Appointment scheduling at a multidisciplinary outpatient clinic using stochastic programming

The purpose of this paper is to investigate the problem of constructing an appointment template for scheduling patients at a specific type of multidisciplinary outpatient clinic called an integrated practice unit (IPU). The focus is on developing and solving a stochastic optimization model for a back pain IPU in the face of random arrivals, an uncertain patient mix, and variable service times. The deterministic version of the problem is modeled as a mixed integer program with the objective of minimizing a weighted combination of clinic closing time (duration) and total patient waiting time (length of stay). A two‐stage stochastic program is then derived to account for the randomness and the sequential nature of the decisions. Although it was not possible to solve the two‐stage problem for even a limited number of scenarios, the wait‐and‐see (WS) problem was sufficiently tractable to provide a lower bound on the stochastic solution. The introduction of valid inequalities, limiting indices, and the use of special ordered sets helped to speed up the computations. A greedy heuristic was also developed to obtain solutions much more quickly. Out of practical considerations, it was necessary to develop appointment templates with time slots at fixed intervals, which are not available from the WS solution. The first to be derived was the expected value (EV) template that is used to find the expected value of the EV solution (EEV). This solution provides an upper bound on the objective function value of the two‐stage stochastic program. The average gap between the EEV and WS solutions was 18%. Results from extensive computational testing are presented for the EV template and for our adaptation of three other templates found in the literature. Depending on the relative importance of the two objective function metrics, the results demonstrate the trade‐off that exists between them. For the templates investigated, the “closing time” ranged from an average of 235 to 275 minutes for a 300‐minute session, while the corresponding “total patient time in clinic” ranged from 80 to 71 minutes.     

长向量处理器高效RNN推理方法

模型深度的不断增加和处理序列长度的不一致对循环神经网络在不同处理器上的性能优化提出巨大挑战。针对自主研制的长向量处理器FT-M7032,实现了一个高效的循环神经网络加速引擎。该引擎采用行优先矩阵向量乘算法和数据感知的多核并行方式,提高矩阵向量乘的计算效率;采用两级内核融合优化方法降低临时数据传输的开销;采用手写汇编优化多种算子,进一步挖掘长向量处理器的性能潜力。实验表明,长向量处理器循环神经网络推理引擎可获得较高性能,相较于多核ARM CPU以及Intel Golden CPU,类循环神经网络模型长短记忆网络可获得最高62.68倍和3.12倍的性能加速。     

Amphetamines,Cognitive Enhancement and their Implications for Medical Military Ethics

ABSTRACT

The growing area of military bio-technologies, especially the use of cogniceuticals, raises several ethical concerns for military physicians. These include the role of military physicians in prescribing amphetamines whose long-term effects are largely unknown, and the possible undermining of the ethic of “do no harm,” since amphetamines may diminish a soldier’s moral responsibility. Below, we outline some important questions relating to the ethics of amphetamines and medical military physicians.     

Ireland: rebellion and counter-insurgency, 1848–1867

ABSTRACT

The period 1848 to 1867 witnessed what could be regarded as a very small-scale insurgency campaign in Ireland, waged by agrarian groups; the Whiteboys and Ribbonmen. 1848 and 1867 witnessed rebellions by the Young Irelanders and Fenians, which proved to be small-scale and of short duration but the British government had prepared for a nationwide counter-insurgency campaign. The government relied heavily on the militarised Irish Constabulary but in 1848 and 1867 troops were used in large numbers and there were concerns about how they could be best concentrated to meet the envisaged threat.