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r
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s
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v
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an
d
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co
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[
1
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.
Ser
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co
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p
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en
a
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[
2
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.
Mic
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Ar
ch
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ap
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Mic
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Evaluation Warning : The document was created with Spire.PDF for Python.
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4
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T
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[
2
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[
5
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.
T
h
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I
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T
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m
e
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t
is
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ly
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tab
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[
6
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.
A
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s
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in
co
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d
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b
y
th
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d
ev
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[
7
]
.
A
t
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c
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r
f
u
n
c
t
i
o
n
a
l
it
y
,
c
a
u
s
i
n
g
a
c
o
m
b
i
n
at
o
r
i
a
l
e
x
p
l
o
s
i
o
n
[
2
]
.
T
r
ad
itio
n
al
ce
n
tr
alize
d
s
er
v
ic
e
co
m
p
o
s
itio
n
tech
n
iq
u
es
ar
e
in
s
u
f
f
icien
t
f
o
r
ap
p
licatio
n
s
in
h
ig
h
ly
d
y
n
am
ic
an
d
o
p
en
en
v
ir
o
n
m
en
ts
s
u
ch
as
th
e
I
o
T
.
T
h
er
e
is
a
n
ee
d
f
o
r
d
ec
en
tr
alize
d
m
o
d
els
th
at
ca
n
ef
f
ec
tiv
ely
ad
ap
t
t
o
th
ese
h
ig
h
ly
d
y
n
am
ic
an
d
o
p
e
n
en
v
ir
o
n
m
e
n
ts
.
Self
-
o
r
g
an
izatio
n
is
a
well
-
k
n
o
wn
b
o
tto
m
-
u
p
a
p
p
r
o
ac
h
th
at
s
u
p
p
o
r
ts
th
e
h
ig
h
ly
d
y
n
a
m
ic
an
d
o
p
en
n
atu
r
e
o
f
th
e
I
o
T
e
n
v
ir
o
n
m
e
n
t
[
8
]
.
T
h
is
r
esear
ch
p
r
o
p
o
s
es
a
s
elf
-
o
r
g
an
izin
g
m
ic
r
o
s
er
v
ice
c
o
m
p
o
s
itio
n
m
o
d
el
f
o
r
t
h
e
I
o
T
ec
o
s
y
s
tem
to
f
ac
ilit
ate
s
er
v
ice
co
m
p
o
s
itio
n
in
th
ese
co
m
p
le
x
en
v
ir
o
n
m
en
ts
.
S
o
m
e
o
f
th
e
f
ea
tu
r
es
o
f
s
elf
-
o
r
g
an
izi
n
g
s
er
v
ice
co
m
p
o
s
itio
n
ar
e
t
h
at
th
e
in
ter
ac
tio
n
s
am
o
n
g
t
h
e
s
er
v
ices
a
r
e
d
ec
en
tr
alize
d
an
d
l
o
ca
l,
e
n
a
b
led
b
y
b
io
-
in
s
p
ir
e
d
m
ec
h
an
is
m
s
,
with
o
u
t
th
e
n
e
ed
f
o
r
a
ce
n
tr
alize
d
c
o
n
tr
o
l
ler
,
an
d
th
e
s
er
v
ice
co
m
p
o
s
itio
n
is
d
y
n
am
ic
(
at
r
u
n
tim
e)
,
an
d
ad
ap
ts
to
s
er
v
ice
f
ailu
r
es.
T
h
er
e
is
au
to
n
o
m
o
u
s
a
n
d
s
p
o
n
tan
eo
u
s
in
ter
ac
tio
n
am
o
n
g
th
e
s
er
v
ices,
en
ab
lin
g
im
p
r
o
v
ed
r
esp
o
n
s
e
an
d
s
ca
lab
ilit
y
,
a
n
d
s
u
p
p
o
r
t
f
o
r
em
er
g
en
t
b
e
h
av
io
r
,
i.e
.
