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中新经纬客户端8月28日电 据发改委网站28日消息,发改委联合税务总局发布《关于加强个人所得税纳税信用建设的通知》(下称“《通知》”),要求全面实施个人所得税申报信用承诺制,对个人所得税严重失信当事人实施联合惩戒等,旨在强化个人所得税纳税信用协同共治,促进纳税人依法诚信纳税。
《通知》要求,建立个人所得税纳税信用管理机制。
一是全面实施个人所得税申报信用承诺制。税务部门在个人所得税自行纳税申报表、个人所得税专项附加扣除信息表等表单中设立格式规范、标准统一的信用承诺书,纳税人需对填报信息的真实性、准确性、完整性作出守信承诺。信用承诺的履行情况纳入个人信用记录,提醒和引导纳税人重视自身纳税信用,并视情况予以失信惩戒。
二是建立健全个人所得税纳税信用记录。税务总局以自然人纳税人识别号为唯一标识,以个人所得税纳税申报记录、专项附加扣除信息报送记录、违反信用承诺和违法违规行为记录为重点,研究制定自然人纳税信用管理的制度办法,全面建立自然人纳税信用信息采集、记录、查询、应用、修复、安全管理和权益维护机制,依法依规采集和评价自然人纳税信用信息,形成全国自然人纳税信用信息库,并与全国信用信息共享平台建立数据共享机制。
三是建立自然人失信行为认定机制。对于违反《中华人民共和国税收征管法》《中华人民共和国个人所得税法》以及其他法律法规和规范性文件,违背诚实信用原则,存在偷税、骗税、骗抵、冒用他人身份信息、恶意举报、虚假申诉等失信行为的当事人,税务部门将其列入重点关注对象,依法依规采取行政性约束和惩戒措施;对于情节严重、达到重大税收违法失信案件标准的,税务部门将其列为严重失信当事人,依法对外公示,并与全国信用信息共享平台共享。
《通知》明确,完善守信联合激励和失信联合惩戒机制。
一方面,对个人所得税守信纳税人提供更多便利和机会。探索将个人所得税守信情况纳入自然人诚信积分体系管理机制。对个人所得税纳税信用记录持续优良的纳税人,相关部门应提供更多服务便利,依法实施绿色通道、容缺受理等激励措施;鼓励行政管理部门在颁发荣誉证书、嘉奖和表彰时将其作为参考因素予以考虑。
另一方面,对个人所得税严重失信当事人实施联合惩戒。税务部门与有关部门合作,建立个人所得税严重失信当事人联合惩戒机制,对经税务部门依法认定,在个人所得税自行申报、专项附加扣除和享受优惠等过程中存在严重违法失信行为的纳税人和扣缴义务人,向全国信用信息共享平台推送相关信息并建立信用信息数据动态更新机制,依法依规实施联合惩戒。
《通知》还强调,加强信息安全和权益维护。
强化信息安全和隐私保护。税务部门依法保护自然人纳税信用信息,积极引导社会各方依法依规使用自然人纳税信用信息。各地区、各部门要按最小授权原则设定自然人纳税信用信息管理人员权限。加大对信用信息系统、信用服务机构数据库的监管力度,保护纳税人合法权益和个人隐私,确保国家信息安全。
同时,建立异议解决和失信修复机制。对个人所得税纳税信用记录存在异议的,纳税人可向税务机关提出异议申请,税务机关应及时回复并反馈结果。自然人在规定期限内纠正失信行为、消除不良影响的,可以通过主动做出信用承诺、参与信用知识学习、税收公益活动或信用体系建设公益活动等方式开展信用修复,对完成信用修复的自然人,税务部门按照规定修复其纳税信用。对因政策理解偏差或办税系统操作失误导致轻微失信,且能够按照规定履行涉税义务的自然人,税务部门将简化修复程序,及时对其纳税信用进行修复。
《通知》称,各地区、各部门要统筹实施个人所得税纳税信用管理工作,完善配套制度建设,建立联动机制,实现跨部门信用信息共享,构建税收共治管理、信用协同监管格局;并充分利用报纸、广播、电视、网络等渠道,做好个人所得税改革的政策解读和舆论引导,加大依法诚信纳税的宣传力度。(中新经纬APP)

正常人的颈部活动范围如下:屈曲35°~45°,伸展35°~45°,左右侧屈均45°,左右旋转均60°~80°。
人体端坐或站立时,从侧方看人的颈部似乎是直的,但包绕于内的颈椎并不是直的,而是在其中段有一向前凸出的弧度。这一向前的弧形凸起,在医学上称为颈椎的生理曲度。在X线片上,沿此曲度走行,在各个颈椎椎体后缘形成的连续、光滑的弧形曲线,称之为颈椎生理曲线。
颈椎生理曲线,正常值是12±5mm。其测量方法是,从齿状突后上缘开始向下,将每个椎体后缘相连成为一条弧线,然后从齿状突后上缘至第7颈椎椎体后下缘做一直线,上述弧线的最高点至这条直线的最大距离就是反映颈曲大小的数值。

