基于多核处理器的PLC控制程序并行执行

针对可编程逻辑控制器（Programmable Logic Controller,PLC）的编程语言不支持程序的并行编译,无法使控制程序并行执行于多核处理器的问题,根据功能块图的可拆分性,提出了用有向无环图（Directed Acyclic Graph,DAG）任务模型表示PLC控制程序的方法,并采用静态列表任务调度算法,优化DAG中的任务节点在不同CPU核上的分配调度,解决了PLC控制程序并行执行时会遇到的通信延时问题。此外,针对变量资源的竞争问题提出了使用互斥量的方法。实验结果表明,此方法能有效地将PLC控制程序并行运行在多核处理器上,大大缩短了程序的执行时间。     

Optimal feedback solution of a constrained stochastic one-storage model

We describe a method for obtaining the optimal feedback solution to a constrained discrete time linear-quadratic optimal control problem. The dimensions of the state and control vectors are one and the stochasticity is represented by a finite number of possible outcomes at each stage. The method is based on dynamic programming and exploits that the optimal value is piecewise quadratic and that the optimal feedback solution is piecewise linear. Also the special case with linear criterion function is considered. Approximation methods which allow a trade-off between computation times and solution accuracy are discussed. The method is applied to two cases, viz., hydropower scheduling and temperature control of a greenhouse. Comparative studies on these two cases were made with a mathematical programming formulation solved by a standard code. On the cases studied the new method was found to be around 100 times faster and to display a better solution stability. © 1997 John Wiley & Sons, Ltd.     

Nurse staffing and quality of care in UK general practice: cross-sectional study using routinely collected data

Background

In many UK general practices, nurses have been used to deliver results against the indicators of the Quality and Outcomes Framework (QOF), a ‘pay for performance’ scheme.

Aim

To determine the association between the level of nurse staffing in general practice and the quality of clinical care as measured by the QOF.

Design of the study

Cross-sectional analysis of routine data.

Setting

English general practice in 2005/2006.

Method

QOF data from 7456 general practices were linked with a database of practice characteristics, nurse staffing data, and census-derived data on population characteristics and measures of population density. Multi-level modelling explored the relationship between QOF performance and the number of patients per full-time equivalent nurse. The outcome measures were achievement of quality of care for eight clinical domains as rated by the QOF, and reported achievement of 10 clinical outcome indicators derived from it.

Results

A high level of nurse staffing (fewer patients per full-time equivalent practice-employed nurse) was significantly associated with better performance in 4/8 clinical domains of the QOF (chronic obstructive pulmonary disease, coronary heart disease, diabetes, and hypertension, P = 0.004 to P<0.001) and in 4/10 clinical outcome indicators (diabetes: glycosylated haemoglobin [HbA_1C] ≤7.4%, HbA_1C ≤10% and total cholesterol ≤193 mg/dl; and stroke: total cholesterol ≤5 mmol/L, P = 0.0057 to P<0.001).

Conclusion

Practices that employ more nurses perform better in a number of clinical domains measured by the QOF. This improved performance includes better intermediate clinical outcomes, suggesting real patient benefit may be associated with using nurses to deliver care to meet QOF targets.     

医院中心导管室护士排班的实践探讨

随着医院导管室规模的扩大和诊疗患者的增加,护士的工作压力进一步加大,合理有效的排班机制是缓解护士的工作压力和提高工作效率的办法之一.文章以患者需求和医院人力资源情况为依据,总结了原有全夜班、弹性排班、APN排班等低信息化手工排班的缺点,建立了基于ILP模型的、具有强弱约束条件的护士排班方法,取得了良好的实践效果.     

Scheduling GnRH antagonist cycles by a short course of oral estradiol administration during early follicular phase: a comparative study with non-scheduled cycles

Abstract

This hypothesis generating study investigated whether GnRH antagonist cycles can be scheduled by a short course of oral estradiol administration during the follicular phase without impairing treatment outcome. Thirty-five women who underwent follicular phase estrogen scheduling (ES) of GnRH antagonist cycles were retrospectively matched for age and number of prior failed cycles with 35 women who underwent unscheduled GnRH antagonist cycles. ES group was given 6?mg/day estradiol orally from cycle day 2 until (including) one day before the scheduled start of stimulation. Gonadotropins were started on cycle days 2–3 in the control group. Flexible GnRH antagonist protocol was employed in both groups. ES group received estradiol for a median of 5 days. Total gonadotropin consumption was similar but one more GnRH antagonist injection was required in the ES group. Endometrial thickness on the day of hCG injection was increased in the ES group (12 versus 10?mm, p?<?0.01). Number of oocytes, metaphase II oocytes and transferred embryos were similar. Embryo implantation rates were 44.8% versus 34.4% (p?=?0.3), and clinical pregnancy rates were 48.6% versus 37.1%, (p?=?0.33) in the ES and control groups, respectively. All women in the ES group had oocyte retrieval and embryo transfer within the desired period.     