,
a
c
o
m
p
o
s
ite
s
er
v
ice
is
f
o
r
m
e
d
t
h
r
o
u
g
h
th
e
b
io
-
i
n
s
p
ir
ed
m
ec
h
an
is
m
s
an
d
co
n
tin
u
o
u
s
lea
r
n
in
g
.
T
h
e
s
er
v
ices
also
au
to
n
o
m
o
u
s
ly
r
e
o
r
g
a
n
ize
in
r
e
s
p
o
n
s
e
to
ch
a
n
g
in
g
en
v
ir
o
n
m
e
n
tal
co
n
d
itio
n
s
an
d
wo
r
k
l
o
ad
v
ar
iatio
n
s
[
9
]
.
T
h
e
r
esear
ch
p
r
esen
ts
a
d
ec
e
n
tr
alize
d
an
d
au
t
o
n
o
m
o
u
s
m
i
cr
o
s
er
v
ice
co
m
p
o
s
itio
n
m
o
d
el
s
elf
-
o
r
g
a
n
izin
g
m
icr
o
s
er
v
ices
u
s
in
g
in
tellig
en
t
lear
n
in
g
(
SMI
L
)
m
o
d
el
th
at
en
ab
les
d
ec
en
t
r
alize
d
an
d
au
t
o
n
o
m
o
u
s
m
icr
o
s
er
v
ice
in
ter
ac
tio
n
s
th
r
o
u
g
h
b
io
-
in
s
p
ir
ed
m
ec
h
an
i
s
m
s
f
o
r
ad
ap
tiv
e
an
d
s
elf
-
o
r
g
an
izin
g
s
er
v
ice
co
m
p
o
s
itio
n
.
T
h
e
ce
n
tr
al
c
o
m
p
o
n
en
t
o
f
th
is
m
o
d
el
is
th
e
s
elf
-
o
r
g
a
n
izin
g
B
I
OC
OR
E
,
wh
ich
is
d
ev
elo
p
e
d
an
d
im
p
lem
en
ted
th
r
o
u
g
h
a
s
elf
-
o
r
g
an
izin
g
m
a
p
(
SOM)
to
em
u
late
th
e
b
io
-
in
s
p
ir
ed
m
ec
h
a
n
is
m
s
o
f
s
p
r
ea
d
in
g
,
ev
ap
o
r
atio
n
,
ag
g
r
eg
atio
n
,
a
n
d
b
o
n
d
in
g
to
en
a
b
le
em
er
g
e
n
t
s
elf
-
o
r
g
an
izatio
n
.
T
h
is
u
n
s
u
p
er
v
is
ed
lear
n
in
g
ap
p
r
o
ac
h
is
c
o
m
b
in
e
d
with
a
d
ee
p
lear
n
in
g
ag
e
n
t
th
at
en
ab
l
es
th
e
m
o
d
el
t
o
c
o
m
p
o
s
e
v
ali
d
s
er
v
ice
s
eq
u
en
ce
s
th
at
ad
ap
t
d
y
n
am
ically
at
r
u
n
t
im
e.
B
y
f
o
cu
s
in
g
o
n
th
ese
d
i
m
en
s
io
n
s
,
th
is
r
esear
c
h
aim
s
to
en
h
an
ce
r
esp
o
n
s
e
tim
e,
m
in
im
ize
s
er
v
ice
f
ail
u
r
e
,
an
d
en
h
an
ce
n
eo
n
atal
h
ea
lth
ca
r
e
o
u
tco
m
es.
T
h
e
a
p
p
licab
il
ity
o
f
th
is
wo
r
k
is
h
ig
h
lig
h
ted
b
y
a
r
ec
en
t
UN
r
ep
o
r
t
[
1
0
]
,
w
h
ich
p
o
s
itio
n
s
I
n
d
ia
am
o
n
g
th
e
t
o
p
f
iv
e
n
ati
o
n
s
with
th
e
h
ig
h
est
n
u
m
b
er
o
f
p
r
eter
m
b
ir
th
s
,
r
ef
l
ec
tin
g
th
e
co
m
p
ellin
g
n
ee
d
f
o
r
ef
f
icien
t a
n
d
in
n
o
v
ativ
e
n
e
o
n
atal
ca
r
e
s
o
lu
tio
n
s
.
