基于CHAID算法的病毒性肝炎患者DRGs分组研究

目的了解影响患者住院医疗费用的因素,建立drgS病例分组并对各组医疗费用进行分析评价。方法以厦门地区病毒性肝炎患者为研究对象,首先利用单因素和多因素方法分析患者住院医疗费用的影响因素,然后以患者住院医疗费用作为目标变量,通过CHAId模型进行drgS病例分组,最后采用rIV、CV等评价指标分析和评价分组结果。结果对可能影响住院医疗费用的变量进行单因素分析显示,年龄、付费方式、入院情况和是否手术4个因素具有统计学意义,通过多因素分析显示年龄、费用支付方式、入院情况是厦门地区肝炎患者住院费用的主要影响因素;进一步使用决策树CHAId模型分组得到3组该疾病的drgS病例组合,第一组为自费方式的患者,第二组为具有医疗保险且入院情况为一般的患者,第三组为具有医疗保险且入院情况为紧急的患者。经非参数kruSkAl-WAllIS H检验、rIV值、变异系数评价,该病例组合方案具有较好的可靠性和合理性。各病例分组的标准费用分别为1984.73元、1359.23元与1874.68元。分析每个分组的费用门坎值,发现线外病人比例为6.47%~7.65%,却消耗了23.07%-30.09%的医疗费用。结论通过drgS分组计算患者住院费用标准值可提供医疗保险机构的偿付参考值,自费病人的标准费用最高,其次是具有医疗保险且入院情况为紧急的患者,线外病人及其医疗消费应作为住院医疗费用总量控制重点。国家自然科学基金青年项目(71403229); 教育部人文社会科学研究项目资助(12YJA790030); 福建省自然科学基金资助项目(2013J05108

Sistem Pendukung Keputusan Prioritas Calon Penerima Program Indonesia Pintar Pada Siswa Sekolah Menengah Pertama Menggunakan Metode Topsis

Pendidikan merupakan hal penting dalam memajukan pembangunan negara, dengan itu pemerintah membuat kebijakan wajib belajar pendidikan sembilan tahun. Namun perekonomian masyarakat yang minim sering kali mengakibatkan mereka lebih memilih bekerja sebelum menuntaskan pendidikan dasar sembilan tahun tersebut. Demi mewujudkan hal tersebut pemerintah memiliki program bantuan pendidikan PIP (Program Indonesia Pintar) yang ditujukan pada masyarakat miskin. Namun implementasinya masih terdapat banyak kendala yang mengakibatkan tidak tepat sasaran dalam pemberian program bantuan pendidikan tersebut. Oleh Karena itu, untuk mengatasi permasalahan tersebut perlu adanya sistem dalam menentukan prioritas calon penerima PIP dengan menambahkan beberapa kriteria yang lebih mendasar. Pada penelitian ini dirancang sistem pendukung keputusan menggunakan metode TOPSIS (Technique for Order Performance by Similarity to Ideal Solutions) dengan beberapa kriteria yaitu Status Aktif Siswa, Surat Keterangan Miskin, Kondisi Yatim Piatu, Gaji Orang Tua, Presentasi Absensi. Pada aplikasi ini didapatkan hasil akhir berupa perankingan prioritas siswa yang akan menerima bantuan PIP

一个新兴的心理学学派——美国人本主义心理学的兴起及其理论观点概述

美国人本主义心理学是六十年代兴起的一个心理学新学派。这一学派强调,心理学应着重研究人的本性或价值,反对贬低人性的生物还原论和机械决定论。在美国,由于他们的观点同近代心理学两大传统流派——弗洛伊德心理分析学和行为主义心理学有分歧,现已被称为心理学的“第三种力量”。美国人本心理学的兴盛和发展正值我国“文化大革命”时期,国内对于这一学派的情况及理论观点尚无系统介绍,这里是一个初步的概述

Validation and Application of Analytical Methods for Determination of Total Mercury and Methyl Mercury In Marine Environmental Samples

