In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumpt...In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumptive consent under the patient’s right to self-determination as the basis for its justification. In general, the patient’s genuine consent takes precedence, but in case of the unavail-ability of the patient’s genuine consent, his or her presumptive consent should be applied as a substitute. The judgment of presumptive con-sent should follow the subsequence, with the living will of the patient applied first and then the substitute decision-making. If the patient’s personal will cannot be inferred after exhausting all available possi-bilities, the principle of prioritizing the interests of life should prevail, and the ongoing life-sustaining medical care should not be interrupted or terminated.展开更多
To describe and analyze the factors affecting the referral of presumptive tuberculosis patients between health-care facilities that are not affiliated with the National TB Control Program （NTP） and NTP-designated me...To describe and analyze the factors affecting the referral of presumptive tuberculosis patients between health-care facilities that are not affiliated with the National TB Control Program （NTP） and NTP-designated medical facilities in China, we carried out a retrospective study based on data collected in the Tuberculosis Information Management System in 2015. Out of 324,221 presumptive pulmonary tuberculosis （PTB） cases reported by non-NTP health-care facilities, 302,006 （93.1%） reported cases successfully arrived at designated medical facilities and 22,215 cases （6.9%） were lost to follow-up. The arrival rate of presumptive cases among male patients （92.9%） was slightly lower than that among female ones （93.7%）, and this difference is statistically significant. The majority （73.3%） of reported cases were local permanent residents. Migrants have a higher risk of being lost to follow-up compared with local residents （adjusted odds ratios 4.126 and 5.003, respectively）. Compared with farmers and herdsmen, pre-school children, unemployed laborers, retirees, and people with other occupations （adjusted odds ratios 2.361, 1.274, 1.068, and 1.993, respectively） had higher rates of loss to follow-up during the referral and tracing processes. In conclusion, this study demonstrates that the high referral rate of presumptive TB cases from non-NTP health-care facilities to designated medical facilities in China is due to implementation of effective active case identification strategies. In addition, migrant populations, pre-school children, unemployed laborers, and retirees were identified as high-risk groups that contribute to the loss to follow-up.展开更多
This paper makes in-depth reflections on the writer＇s first year experience as an ESL writing teacher at a Chinese college. In this paper, the author reflects on four popular presumptions about ESL writing teaching h...This paper makes in-depth reflections on the writer＇s first year experience as an ESL writing teacher at a Chinese college. In this paper, the author reflects on four popular presumptions about ESL writing teaching he held at the outset of the course and the problems he encountered during the course, and critically points out fallacies and dangers rooted in the presumptions, arguing that without conscious understanding of them, inexperienced writing teachers could be trapped and end up in a failure of teaching. The author therefore highlights some new developments of ESL writing and their significance for the situation in China, and proposes an integrated approach for the green ESL teachers to create leaner-centered L2 writing ：classes in their own classroom practice.展开更多
Background:Rapid diagnostic tests(RDT)can effectively manage malaria cases and reduce excess costs brought by misdiagnosis.However,few studies have evaluated the economic value of this technology.The purpose of this s...Background:Rapid diagnostic tests(RDT)can effectively manage malaria cases and reduce excess costs brought by misdiagnosis.However,few studies have evaluated the economic value of this technology.The purpose of this study is to systematically review the economic value of RDT in malaria diagnosis.Main text:A detailed search strategy was developed to identify published economic evaluations that provide evidence regarding the cost-effectiveness of malaria RDT.Electronic databases including MEDLINE,EMBASE,Biosis Previews,Web of Science and Cochrane Library were searched from Jan 2007 to July 2018.Two researchers screened studies independently based on pre-specified inclusion and exclusion criteria.The Consolidated Health Economic Evaluation Reporting Standards(CHEERS)checklist was applied to evaluate the quality of the studies.Then cost and effectiveness data were extracted and summarized in a narrative way.Fifteen economic evaluations of RDT compared to other diagnostic methods were identified.The overall quality of studies varied greatly but most of them were scored to be of high or moderate quality.Ten of the fifteen studies reported that RDT was likely to be a cost-effective approach compared to its comparisons,but the results could be influenced by the alternatives,study perspectives,malaria prevalence,and the types of RDT.Conclusions:Based on available evidence,RDT had the potential to be more cost-effective than either microscopy or presumptive diagnosis.Further research is also required to draw a more robust conclusion.展开更多
Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infue...Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infuencing progression along the TB cascade have been identifed,the impact of stigma is underexplored and underappreciated.We conducted an exploratory study to 1)describe diferences in perceived community-level TB stigma among community members,TB presumptives,and TB patients,and 2)identify factors associated with TB stigma levels among these groups.Methods:A cross sectional study was conducted in November 2017 at public health care facilities in Bufalo City Metro(BCM)and Zululand health districts,South Africa.Community members,TB presumptives,and TB patients were recruited.Data were collected on sociodemographic characteristics,TB knowledge,health and clinical history,social support,and both HIV and TB stigma.A validated scale assessing perceived community TB stigma was used.Univariate and multivariate linear regression models were used to describe diferences in perceived community TB stigma by participant type and to identify factors associated with TB stigma.Results:We enrolled 397 participants.On a scale of zero to 24,the mean stigma score for TB presumptives(14.7±4.4)was statistically higher than community members(13.6±4.8)and TB patients(13.3±5.1).Community members from Zululand(β=5.73;95%CI 2.19,9.72)had higher TB stigma compared to those from BCM.Previously having TB(β=−2.19;95%CI−4.37,0.0064)was associated with reduced TB stigma among community members.Understanding the relationship between HIV and TB disease(β=2.48;95%CI 0.020,4.94),and having low social support(β=−0.077;95%CI−0.14,0.010)were associated with increased TB stigma among TB presumptives.Among TB Patients,identifying as Black African(β=−2.90;95%CI−4.74,−1.04)and knowing the correct causes of TB(β=−2.93;95%CI−4.92,−0.94)were associated with decreased TB stigma,while understanding the relationship between HIV and TB disease(β=2.48;95%CI 1.05,3.90)and higher HIV stigma(β=0.32;95%CI 0.21,0.42)were associated with increased TB stigma.Conclusions:TB stigma interventions should be developed for TB presumptives,as stigma may increase initial-lossto-follow up.Given that stigma may be driven by numerous factors throughout the TB cascade,adaptive stigma reduction interventions may be required.展开更多
Over the past two decades,China's tax law reform has become a highly valued and distinguished area for earnestly advancing Chinese socialist rule of law construction.With the establishment of the principle on stre...Over the past two decades,China's tax law reform has become a highly valued and distinguished area for earnestly advancing Chinese socialist rule of law construction.With the establishment of the principle on strengthening legality of imposing tax,as well as new settings regarding China's social and economic development,the administration and management of tax collection and protection of taxpayers'well-being gradually and vigilantly attain responsiveness from top national legislators and scholars.Meanwhile,the efforts exerted by tax administers on fighting tax evasion have been elevated on both international and domestic grounds.For example,a focal area is the evaluation and collction of presumptive tax which is a common routine for administers around the world.Moreover,the current laws and regulations on administering tax collection invite a rigorous process of revision and modification with contermporary conceptions of taxpayers'well-being.This article argues that,through the example of presumptive tax collection,the administration and management of tax collection should adhere to the basic principles of protecting taxpayers and advancing the goals of de-administrating arduous procedures to conform to new trends of social and economic development.It also proposes that the vigor and dynamics of tax collection efforts should coincide with national goals of reformulating the individual income tax collection mechanisms,solidifying the national conversion of business tax to value-added tax,matching with the new wave of bankruptcy of certain enterprises,and so forth.展开更多
In the case of suspension flows, the rate of interphase momentum transfer M_k and thatof interphase energy transfer E_k, which were expressed as a sum of infinite discontinuitiesby Ishii, have been reduced to the sum ...In the case of suspension flows, the rate of interphase momentum transfer M_k and thatof interphase energy transfer E_k, which were expressed as a sum of infinite discontinuitiesby Ishii, have been reduced to the sum of several terms which have concise physical signifi-cance. M_k is composed of the following terms: (i) the momentum carried by the interphasemass transfer; (ii) the interphase drag force due to the relative motion between phases; (iii)the interphase force produced by the concentration gradient of the dispersed phase in apressure field. And E_k is composed of the following four terms, that is, the energy carriedby the interphase mass transfer, the work produced by the interphase forces of the second andthird parts above, and the heat transfer between phases. It is concluded from the results that (i) the term, (-α_k?p), which is related to thepressure gradient in the momentum equation, can be derived from the basic conservation lawswithout introducing the 'shared-pressure presumption'; (ii) the mean velocity of the actionpoint of the interphase drag is the mean velocity of the interface displacement, v_i. It isapproximately equal to the mean velocity of the dispersed phase, v_d. Hence the work termsproduced by the drag forces are f_(dc)·v_d. and f_(cd)·v_d, respectively. with v_i not being replacedby the mean velocity of the continuous phase, v_c; (iii) by analogy, the terms of the momentumtransfer due to phase change are v_dΓ_c. and v_dΓ_d. respectively; (iv) since the transformationbetween explicit heat and latent heat occurs in the process of phase change, the algebraic sumof the heat transfer between phases is not equal to zero. Q_(ic) and Q_(id) are composed of theexplicit heat and latent heat, so that the sum (Q_(ic)+Q_(id)) is equal to zero.展开更多
基金the Beijing Social Science Foundation Project (Project Number 20221BS0009).
