医院信息化系统在武汉新冠肺炎防疫救治过程中暴露出的问题及其引发的思考

目的针对武汉地区医院信息化系统在新型冠状病毒肺炎(简称新冠肺炎)防疫救治过程中暴露出的问题,提出应对突发公共卫生事件时医院信息化的完善方法。方法充分分析医院信息化系统在新冠肺炎防疫救治中所暴露出的各个医院信息化系统结构不同、各个医院之间无法实施信息共享、门诊病房之间系统相互独立、数据信息更新不及时等九大问题,并提出医院信息化基础布局的建立、区域链及大数据临床中的应用等多项措施。结果医院信息化能力的提高有助于降低医护人员工作强度,提高患者的安全。结论新冠肺炎疫情的发生给我国医院信息化系统带来了严峻的挑战,但同时也给我们带来了更大的机遇。我国在未来针对突发公共卫生事件时,医院信息化将为医护人员、患者提供更有利的支持。     

Vibratory stimulus to the masseter muscle impairs the oral fine motor control during biting tasks

PurposeTo investigated the effect of vibratory stimulus on masseter muscles during oral fine motor biting tasks.MethodsSixteen healthy individuals (age: 24.5 ± 2.4 years) participated in experiment I during which the participants were asked to “hold and split” half a roasted peanut placed on a force transducer with their front teeth. The participant performed ten series with ten trials of the “hold and split” behavioral task while vibratory stimulus was applied on the masseter muscle every alternate series. Further, fourteen participants participated (age: 25.2 ± 4.8 years) in experiment II during which they performed a series each of the behavioral task at baseline, an adjusted baseline without and with vibration as well as with and without visual feedback. Hold and split forces along with the variability of hold force and duration and force rate during the split were measured.ResultsThe results of the study showed an increase in the magnitude of the hold force (P = 0.002), force rate during the split (P < 0.001) and a significant decrease in the duration of split (P < 0.001) due to the vibratory stimulus. However, there was no significant effect of the vibratory stimulus on the variability of hold forces (P = 0.879) or mean split force (P = 0.683) during the “hold and split” behavioral task. The results of experiment II also showed an increase in hold force due to the vibratory stimulus (P < 0.001).ConclusionsVibratory stimulus to the masseter muscles impairs the oral force control during a standardized biting task and provide further insight into the sensorimotor regulation of the masticatory system.     

Real‐time RF pulse adjustment for B0 drift correction

Although the magnetic field of an MR scanner is very stable under little or no load, it can become less stable under heavy‐duty cycle conditions, such as in diffusion tensor imaging (DTI). Uncorrected, such field drifts lead to an apparent image shift along the phase‐encoding direction and decreasing effectiveness of fat saturation pulses. A method is presented to adjust the center frequency of all RF pulses and the receiver in real time during the acquisition. No data postprocessing or changes to the sequence timing are necessary. In vivo acquisitions were performed to assess the prolonged effectiveness of fat saturation. Field drifts of approximately 2.5 Hz/min were measured and corrected during DTI acquisitions at b‐values of up to 3000 s/mm². The effectiveness of fat saturation diminished over the duration of an 18‐min acquisition when the drift was left uncorrected. The proposed method corrects for apparent image shift and ensures continuously effective fat saturation over the duration of an acquisition. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.     

State and output feedback design for robust tracking of linear systems with rate limited actuators

A design technique (Control of Uncertain Systems with Bounded Inputs, Tarbouriech S, Garcia G, (Eds), Lecture Notes in Control and Information Sciences, vol. 227 , Springer: Berlin, 1997; 173–186) recently proposed for stabilization of a linear system with rate‐limited actuators is utilized to design feedback laws that cause the system output to track a desired command signal. This design technique combines two design techniques recently developed for linear systems with position limited actuators, piecewise‐linear LQ control (Automatica, 1994; 30 : 403–416) and low‐and‐high gain feedback (IEEE Trans. Automat. Control, 1996; 41 : 368–378), and hence takes advantage of both design techniques, while avoiding their disadvantages. In the case that only the output is available for feedback, the performance of the state feedback law is preserved by the use of a fast observer. An open‐loop exponentially unstable fighter aircraft is used to demonstrate the effectiveness of the proposed control design method. Copyright © 2002 John Wiley & Sons, Ltd.     

随机系统的最小熵控制

本文放弃传统的MSE准则,从信息论观点出发,发展了随机系统的一种最小熵(ME)控制方法,并从ME控制的等价性、控制限度、存在性、唯一性及必要条件等方面,研究了ME控制的合理性和实用性。ME方法是一种全局分析法,它不仅包含了MSE和MAP准则,且由于全文在整个推导中并未假定高斯性、线性和非时变等,因而原则上适用于诸如非高斯、非线性、时变等传统方法难以处理的复杂系统;不仅适用于工程系统,将其推广到决策、社会、经济等领域会更为自然和切合实际。     

A Paradigm for Design of Closed Loop Neuromuscular Electrical Stimulator Control Systems

Abstract: The use of neuromuscular electrical stimulation (NMES) for rehabilitation of gait in spinal patients is widely known. The best results can be obtained with the use of biomechanical sensors and a closed loop NMES system. One of the biggest problems faced in the design of control systems for closed-loop operation, in gait rehabilitation, is the variation of the mechanical conditions during the phases of gait. This work presents a new approach to ease the design of rule-based closed loop systems for operation in conditions such as gait rehabilitation.     

FEEDBACK CONTROL OF A HEAT DIFFUSION SYSTEM WITH TIME-DEPENDENT SPATIAL DOMAIN

The problem of controlling the temperature distribution in a solid cylinder whose length varies with time and with one end in contact with a constant temperature medium is considered. This problem is motivated from that of controlling the temperature and thermal gradient inside a crystal pulled from a melt by the Czochralski method. Boundary feedback controls are derived by considering the time rate of change of a cost functional involving the deviations of both the solid temperature and its gradient from their desired values. The derived feedback controls consist of spatially distributed proportional-plus-rate and lag compensators and a non-linear feedback control involving the temperature gradient at the cylinder surface and the velocity of the spatial domain boundary. The resulting feedback-controlled system has the property that the cost functional along any motion decreases monotonically to zero with time. A numerical scheme for solving the partial differential equation of the feedback-controlled system is proposed. Typical numerical results on the dynamic behaviour of the feedback-controlled system obtained by means of the proposed scheme are presented.