汞是一种可在全球循环的持久性有毒污染物，人类活动是汞污染的主要成因。各形态的汞化合物中，无机汞较容易排泄，而有机汞毒性较强，其中甲基汞毒性最大。为研究环境中汞的含量、分布及形态，进而探讨汞污染来源、汞的环境行为和生态毒理效应，各种环境样品中汞和甲基汞的分析方法不断发展。 然而，我国测定总汞、甲基汞的现行标准方法仍存在不足。对于总汞测定，针对海洋环境样品的GB17378.6-2007国家标准方法无法满足海水样品中低浓度汞的测定需要；冷原子吸收光度法装置复杂，不便普及应用。因此，建立统一的海水、生物体和沉积物中汞分析的方法，以便于进行数据统计和比对分析是十分必要的。 目前，甲基汞的测定仅在全国...Mercury is a persistent toxic pollutant cycling around the world. Anthropogenic activity is the main source of mercury pollution. Among all mercury species, inorganic mercury is easier to excrete, while organic mercury is more toxic. Methyl mercury is considered to be the most toxic organic mercury. To better understand the distribution, speciation, behavior and toxicity of mercury, the analytical...学位：理学硕士院系专业：环境与生态学院_环境科学学号：2262010115139

老年人跌倒的公共卫生研究进展

据世界卫生组织（WHO）报告,跌倒是全球老年人面临的主要健康问题,且它在老年人意外伤害中的发生率和死亡率均居首位,跌倒不仅造成老年人身体上的创伤和残疾,而且还将导致如抑郁、焦虑、活动限制、跌到恐惧等心理问题[1]。据统计,2008年美国老年人由于跌倒所导致的医疗费用是233亿美元,英国为16亿美元[2]。中国老年人每年发生跌倒的直接医疗费用在50亿人民币以上,疾病负担为（160～800）亿元国家自然科学基金项目(71403229

How to Improve the Psychological Environment of Underground Buildings

本文通过对地下建筑环境的分析,发现当前地下建筑生理环境问题并不大,主要是地下建筑心理环境暂时问题较大,通过对地下建筑心理环境成因的解析,再通过建筑设计手段针对地下建筑心理环境问题作出相应的策略和应答,最终达到改善地下建筑心理环境的目的,希望本文的研究成果对地下空间的开发利用能起到一定的推动作用。Based on the analysis of the underground building environment, it is found that the current physical environment of the underground building is not big, mainly due to the temporary problem of the psychological environment of the underground construction. Through the analysis of the causes of the psychological environment of the underground building, Environmental problems to make the appropriate strategies and responses, and ultimately to improve the psychological environment of the underground building, the hope that the research results of underground space development and utilization can play a certain role in promoting

NOSTALGIA IN LIGHT AND SHADOW

建筑学角度的乡愁是指在西方现代建筑思潮的冲击下，人们对中国传统文化传承的断裂而产生的担忧。特定的光影与建筑配合能够带给人特定的情感，如乡愁。本文以“光与影”作为物质载体，探究光影如何将传统文化转译到现代建筑中去，传达乡愁之感。The nostalgia in architecture is the concern of the decline of the traditional Chinese cultural heritage under the impact of the modern western architectural thoughts.The specific light and shadow on the building can bring people specific feelings,such as nostalgia.This paper regards“light and shadow”as the material carriers,to explore how light and shadow interprete the traditional culture into the modern architecture,to convey the sense of nostalgia

Building an Integrated Database System of Information on Disaster Hazard, Risk, and Recovery Process – Cross-Media Database (3)