T
h
e
r
est
o
f
th
is
p
ap
er
is
d
i
v
id
ed
as
f
o
llo
ws:
s
ec
tio
n
2
d
elv
es
in
to
th
e
liter
atu
r
e
o
v
er
v
iew
o
n
s
elf
-
o
r
g
an
izatio
n
an
d
r
ec
en
t
s
er
v
ice
c
o
m
p
o
s
itio
n
m
o
d
e
ls
an
d
f
r
am
ewo
r
k
s
.
Sectio
n
3
d
escr
ib
es
th
e
s
elf
-
o
r
g
an
izin
g
m
icr
o
s
er
v
ice
co
m
p
o
s
itio
n
m
o
d
el
,
its
co
m
p
o
n
en
ts
,
an
d
th
e
s
er
v
ice
co
m
p
o
s
itio
n
p
r
o
ce
s
s
.
Sectio
n
4
ex
p
lain
s
th
e
ex
p
er
im
en
tal
s
etu
p
,
s
im
u
latio
n
o
u
tco
m
es,
an
d
p
er
f
o
r
m
an
ce
e
v
a
lu
atio
n
.
Sectio
n
5
co
n
clu
d
es
th
e
p
ap
e
r
an
d
s
u
g
g
ests
p
o
s
s
ib
le
f
u
tu
r
e
en
h
a
n
ce
m
en
ts
.
T
h
is
r
esear
ch
m
a
k
es
an
I
o
T
-
d
r
i
v
en
h
ea
lth
ca
r
e
co
n
tr
ib
u
tio
n
b
y
i
n
tr
o
d
u
ci
n
g
a
s
ca
lab
le,
ad
a
p
tiv
e,
an
d
in
tellig
en
t
s
er
v
ice
c
o
m
p
o
s
itio
n
m
o
d
el,
u
ltima
tely
im
p
r
o
v
in
g
n
eo
n
atal
h
ea
lth
ca
r
e
o
u
tco
m
es a
n
d
I
o
T
-
b
ased
h
ea
lth
ca
r
e
s
er
v
ices.
2.
RE
L
AT
E
D
WO
RK
T
h
e
n
atu
r
e
o
f
an
I
o
T
en
v
ir
o
n
m
en
t
is
in
h
er
en
tly
o
p
en
an
d
d
y
n
am
ic,
m
ak
in
g
it
v
u
ln
er
ab
le
to
n
etwo
r
k
in
s
tab
ilit
y
an
d
p
o
ten
tial
s
er
v
ice
f
ailu
r
e.
Ad
d
itio
n
ally
,
wh
en
th
e
s
er
v
ices
ar
e
co
m
p
o
s
ed
(
ad
d
ed
in
to
th
e
wo
r
k
f
lo
w)
d
u
r
in
g
d
esig
n
tim
e
,
s
o
m
e
o
f
th
e
s
elec
ted
s
er
v
ices
m
ay
n
o
t
b
e
av
ailab
le
d
u
r
in
g
r
u
n
tim
e,
lead
in
g
to
th
e
co
m
p
lete
f
ailu
r
e
o
f
th
e
co
m
p
o
s
itio
n
.
I
n
c
o
n
tr
ast,
s
elf
-
o
r
g
a
n
izin
g
s
er
v
ice
c
o
m
p
o
s
itio
n
d
y
n
am
ically
co
m
p
o
s
es
s
er
v
ices
th
at
ar
e
p
r
o
v
id
e
d
b
y
I
o
T
d
ev
ices,
s
u
itin
g
th
e
o
p
en
n
at
u
r
e
o
f
th
e
I
o
T
s
y
s
tem
.