文摘In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumptive consent under the patient’s right to self-determination as the basis for its justification. In general, the patient’s genuine consent takes precedence, but in case of the unavail-ability of the patient’s genuine consent, his or her presumptive consent should be applied as a substitute. The judgment of presumptive con-sent should follow the subsequence, with the living will of the patient applied first and then the substitute decision-making. If the patient’s personal will cannot be inferred after exhausting all available possi-bilities, the principle of prioritizing the interests of life should prevail, and the ongoing life-sustaining medical care should not be interrupted or terminated.
基金supported by the World Health Organization Western Pacific TB Operational Research Grant(WPDCC1408653)
文摘To describe and analyze the factors affecting the referral of presumptive tuberculosis patients between health-care facilities that are not affiliated with the National TB Control Program （NTP） and NTP-designated medical facilities in China, we carried out a retrospective study based on data collected in the Tuberculosis Information Management System in 2015. Out of 324,221 presumptive pulmonary tuberculosis （PTB） cases reported by non-NTP health-care facilities, 302,006 （93.1%） reported cases successfully arrived at designated medical facilities and 22,215 cases （6.9%） were lost to follow-up. The arrival rate of presumptive cases among male patients （92.9%） was slightly lower than that among female ones （93.7%）, and this difference is statistically significant. The majority （73.3%） of reported cases were local permanent residents. Migrants have a higher risk of being lost to follow-up compared with local residents （adjusted odds ratios 4.126 and 5.003, respectively）. Compared with farmers and herdsmen, pre-school children, unemployed laborers, retirees, and people with other occupations （adjusted odds ratios 2.361, 1.274, 1.068, and 1.993, respectively） had higher rates of loss to follow-up during the referral and tracing processes. In conclusion, this study demonstrates that the high referral rate of presumptive TB cases from non-NTP health-care facilities to designated medical facilities in China is due to implementation of effective active case identification strategies. In addition, migrant populations, pre-school children, unemployed laborers, and retirees were identified as high-risk groups that contribute to the loss to follow-up.
文摘This paper makes in-depth reflections on the writer＇s first year experience as an ESL writing teacher at a Chinese college. In this paper, the author reflects on four popular presumptions about ESL writing teaching he held at the outset of the course and the problems he encountered during the course, and critically points out fallacies and dangers rooted in the presumptions, arguing that without conscious understanding of them, inexperienced writing teachers could be trapped and end up in a failure of teaching. The author therefore highlights some new developments of ESL writing and their significance for the situation in China, and proposes an integrated approach for the green ESL teachers to create leaner-centered L2 writing ：classes in their own classroom practice.
基金This study supported by the Natural Science Foundation of Jiangsu Province(No.BK20150001)the Jiangsu Provincial Department of Science and Technology(BE2018020)+1 种基金the Jiangsu Provincial Project of Invigorating Health Care through Science,Technology and EducationThe funders had no role in the study design,data collection,analysis,decision to publish,or preparation of the manuscript.
文摘Background:Rapid diagnostic tests(RDT)can effectively manage malaria cases and reduce excess costs brought by misdiagnosis.However,few studies have evaluated the economic value of this technology.The purpose of this study is to systematically review the economic value of RDT in malaria diagnosis.Main text:A detailed search strategy was developed to identify published economic evaluations that provide evidence regarding the cost-effectiveness of malaria RDT.Electronic databases including MEDLINE,EMBASE,Biosis Previews,Web of Science and Cochrane Library were searched from Jan 2007 to July 2018.Two researchers screened studies independently based on pre-specified inclusion and exclusion criteria.The Consolidated Health Economic Evaluation Reporting Standards(CHEERS)checklist was applied to evaluate the quality of the studies.Then cost and effectiveness data were extracted and summarized in a narrative way.Fifteen economic evaluations of RDT compared to other diagnostic methods were identified.The overall quality of studies varied greatly but most of them were scored to be of high or moderate quality.Ten of the fifteen studies reported that RDT was likely to be a cost-effective approach compared to its comparisons,but the results could be influenced by the alternatives,study perspectives,malaria prevalence,and the types of RDT.Conclusions:Based on available evidence,RDT had the potential to be more cost-effective than either microscopy or presumptive diagnosis.Further research is also required to draw a more robust conclusion.
