Building a tiered rehabilitation system: the case of Yunnan Province

Research purposes: The hierarchical rehabilitation system model of Yunnan Province is built to provide a reference for the establishment of a standardized three-level rehabilitation system so as to meet the patient demands for different functional rehabilitation at different stages during the whole treatment. Research methods: 1. The General System Theory model is adopted as a guidance for the organizational structure construction of the hierarchical rehabilitation system model in rehabilitation centers, rehabilitation sub-centers, and rehabilitation stations in Yunnan Province. Standardized hierarchical rehabilitation hardware construction for these rehabilitation institutions of different levels helps form an exemplary structural model of a three-level standardized rehabilitation system. 2. The Learning Cycle Theory model is adopted as a guidance for the unified standardized training for patient rehabilitation management in the exemplary rehabilitation institutions of the three-level system. The researchers regularly guide, supervise, and summarize the standard implementation situations of patient rehabilitation management in these institutions and assess the operational quality and management efficiency of the hierarchical rehabilitation system model in Yunnan Province, finally forming the exemplary and standardized three-level rehabilitation system model. 3. The researchers analyze the operating parameters of the medical institutions at all levels in the three-level standardization rehabilitation system and evaluate the structural process and operational efficiency of the three-level standardized rehabilitation system model based on the analysis results.O modelo do sistema de reabilitação hierárquico da Província Yunnanfoi concebido comoumreferencial para a implementação de um sistema de reabilitação estruturado em três níveis, de modo a responder às necessidades dos doentes nas diferentes fases da sua reabilitação funcional. Como guias metodológicos foram adotadosa Teoria Geral dos Sistemas e o LearningCycleTheory, entre outros contributos teóricos considerados relevantes. Os investigadores participantes supervisionaram a operacionalização do sistema e avaliaram as instituições de cada um dos três níveis, quanto àestrutura, ao processo e à eficiência operacional. Quanto aos resultados houve uma clara perceção dos ganhos obtidos em várias dimensões. Pelo lado das instituições governamentais, pela redução dos recursos utilizados e pela maior mobilização e empenhamento dos profissionais e por parte dos doentes, pela maior rapidez de resposta às suas necessidades e a uma redução do tempo da sua reintegração no mercado de trabalho. A reputação deste sistema implicoutambém ganhos significativos nas receitas obtidas, que aumentaram em mais de 10% em dois anos, tendo mesmo algumas serviços atingido incrementos de 89,6%. A mudança de cultura organizacional das instituições envolvidas,no sentido da inovação e da proatividadeé também um facto a reter com particular relevância. Como conclusão, poderemos referir que este modelorespondeu as expectativas de todos os stakeholders, desde o governo, aos doentes e ao público em geral, bem assim como às das instituições de saúde implicadas e os seus profissionais. Deste modo, este modelo pode fornecer contributos sustentados de aprendizagem para a conceção e implementação de sistemas de reabilitação regional de um modo rápido e estruturado

Modified evolution of stellar binaries from supermassive black hole binaries

The evolution of main sequence binaries resided in the galactic centre is influenced a lot by the central super massive black hole (SMBH). Due to this perturbation, the stars in a dense environment are likely to experience mergers or collisions through secular or non-secular interactions. In this work, we study the dynamics of the stellar binaries at galactic center, perturbed by another distant SMBH. Geometrically, such a four-body system is supposed to be decomposed into the inner triple (SMBH-star-star) and the outer triple (SMBH-stellar binary-SMBH). We survey the parameter space and determine the criteria analytically for the stellar mergers and the tidal disruption events (TDEs). For a relative distant and equal masses SMBH binary, the stars have more opportunities to merge as a result from the Lidov-Kozai(LK) oscillations in the inner triple. With a sample of tight stellar binaries, our numerical experiments reveal that a significant fraction of the binaries, ~70 per cent, experience merger eventually. Whereas the majority of the stellar TDEs are likely to occur at a close periapses to the SMBH, induced by the outer Kozai effect. The tidal disruptions are found numerically as many as ~10 per cent for a close SMBH binary that is enhanced significantly than the one without the external SMBH. These effects require the outer perturber to have an inclined orbit (>=40 degree) relatively to the inner orbital plane and may lead to a burst of the extremely astronomical events associated with the detection of the SMBH binary.Comment: 12 pages, 9 figures, MNRAS in pres

Base-isolation design of single-tower cable-stayed bridges: a case study in meizoseismal area

The single-tower cable-stayed bridge is one of the most popular types of bridges. Seismic design for this type of bridge, however, is rather difficult. When subjected to longitudinal earthquakes, the tower stands as the weakest part of all the bridge components. To solve this problem, a base-isolation design was developed and adopted for a practical single-tower cable-stayed bridge. In this design, laminated elastomeric bearings (EB) and liquid viscous dampers (LVD) were installed to serve as a base-isolation layer inside the tower cap. Numerical analysis was then conducted to investigate the variations of dynamic characteristics and seismic responses between conventional designs and base-isolation designs. LVD were used on the top of the transition pier to optimize the seismic system of the bridge. It was found that: i) the seismic loads acting on the bridge component were reduced as the seismic displacements increased. This was the result of amplification of the bridge vibration period by the EB in the base-isolation layer; ii) the seismic displacements were restrained by the LVD in the base-isolation layer, but the seismic forces increased due to improper parameter values; and iii) the seismic response decreased further by the transition pier’s LVD

Multi-dimensional key generation of ICMetrics for cloud computing

Despite the rapid expansion and uptake of cloud based services, lack of trust in the provenance of such services represents a significant inhibiting factor in the further expansion of such service. This paper explores an approach to assure trust and provenance in cloud based services via the generation of digital signatures using properties or features derived from their own construction and software behaviour. The resulting system removes the need for a server to store a private key in a typical Public/Private-Key Infrastructure for data sources. Rather, keys are generated at run-time by features obtained as service execution proceeds. In this paper we investigate several potential software features for suitability during the employment of a cloud service identification system. The generation of stable and unique digital identity from features in Cloud computing is challenging because of the unstable operation environments that implies the features employed are likely to vary under normal operating conditions. To address this, we introduce a multi-dimensional key generation technology which maps from multi-dimensional feature space directly to a key space. Subsequently, a smooth entropy algorithm is developed to evaluate the entropy of key space

3-Allyl-1-(2-cyano­benz­yl)-2-methyl­benzimidazol-3-ium bromide

In the title compound, C19H18N3 +·Br−, both the allyl and cyano­phenyl groups are approximately perpendicular to the central benzimidazole unit, making dihedral angles of 89.7 (2) and 85.09 (13)°, respectively. The crystal packing is dominated by C—H⋯Br inter­actions, with each anion inter­acting with five neighboring cations