T
h
e
a
d
v
an
tag
es o
f
s
elf
-
o
r
g
an
izin
g
s
er
v
ice
co
m
p
o
s
itio
n
ar
e
th
at
it
en
ab
les ad
ap
tiv
e
s
er
v
ice
co
m
p
o
s
itio
n
,
en
h
an
cin
g
s
ca
lab
ilit
y
.
I
t
im
p
r
o
v
es
th
e
s
er
v
ice
ex
ec
u
tio
n
,
esp
ec
ially
i
n
d
y
n
am
ic
en
v
ir
o
n
m
en
ts
,
en
s
u
r
in
g
ef
f
icien
t
an
d
r
eliab
le
p
er
f
o
r
m
an
ce
.
Self
-
o
r
g
an
izin
g
m
ec
h
an
is
m
s
m
im
ic
b
io
lo
g
ical
an
d
p
h
y
s
ical
p
r
o
ce
s
s
es
th
at
ar
e
o
b
s
er
v
ab
le
i
n
n
atu
r
e.
Self
-
o
r
g
an
izatio
n
h
as
b
ee
n
a
p
p
lied
t
o
a
m
u
ltit
u
d
e
o
f
tech
n
o
lo
g
ical
ap
p
licatio
n
s
.
W
ith
th
e
r
is
e
o
f
cy
b
e
r
-
p
h
y
s
ical
an
d
au
to
m
ate
d
s
y
s
tem
s
,
r
esear
c
h
in
s
elf
-
o
r
g
a
n
izatio
n
h
as
g
ai
n
ed
m
u
ch
i
n
ter
est.
Ho
wev
er
,
th
e
im
p
lem
e
n
tatio
n
o
f
s
elf
-
o
r
g
an
izatio
n
in
s
er
v
ice
co
m
p
o
s
itio
n
h
as
n
o
t
y
et
r
ea
ch
ed
its
f
u
ll
p
o
ten
tial.
An
in
itial
s
u
r
v
ey
o
f
s
elf
-
o
r
g
an
izatio
n
an
d
s
er
v
ice
co
m
p
o
s
itio
n
h
as
g
iv
en
in
s
ig
h
ts
th
at
m
eth
o
d
s
f
o
r
s
elf
-
o
r
g
an
izatio
n
an
d
its
p
atter
n
s
h
av
e
ex
is
ted
in
tec
h
n
o
lo
g
ic
al
ap
p
licatio
n
s
f
o
r
a
f
ew
d
ec
a
d
es.
A
liter
atu
r
e
s
u
r
v
ey
was
co
n
d
u
cted
u
s
in
g
th
e
k
ey
wo
r
d
s
“
s
elf
-
o
r
g
an
izatio
n
,
”
“self
-
o
r
g
an
izin
g
,
”
“self
-
ev
o
lv
in
g
,
”
“self
-
a
d
ap
tiv
e,
”
“ser
v
ice
co
m
p
o
s
itio
n
,
”
a
n
d
“self
-
co
m
p
o
s
iti
o
n
.
”
B
ased
o
n
th
is
s
ea
r
ch
,
5
0
r
elev
an
t
p
a
p
er
s
p
u
b
lis
h
ed
b
etwe
en
2
0
1
4
a
n
d
2
0
2
4
wer
e
id
en
tifie
d
an
d
an
aly
ze
d
.
T
h
e
m
eth
o
d
o
lo
g
ies
em
p
lo
y
ed
f
o
r
d
ev
elo
p
in
g
s
elf
-
o
r
g
an
izin
g
s
y
s
tem
s
ar
e
illu
s
tr
ated
in
Fig
u
r
e
1
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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m
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[
6
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I
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t
r
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G
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1
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[
1
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
5
2
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8
9
3
8
I
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t J Ar
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tell
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15
,
No
.
2
,
Ap
r
il
20
26
:
109
7
-
1
1
0
8
1100
n
ee
d
f
o
r
f
u
r
th
e
r
r
esear
ch
in
th
is
d
o
m
ain
.