文摘Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infuencing progression along the TB cascade have been identifed,the impact of stigma is underexplored and underappreciated.We conducted an exploratory study to 1)describe diferences in perceived community-level TB stigma among community members,TB presumptives,and TB patients,and 2)identify factors associated with TB stigma levels among these groups.Methods:A cross sectional study was conducted in November 2017 at public health care facilities in Bufalo City Metro(BCM)and Zululand health districts,South Africa.Community members,TB presumptives,and TB patients were recruited.Data were collected on sociodemographic characteristics,TB knowledge,health and clinical history,social support,and both HIV and TB stigma.A validated scale assessing perceived community TB stigma was used.Univariate and multivariate linear regression models were used to describe diferences in perceived community TB stigma by participant type and to identify factors associated with TB stigma.Results:We enrolled 397 participants.On a scale of zero to 24,the mean stigma score for TB presumptives(14.7±4.4)was statistically higher than community members(13.6±4.8)and TB patients(13.3±5.1).Community members from Zululand(β=5.73;95%CI 2.19,9.72)had higher TB stigma compared to those from BCM.Previously having TB(β=−2.19;95%CI−4.37,0.0064)was associated with reduced TB stigma among community members.Understanding the relationship between HIV and TB disease(β=2.48;95%CI 0.020,4.94),and having low social support(β=−0.077;95%CI−0.14,0.010)were associated with increased TB stigma among TB presumptives.Among TB Patients,identifying as Black African(β=−2.90;95%CI−4.74,−1.04)and knowing the correct causes of TB(β=−2.93;95%CI−4.92,−0.94)were associated with decreased TB stigma,while understanding the relationship between HIV and TB disease(β=2.48;95%CI 1.05,3.90)and higher HIV stigma(β=0.32;95%CI 0.21,0.42)were associated with increased TB stigma.Conclusions:TB stigma interventions should be developed for TB presumptives,as stigma may increase initial-lossto-follow up.Given that stigma may be driven by numerous factors throughout the TB cascade,adaptive stigma reduction interventions may be required.
文摘Over the past two decades,China's tax law reform has become a highly valued and distinguished area for earnestly advancing Chinese socialist rule of law construction.With the establishment of the principle on strengthening legality of imposing tax,as well as new settings regarding China's social and economic development,the administration and management of tax collection and protection of taxpayers'well-being gradually and vigilantly attain responsiveness from top national legislators and scholars.Meanwhile,the efforts exerted by tax administers on fighting tax evasion have been elevated on both international and domestic grounds.For example,a focal area is the evaluation and collction of presumptive tax which is a common routine for administers around the world.Moreover,the current laws and regulations on administering tax collection invite a rigorous process of revision and modification with contermporary conceptions of taxpayers'well-being.This article argues that,through the example of presumptive tax collection,the administration and management of tax collection should adhere to the basic principles of protecting taxpayers and advancing the goals of de-administrating arduous procedures to conform to new trends of social and economic development.It also proposes that the vigor and dynamics of tax collection efforts should coincide with national goals of reformulating the individual income tax collection mechanisms,solidifying the national conversion of business tax to value-added tax,matching with the new wave of bankruptcy of certain enterprises,and so forth.
基金Project supported by the National Natural Science Foundation of China.
文摘In the case of suspension flows, the rate of interphase momentum transfer M_k and thatof interphase energy transfer E_k, which were expressed as a sum of infinite discontinuitiesby Ishii, have been reduced to the sum of several terms which have concise physical signifi-cance. M_k is composed of the following terms: (i) the momentum carried by the interphasemass transfer; (ii) the interphase drag force due to the relative motion between phases; (iii)the interphase force produced by the concentration gradient of the dispersed phase in apressure field. And E_k is composed of the following four terms, that is, the energy carriedby the interphase mass transfer, the work produced by the interphase forces of the second andthird parts above, and the heat transfer between phases. It is concluded from the results that (i) the term, (-α_k?p), which is related to thepressure gradient in the momentum equation, can be derived from the basic conservation lawswithout introducing the 'shared-pressure presumption'; (ii) the mean velocity of the actionpoint of the interphase drag is the mean velocity of the interface displacement, v_i. It isapproximately equal to the mean velocity of the dispersed phase, v_d. Hence the work termsproduced by the drag forces are f_(dc)·v_d. and f_(cd)·v_d, respectively. with v_i not being replacedby the mean velocity of the continuous phase, v_c; (iii) by analogy, the terms of the momentumtransfer due to phase change are v_dΓ_c. and v_dΓ_d. respectively; (iv) since the transformationbetween explicit heat and latent heat occurs in the process of phase change, the algebraic sumof the heat transfer between phases is not equal to zero. Q_(ic) and Q_(id) are composed of theexplicit heat and latent heat, so that the sum (Q_(ic)+Q_(id)) is equal to zero.