2005年美国的脊柱创伤研究学组的(The spinal trauma study group, STSG)结合患者X线片、CT、MRI检查及患者的神经损伤情况提出了胸腰椎损伤评分系统(thoracolumbar injury severity score, TLISS)。TLISS主要依据3个方面:(1)基于影像学资料了解骨折的受伤机制;(2)椎体后方韧带复合结构的完整;(3)患者的神经功能状态。后来STSG改进了TLISS,把带有主观色彩的受伤机制改为更为客观的骨折形态描述,并称之为胸腰椎损伤分型及评分系统(thoracolumbar injury classification and severity score,TLICS)。具体标准是:(1)骨折的放射学形态:压缩性骨折1分,爆裂性骨折2分,旋转型骨折3分,牵张性骨折4分。若有重复,取最高分。(2)后方韧带复合体结构的完整性:完整者0分,完全断裂者3分,不完全断裂者或可疑断裂2分。(3)患者的神经功能状态:无神经损害者0分,完全性脊髓损伤者2分,不完全损伤者或马尾综合征者3分。各项分值相加即为TLICS总评分,评分越高代表损伤越严重。该分类首次综合考虑了椎体、韧带及神经功能对脊柱损伤稳定性的作用,并且量化损伤的严重程度,是具有重大意义的一次进步。

《胸腰椎损伤分类评分系统及其评价》中华外科杂志 2010 48(12)

对于胸腰椎骨折,Vaccaro等在2005年提出了TLISS评分系统,后改名为TLICS,也运用于指导临床治疗及手术决策。依据骨折形态、PLC完整性、神经症状,强调PLC在胸腰段损伤中评估和治疗的重要性。TLICS总评分≥5分,手术治疗;≤3分,非手术治疗;在两者之间手术治疗或非手术治疗。


特朗普的计划会让政府变得愚蠢

Political leaders in most functioning democracies have established checks and laws to ensure that their countries are guided by knowledge. On 14 June, President Donald Trump took one of his biggest steps yet to dismantle an important part of this system in the United States: an executive order that federal agencies should cut the number of advisory panels by at least one-third.

This is not just another of his ill-informed policies, or one that only wonks care about. It is the government making itself stupid. Ignoring, suppressing or manipulating science advice has been a pattern of this administration; now the very committees that provide that advice are being eliminated.

Scientists must sound the alarm.

As the research director of the Center for Science and Democracy at the Union of Concerned Scientists in Washington DC, I’ve long studied the use and misuse of science in government decision-making. The federal advisory system — which includes both science and stakeholder committees — is a safeguard. It ensures that policy decisions are guided by evidence, even when there is political pressure to ignore information.

There are roughly 1,000 such committees, totalling some 60,000 members. To address issues from drug laws to foodborne illness, government agencies rely on the advice of leading specialists. Committees at the Department of Transportation make public transit safer; panels at the Department of Agriculture oversee food safety, and so on.

The Trump administration’s assault on science will have an impact far beyond this presidency. The loss of institutional knowledge, technical training and overall capacity in the government won’t simply be restored through the election of a science-friendly administration. It will take years to rebuild. Meanwhile, federal science agencies will struggle to fulfil their missions of protecting public health and safety, and the environment.

The committees now under threat also help the public to hold decision-makers accountable when they ignore important evidence. In 2008, the administration of George W. Bush — and in 2011, that of Barack Obama — failed to set a standard for ambient levels of ozone (an air pollutant that causes respiratory and cardiovascular distress) that the seven-member Clean Air Scientific Advisory Committee recommended. The recommendation enabled the public to challenge the administrations’ decisions. Without an advisory committee, the lines between science assessments and policy decisions are blurred.

The executive order is ostensibly a cost-cutting measure. But federal advisory committees are a bargain for taxpayers. Agency staff run a few meetings a year, alongside other duties, and some compensation is granted for economy-class travel and other expenses that committee members incur. According to the US Federal Advisory Committee Act Database, the Clean Air Scientific Advisory Committee spent US$951,860 in 2018, of which only $110,540 went to direct committee costs. (The rest went to existing staff members, who would have been paid anyway.) Thousands of world-class specialists donate their time to help the government to make informed decisions.

Also, every meeting of an advisory committee solicits public comments. This gives community advocates and people without easy access to government officials a way to make their views known. The upcoming cull will give the public less opportunity for input.

External advice has been one of the main targets of the Trump administration’s many attempts to sideline science. In 2017, the head of the Environmental Protection Agency (EPA) issued a directive to remove advisers with current EPA grants (individuals whose expertise the EPA clearly found useful). The agency retained advisers tied to industries that have financial interests in EPA regulations.

Our analysis found that, in the first year of the Trump administration, federal science advisory committees met less frequently than in any of the 21 years since the government started tracking them. Nearly two-thirds of these committees met less often than their charters direct. We have also logged more than 100 attacks on the use and communication of science in the Trump administration so far, more than for any other president. These include avoiding or removing terms such as ‘climate change’, halting a study by the US National Academy of Sciences and reversing a decision to ban a pesticide linked to neurological conditions in children.

Those actions have chipped away at the nation’s access to science advice. The executive order takes a jackhammer to it. By asking agencies to arbitrarily eliminate one-third of their advisory committees, the president is essentially asking which wheel you’d like removed from your car. Which is it to be: water quality, air pollution or chemical waste?

James Madison, the fourth president and a founding father of the United States, wrote, “Knowledge will forever govern ignorance; And a people who mean to be their own Governors, must arm themselves with the power which knowledge gives.” We owe it to ourselves and our expertise, to the United States and the many other nations affected by its decisions — on emissions, infectious agents, drugs and so much more — to insist on being governed by knowledge, not ignorance. Speaking up for science panels is speaking up for democracy.

So what to do? Push back, demand action. Use the power of constituency, urge Congress for oversight, and even go to court if necessary. This is not about partisan politics; it is about making decisions based on the best available information.

Nature 570, 417 (2019)

doi: 10.1038/d41586-019-01961-6

https://www.nature.com/articles/d41586-019-01961-6