本年度はクロスメディアプロジェクトに新しい幾つかの電子図書館イニシアチブを統合するための研究を開始した。本稿はこれらに関する研究，すなわち，デジタルリポジトリー, ソーシャル・ブックマーキング, またダイナミック・クラシフィケイションに関する調査をまとめたものである。技術検討を行ったものには, 自動フォーマット検証及び特徴付けの機能を有するJHOVE; 研究用データを入手，格納，インデックス化，保存，そして再配信するためのデジタルリポジトリーであるDspace; 無料のオンライン参照管理システムであるCannotea; また，組織が提供する情報のタイプを基に検索結果を分類するダイナミック・クラシフィケイションが含まれる。Research in adopting digital library initiatives into the XMDB project has begun during the year. This report specifically focuses on these activities: digital repository researches, social bookmarking, and dynamic classification. Some of the technologies that were examined include JHOVE, which provides automated format validation and characterization; Dspace, which is a digital repository system that captures, stores, indexes, preserves, and redistributes research data; Cannotea, which is a free online reference management service; and Dynamic Classification, which is an approach to organize search results by the types of information provided by the organizations themselves.本年度はクロスメディアプロジェクトに新しい幾つかの電子図書館イニシアチブを統合するための研究を開始した。本稿はこれらに関する研究，すなわち，デジタルリポジトリー, ソーシャル・ブックマーキング, またダイナミック・クラシフィケイションに関する調査をまとめたものである。技術検討を行ったものには, 自動フォーマット検証及び特徴付けの機能を有するJHOVE; 研究用データを入手，格納，インデックス化，保存，そして再配信するためのデジタルリポジトリーであるDspace; 無料のオンライン参照管理システムであるCannotea; また，組織が提供する情報のタイプを基に検索結果を分類するダイナミック・クラシフィケイションが含まれる。Research in adopting digital library initiatives into the XMDB project has begun during the year. This report specifically focuses on these activities: digital repository researches, social bookmarking, and dynamic classification. Some of the technologies that were examined include JHOVE, which provides automated format validation and characterization; Dspace, which is a digital repository system that captures, stores, indexes, preserves, and redistributes research data; Cannotea, which is a free online reference management service; and Dynamic Classification, which is an approach to organize search results by the types of information provided by the organizations themselves

Comprehensive research on character of collapse and fracture of thick and large overburden rock in cave mining

大红山铁矿采用无底柱分段崩落法开采,形成了规模巨大的采动区域,上覆岩层厚度达627~750 m。为了掌握上覆岩层中崩落、开裂与高应力集中区的范围及发展趋势,防止突发性的大规模动力地压灾害的发生,矿山采取多通道微震监测技术、巷道观测和钻孔探测相结合的方法,对上覆岩层进行全面监测和研究。通过多通道微震监测技术对上覆岩体中高应力集中区破裂源进行高精度定位,确定高应力集中区及其变化过程,并据此推断开裂带的外边界;同时基于双力偶点源理论,分析得到震源破裂类型为以体积增加的张拉型为主、压剪切破坏与混合破坏为辅。在专门的巷道中,通过人工直接观察,确定崩落边界、开裂带的内、外边界;地表深钻孔探测作为辅助性手段,用来确定(验证)开裂带的外边界。将这3种技术手段结合起来对2011~2013年间上覆岩层不同时期的崩落带、开裂带与高应力集中区进行综合监测,得到不同时期高应力区、开裂带和崩落带的发展过程。研究表明,上覆岩层中崩落与开裂发展过程是一个缓慢渐进的过程,不会产生大规模的突变型崩塌冲击地压灾害。本文研究成果对矿山的安全生产具有重要的指导作用。A bulky mining-out area was formed at Dahongshan iron mine with sublevel caving method. The thickness of overburden is 627 to 750 meter. In order to understand the development of collapse area,fractured zone and high stress concentration zone in overburden so as to prevent the sudden large-scale and dynamic ground pressure disasters,micro-seismic monitoring,tunnel observation and borehole detection methods were used to carry out the comprehensive monitoring and research. Base on the precise location of fracture source with multi-channel micro-seismic monitoring technology,high-stress concentration zone and its developing trend were determined,and then the outer boundary was deduced. At same time,the analysis on fracture types of fracture source with double couples model showed that the tension fracture with volume-increasing accounted for majority of all sources,while the shear failure and mixed failure accounted for minority. The boundary of collapse area,external and internal boundaries of fractured area were determined directly through the artificial observation in special tunnels. The borehole detection as the auxiliary method was used to determine and validate the external boundary of fractured zone. A comprehensive monitoring and analysis were carried out to obtain the caving zone,cracking zone and high stress concentration area in overburden in different periods from 2011 to 2013. The development of high stress zone,cracking zone and caving zone in different periods were also obtained. The studies showed that the caving and cracking processes in overburden were slow and gradual. The sudden and dynamic large-scale collapse disaster would not occur. The conclusion of this paper played an important role in guiding the safe production of the mine.国家科技支撑计划项目(2013BAB02B06);; 国家科技部科研院所技术开发研究专项资金项目(2013EG21024)~

