overfitting problem during the search process and reducing the error brought about by gradient approximation.Meanwhile,we introduce a natural exponential cosine annealing method to make the learning rate of the neural network training process more suitable for the search procedure.Moreover,group convolution and data augmentation are employed to reduce the computational cost.Finally,through extensive experiments on several public datasets,we demonstrate that our method can more swiftly search for better-performing neural network architectures in a more efficient search space,thus validating the effectiveness of our approach.展开更多
Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns i...Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.展开更多
文摘In this study, a new four-parameter distribution called the Modi Exponentiated Exponential distribution was proposed and studied. The new distribution has three shape and one scale parameters. Its mathematical and statistical properties were investigated. The parameters of the new model were estimated using the method of Maximum Likelihood Estimation. Monte Carlo simulation was used to evaluate the performance of the MLEs through average bias and RMSE. The flexibility and goodness-of-fit of the proposed distribution were demonstrated by applying it to two real data sets and comparing it with some existing distributions.
文摘In this paper, a new distribution called Marshall-Olkin Exponentiated Fréchet distribution (MOEFr) is proposed. The goal is to increase the flexibility of the existing Exponentiated Fréchet distribution by including an extra shape parameter, resulting into a more flexible distribution that can provide a better fit to various data sets than the baseline distribution. A generator method introduced by Marshall and Olkin is used to develop the new distribution. Some properties of the new distribution such as hazard rate function, survival function, reversed hazard rate function, cumulative hazard function, odds function, quantile function, moments and order statistics are derived. The maximum likelihood estimation is used to estimate the model parameters. Monte Carlo simulation is used to evaluate the behavior of the estimators through the average bias and root mean squared error. The new distribution is fitted and compared with some existing distributions such as the Exponentiated Fréchet (EFr), Marshall-Olkin Fréchet (MOFr), Beta Exponential Fréchet (BEFr), Beta Fréchet (BFr) and Fréchet (Fr) distributions, on three data sets, namely Bladder cancer, Carbone and Wheaton River data sets. Based on the goodness-of-fit statistics and information criteria values, it is demonstrated that the new distribution provides a better fit for the three data sets than the other distributions considered in the study.
文摘Exponentiated Generalized Weibull distribution is a probability distribution which generalizes the Weibull distribution introducing two more shapes parameters to best adjust the non-monotonic shape. The parameters of the new probability distribution function are estimated by the maximum likelihood method under progressive type II censored data via expectation maximization algorithm.
文摘In this paper, we introduce a new extension of the power Lindley distribution, called the exponentiated generalized power Lindley distribution. Several mathematical properties of the new model such as the shapes of the density and hazard rate functions, the quantile function, moments, mean deviations, Bonferroni and Lorenz curves and order statistics are derived. Moreover, we discuss the parameter estimation of the new distribution using the maximum likelihood and diagonally weighted least squares methods. A simulation study is performed to evaluate the estimators. We use two real data sets to illustrate the applicability of the new model. Empirical findings show that the proposed model provides better fits than some other well-known extensions of Lindley distributions.
文摘Maximum product spacing for stress–strength model based on progressive Type-II hybrid censored samples with different cases has been obtained.This paper deals with estimation of the stress strength reliability model R=P(Y<X)when the stress and strength are two independent exponentiated Gumbel distribution random variables with different shape parameters but having the same scale parameter.The stress–strength reliability model is estimated under progressive Type-II hybrid censoring samples.Two progressive Type-II hybrid censoring schemes were used,Case I:A sample size of stress is the equal sample size of strength,and same time of hybrid censoring,the product of spacing function under progressive Type-II hybrid censoring schemes.Case II:The sample size of stress is a different sample size of strength,in which the life-testing experiment with a progressive censoring scheme is terminated at a random time T 2 e0;1T.The maximum likelihood estimation and maximum product spacing estimation methods under progressive Type-II hybrid censored samples for the stress strength model have been discussed.A comparison study with classical methods as the maximum likelihood estimation method is discussed.Furthermore,to compare the performance of various cases,Markov chain Monte Carlo simulation is conducted by using iterative procedures as Newton Raphson or conjugate-gradient procedures.Finally,two real datasets are analyzed for illustrative purposes,first data for the breaking strengths of jute fiber,and the second data for the waiting times before the service of the customers of two banks.
文摘By exponentiating each of the components of a finite mixture of two exponential components model by a positive parameter, several shapes of hazard rate functions are obtained. Maximum likelihood and Bayes methods, based on square error loss function and objective prior, are used to obtain estimators based on balanced square error loss function for the parameters, survival and hazard rate functions of a mixture of two exponentiated exponential components model. Approximate interval estimators of the parameters of the model are obtained.
基金Natural Science Foundation of Guangdong Province,China(No.2018A030313829)Characteristic Innovation Projects of Ordinary Universities of Guangdong Province,China(No.2019KTSCX202)+1 种基金Higher Education Teaching Reform Project of Guangdong Province,China(No.2019625)Zhaoqing Educational Development Research Institute Project,China(No.ZQJYY2019033)。
文摘The reliability of a system is discussed when the strength of the system and the stress imposed on it are independent and non-identical exponentiated Pareto distributed random variables with progressively censored scheme.Different interval estimations are proposed.The interval estimations obtained are exact,approximate and bootstrap confidence intervals.Different methods and the corresponding confidence intervals are compared using Monte-Carlo simulations.Simulation results show that the confidence intervals(CIs)of exact and approximate methods are really better than those of the bootstrap method.
