We consider applications that require high rate, reliable message dissemination in a many-to-many environment. Examples of such applications include stock market centers and synchronized server clusters. As network capacity increases, the achievable throughput of messaging applications becomes bounded by processing times rather than communication speed. To reduce processing times we suggest the use of message aggregation. We consider performing message aggregation at either the sender, a message-server, or a network switch. The performance of each of these methods in terms of throughput and delay is analytically evaluated and compared against that of a naive implementation that does not perform message aggregation. We show that in typical real-world messaging applications, performing message aggregation can increase throughput by order of magnitude.We base our results on experiments that have been conducted using various operating systems running on different hardware platforms. Our results indicate that the achievable throughput of messaging applications is determined by the number of packets-per-second, rather than bytes-per-second, a receiver or a transmitter should handle.
The Emergency Department (ED) of a modern hospital is a highly complex system that gives rise to numerous managerial challenges. It spans the full spectrum of operational, clinical, and financial perspectives, over varying horizons: operational—a few hours or days ahead; tactical—weeks or a few months ahead; and strategic, which involves planning on monthly and yearly scales. Simulation offers a natural framework within which to address these challenges, as realistic ED models are typically intractable analytically. We apply a general and flexible ED simulator to address several significant problems that arose in a large Israeli hospital. The article focuses mainly, but not exclusively, on workforce staffing problems over these time horizons. First, we demonstrate that our simulation model can support real-time control, which enables short-term prediction and operational planning (physician and nurse staffing) for several hours or days ahead. To this end, we present a novel simulation-based technique that implements the concept of offered-load and discover that it performs better than a common alternative. Then we evaluate ED staff scheduling that adjusts for midterm changes (tactical horizon, several weeks or months ahead). Finally, we analyze the design and staffing problems that arose from physical relocation of the ED (strategic yearly horizon). Application of the simulation-based approach led to the implementation of our design and staffing recommendations.
The use of Extensible Markup Language (XML) to implement data sharing and semantic interoperability in healthcare and life sciences has become ubiquitous in recent years. Because in many areas there was no preexisting data format, XML has been readily embraced and is having a great impact. Biomedical data is very heterogeneous, varying from administrative information to clinical data, and recently to genomic data, making information exchange a great challenge. In particular, it is hard to achieve semantic interoperability among disparate and dispersed systems-a common constellation in the fragmented world of healthcare. Moreover, the emerging patient-centric and information-based medicine approach is posing another challenge-the development and use of an integrated health record for each patient. This means that diverse data from many systems has to be generated, integrated, and become available at the point of care. This paper presents the case that XML is becoming the integration ''glue'' for biomedical information interoperability, which can lead to improvements in pharmaceuticals, genomic-based clinical research, and personalized medicine, which, for the first time, can be fine-tuned to serve individuals through their longitudinal electronic health records.
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