Hospitalization Expenses of Breast Cancer with Different Payments Based on Gamma Model

目的分析不同支付方式的女性乳腺癌患者住院费用,为合理控制乳腺癌住院费用提供依据。方法收集厦门市某三甲医院2004-2012年入院接受治疗且信息完整的女性乳腺癌患者的人口学、疾病、治疗和住院费用资料,采用Gamma模型分析医保与非医保患者的各项住院费用的差异,并估计边际均值及其95%可信区间。结果共纳入451例乳腺癌住院患者,其中医保患者占71.2%;医保与非医保患者中位住院费用分别为12696.4元和11216.5元,其中药品费分别占40.0%和38.8%,检查费分别占23.2%和22.5%,床位费分别占4.5%和4.3%。在控制协变量的影响后,医保和非医保患者的总住院费用(8889.5元vs 6807.6元)、药品费(1721.2元vs 1290.9元)、检查费(3366.5元vs 2400.6元)和床位费(488.9元vs 299.6元)差异均有统计学意义,医保患者的总住院费用、药品费、检查费和床位费分别是非医保患者的1.31、1.33、1.40和1.63倍。结论基于Gamma模型分析支付方式对乳腺癌住院费用的影响具有一定的科学合理性。医疗支付方式在一定程度上影响女性乳腺癌患者的住院费用,医保患者住院费用高于非医保患者,药品费、检查费和床位费是主要的差异来源。Objective To study the difference of hospitalization expenses between insured and uninsured female breast cancer patients with Gamma model. Methods The female patients with breast cancer in a tertiary hospital in Xiamen from Jan1,2004 to Dec 31,2012 were recruited into our study,whose demographics,disease situation,treatment and hospitalization expenses were collected. Gamma model was applied to analyze hospitalization expenses for insured and uninsured patients under control of other covariates,and to estimate marginal means. Results The study included 451 patients with 71. 2% of which were insured. For insured and uninsured patients,the median cost of hospitalization was 12696. 4 RMB and 11216. 5 RMB,respectively. The proportions of the compositions of hospitalization cost were 40. 0% and 38. 8% for drug cost,23. 2% and 22. 5% for examination cost,4. 5% and 4. 3% for bed cost,respectively. After controlling other covariates,total hospitalization cost(8889. 5 RMB vs. 8889. 5 RM B),drug cost( 1721. 2 RMB vs. 1721. 2 RMB),examination cost( 3366. 5 RMB vs. 3366. 5RMB),and bed cost(488. 9 RMB vs. 488. 9 RMB) between insured and uninsured patients were significantly different. Total cost,drug cost,examination cost and bed cost of insured patients were higher than uninsured patients with 0. 31,0. 33,0. 40,and0. 63 times respectively. Conclusion For its advantage in deal with skewed data,the Gamma model has its own rationality and validity on analysis of hospitalization expense. The hospitalization expense of female breast cancer patients with medical insurance was higher than uninsured patients. Drug cost,examination cost and bed cost made a main contribution of difference.国家自然基金青年项目(71403229);; 厦门市科技计划项目(3502Z20143006