文摘Bayesian predictive probability density function is obtained when the underlying pop-ulation distribution is exponentiated and subjective prior is used. The corresponding predictive survival function is then obtained and used in constructing 100(1 – ?)% predictive interval, using one- and two- sample schemes when the size of the future sample is fixed and random. In the random case, the size of the future sample is assumed to follow the truncated Poisson distribution with parameter λ. Special attention is paid to the exponentiated Burr type XII population, from which the data are drawn. Two illustrative examples are given, one of which uses simulated data and the other uses data that represent the breaking strength of 64 single carbon fibers of length 10, found in Lawless [40].
文摘Maximum likelihood and Bayes estimators of the parameters, survival function (SF) and hazard rate function (HRF) are obtained for the three-parameter exponentiated Burr type XII distribution when sample is available from type II censored scheme. Bayes estimators have been developed using the standard Bayes and MCMC methods under square error and LINEX loss functions, using informative type of priors for the parameters. Simulation comparison of various estimation methods is made when n = 20, 40, 60 and censored data. The Bayes estimates are found to be, generally, better than the maximum likelihood estimates against the proposed prior, in the sense of having smaller mean square errors. This is found to be true whether the data are complete or censored. Estimates improve by increasing sample size. Analysis is also carried out for real life data.
文摘A new generalized exponentiated Weibull model called Gumbel-exponentiated </span><span style="font-family:Verdana;">Weibull</span><span style="font-family:""> </span><span style="font-family:Verdana;">{Logistic} distribution is introduced and studied. The new distribution extends the exponentiated Weibull distribution with additional parameters and bimodal densities. Some new and earlier distributions formed the sub-models of the proposed distribution. The mathematical properties of the new distribution including expressions for the hazard function, survival function, moments, order statistics, mean deviation and absolute mean deviation from the mean, and entropy were derived. Monte Carlo simulation study was carried out to assess the finite sample behavior of the parameter estimates by maximum likelihood estimation approach. The superiority of the new generalized exponentiated Weibull distribution over some competing distributions was proved empirically using the fitted results from </span><span style="font-family:Verdana;">three</span><span style="font-family:Verdana;"> real life datasets.
基金supported by the NSFC(11901120)supported by the NSFC(12171356)the Science and Technology Program of Guangzhou,China(2024A04J4027)。
文摘In this work,we propose a low-regularity Fourier integrator with almost mass conservation to solve the Davey-StewartsonⅡsystem(hyperbolic-elliptic case).Arbitrary order mass convergence could be achieved by the suitable addition of correction terms,while keeping the first order accuracy in H~γ×H^(γ+1)for initial data in H^(γ+1)×H^(γ+1)withγ>1.The main theorem is that,up to some fixed time T,there exist constantsτ_(0)and C depending only on T and‖u‖_(L^(∞)((0,T);H^(γ+1)))such that,for any 0<τ≤τ_(0),we have that‖u(t_(n),·)-u^(n)‖H_γ≤C_(τ),‖v(t_(n),·)-v^(n)‖_(Hγ+1)≤C_(τ),where u^(n)and v^(n)denote the numerical solutions at t_(n)=nτ.Moreover,the mass of the numerical solution M(u^(n))satisfies that|M(u^(n))-M(u_0)|≤Cτ~5.
基金funded by Space Research and Innovation Network (www.sprint.ac.uk)for Technology Grants (OW131743P4V4M,OW131797P4V2B,ZX and CY)grateful to NERC (www.nerc.ac.uk)for the Grant (NE/W002841/1,ZX)to complete the writing of the paper。
文摘A prototype cleanroom for hazardous testing and handling of satellites prior to launcher encapsulation,satisfying the ISO8 standard has been designed and analyzed in terms of performances.Unsteady Reynolds Averaged Navier-Stokes(URANS)models have been used to study the related flow field and particulate matter(PM)dispersion.The outcomes of the URANS models have been validated through comparison with equivalent large-eddy simulations.Special attention has been paid to the location and shape of the air intakes and their orientation in space,in order to balance the PM convection and diffusion inside the cleanroom.Forming a cyclone-type flow pattern inside the cleanroom is a key to maintaining a high ventilation efficiency.
基金Supported by the National Natural Science Foundation of China(11771216)the Key Research and Development Program of Jiangsu Province(Social Development)(BE2019725)the Qing Lan Project of Jiangsu Province。
文摘This paper is concerned with a third order in time linear Moore-Gibson-Thompson equation which describes the acoustic velocity potential in ultrasound wave program.Influenced by the work of Kaltenbacher,Lasiecka and Marchand(Control Cybernet.2011,40:971-988),we establish an observability inequality of the conservative problem,and then discuss the equivalence between the exponential stabilization of a dissipative system and the internal observational inequality of the corresponding conservative system.
基金This work was supported in part by the National Natural Science Foundation of China under Grant 61305001the Natural Science Foundation of Heilongjiang Province of China under Grant F201222.
文摘In differentiable search architecture search methods,a more efficient search space design can significantly improve the performance of the searched architecture,thus requiring people to carefully define the search space with different complexity according to various operations.Meanwhile rationalizing the search strategies to explore the well-defined search space will further improve the speed and efficiency of architecture search.With this in mind,we propose a faster and more efficient differentiable architecture search method,AllegroNAS.Firstly,we introduce a more efficient search space enriched by the introduction of two redefined convolution modules.Secondly,we utilize a more efficient architectural parameter regularization method,mitigating the overfitting problem during the search process and reducing the error brought about by gradient approximation.Meanwhile,we introduce a natural exponential cosine annealing method to make the learning rate of the neural network training process more suitable for the search procedure.Moreover,group convolution and data augmentation are employed to reduce the computational cost.Finally,through extensive experiments on several public datasets,we demonstrate that our method can more swiftly search for better-performing neural network architectures in a more efficient search space,thus validating the effectiveness of our approach.
文摘Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.