儿科病房连续性层级排班与普通排班的效果比较

目的 比较儿科病房连续性层级排班与普通排班的效果,以探讨连续性层级排班的优越性.方法 执行连续性层级排班,即三班制,保证每班有充足的护士及时为患儿提供全方位的护理.结果 连续性从级排班可提高护理质量,缩短患儿住院时间,缓解护患关系,从而提高患者满意度.两种排班方法比较差异具有统计学意义（x2=13.594,P＜0.05）.结论 连续性层级排班可有效提高护理质量,值得临床上推广.     

连续性排班模式优化全院护士分层级管理

目的探讨连续性排班模式对深化护士层级管理、提高护理质量的临床效果和可行性。方法在传统护士层级管理的基础上,全院推行新的连续性排班模式。在病区护士长的统一领导下,重新调整护士岗位和职责,设立早班、晚班和夜班组长,并逐级下设责任护士和助理护士,重组和细化工作职责和流程,分层级使用护士,合理使用有限人力,使护理工作从护士单独履行转变为责任小组共同完成;观察和比较连续性排班模式的护士认同度以及对护理质量和临床事件的影响。结果连续性排班模式与传统排班模式相比,能更好地发挥各级护士的主观能动性,增强其工作责任感,显著提高工作效率和护理质量;明显提高护理工作安全度和护士认同度;强化医护和护患之间的沟通,显著减少护理纠纷和各类临床事件的发生,提高危重患者的抢救成功率。结论连续性排班模式能优化护士层级的科学管理,合理利用有限人力资源,增强各级护士的工作责任心,提高工作效率和护理质量,显著改善患者的临床治疗效果。     

改进护士排班方法的实践与体会

目的改进护士排班方法,提高护理质量。方法采取护士自愿报名,相对固定夜班、白班护士的排班方式。结果护理工作质量达到三级甲等医院标准,服务满意度从原来的90%上升到98%,98%的护士支持排班改进方法。结论改进后的护士排班方法,护士乐于接受,病人满意率增加,同时,缓解了临床护士相对不足的问题,保证了整体护理质量。     

医院护理排班对护士身心社灵健康的影响

目的 探讨医院护理排班对护士身心社灵健康的影响.方法 采用医院护理排班问卷和身心社灵健康量表对334名护士进行调查.结果 护士对医院护理排班的认可率为51.80％～86.83％,认可率最低的条目是护士人数充足;对护理排班满意和非常满意占79.94％;护士的身心社灵健康评分为(6.30±1.28)分;护士对医院护理排班的认可率及满意程度不同,其身心社灵健康评分存在统计学差异(均P＜0.01).结论 护士对医院护理排班的满意度及认可情况还有待提高,医院护理排班对护士身心社灵健康有影响;改善医院护理排班可以提高护士身心社灵健康状况.     

Flexible analytic model to inform multi-stakeholder pediatric vaccine scheduling decisions

BackgroundPediatric immunization is important for preventing potentially life-threatening diseases in children. Over time, the number of recommended pediatric vaccines has increased and is likely to increase further as new vaccines are developed. Given the different number of doses for available vaccines and various constraints (e.g., the appropriate age for each dose of a vaccine or the time between doses), it is challenging to develop a recommended vaccination schedule or a catch-up schedule when a child falls behind on one or more vaccinations.MethodsWe developed an integer programming optimization model, enabled by Python programming and embedded into an Excel-based decision tool, to recommend childhood vaccination schedules or personalized catch-up schedules. The model recommends a vaccination schedule that balances the goal of being as close as possible to the clinically-indicated dosing schedules and the goal of minimizing clinic visits, and gives users the ability to trade off between these two goals. We illustrated the broad applicability of our proposed model with commonly-faced vaccine scheduling challenges in the United States.ResultsThe illustrative computational case study confirms our model’s ability to create personalized schedules based on each child’s age and vaccination history, and to adjust appropriately when a new vaccine becomes available.ConclusionsThe model presented in this paper fills the need for an easy-to-use tool to recommend vaccination schedules for de novo and catch-up purposes. It provides straightforward recommendations that can be easily used by physicians, is flexible to handle the requirements varying by region, and can be updated as new vaccines are approved for use.