T
h
e
co
n
tr
i
b
u
tio
n
s
o
f
th
e
p
r
o
p
o
s
ed
m
o
d
el
in
c
o
m
p
ar
is
o
n
with
th
e
ex
is
tin
g
ap
p
r
o
ac
h
es h
av
e
b
ee
n
p
r
esen
ted
in
T
a
b
le
2
.
T
ab
le
2.
C
o
n
tr
i
b
u
t
i
o
n
o
f
th
e
p
r
o
p
o
s
ed
m
o
d
el
v
s
.
ex
is
tin
g
m
o
d
e
l
s
F
e
a
t
u
r
e
Ex
i
s
t
i
n
g
m
o
d
e
l
s
P
r
o
p
o
se
d
m
o
d
e
l
Le
a
r
n
i
n
g
a
p
p
r
o
a
c
h
P
u
r
e
r
e
i
n
f
o
r
c
e
me
n
t
l
e
a
r
n
i
n
g
i
s
u
se
d
i
n
[
1
0
]
,
[
1
1
]
.
R
u
l
e
-
b
a
se
d
sy
s
t
e
ms
s
u
c
h
a
s
[
6
]
f
a
c
e
c
o
l
d
-
st
a
r
t
a
n
d
sl
o
w
c
o
n
v
e
r
g
e
n
c
e
.
H
y
b
r
i
d
l
e
a
r
n
i
n
g
:
c
o
m
b
i
n
e
s
u
n
su
p
e
r
v
i
se
d
l
e
a
r
n
i
n
g
a
n
d
r
e
i
n
f
o
r
c
e
me
n
t
l
e
a
r
n
i
n
g
e
n
a
b
l
i
n
g
f
a
st
e
r
c
o
n
v
e
r
g
e
n
c
e
a
n
d
a
d
a
p
t
i
v
e
b
o
n
d
i
n
g
.
Emerg
e
n
c
e
a
n
d
se
l
f
-
o
r
g
a
n
i
z
a
t
i
o
n
Emerg
e
n
t
b
e
h
a
v
i
o
r
i
s
d
i
sc
u
sse
d
c
o
n
c
e
p
t
u
a
l
l
y
i
n
[
1
3
]
,
[
1
4
]
.
T
h
e
r
e
i
s
n
o
r
e
a
l
-
t
i
m
e
l
e
a
r
n
i
n
g
o
r
r
u
n
t
i
me
e
v
a
l
u
a
t
i
o
n
.
F
o
r
mat
i
o
n
o
f
e
f
f
e
c
t
i
v
e
e
m
e
r
g
e
n
t
p
a
t
t
e
r
n
s
a
i
d
e
d
b
y
S
O
M
a
n
d
r
e
i
n
f
o
r
c
e
m
e
n
t
l
e
a
r
n
i
n
g
a
t
r
u
n
t
i
me.
C
o
mm
u
n
i
c
a
t
i
o
n
a
n
d
n
a
t
u
r
e
-
i
n
s
p
i
r
e
d
o
p
t
i
m
i
z
a
t
i
o
n
S
p
r
e
a
d
i
n
g
c
a
u
ses
t
h
e
r
i
s
k
o
f
n
e
t
w
o
r
k
f
l
o
o
d
i
n
g
(
o
b
s
e
r
v
e
d
i
n
[
1
1
]
,
[
1
2
]
)
.
S
t
i
g
merg
i
c
o
p
t
i
mi
z
a
t
i
o
n
i
s
u
se
d
i
n
[
1
6
]
.
T
h
e
s
e
st
r
a
t
e
g
i
e
s
a
r
e
n
o
t
a
p
p
l
i
e
d
t
o
h
e
a
l
t
h
c
a
r
e
.
Th
e
a
n
t
a
g
e
n
t
u
se
s
p
h
e
r
o
mo
n
e
st
r
a
t
e
g
i
e
s
t
o
o
p
t
i
m
i
z
e
b
i
o
-
i
n
s
p
i
r
e
d
mec
h
a
n
i
sm
s,
r
e
d
u
c
i
n
g
n
e
t
w
o
r
k
a
n
d
c
o
m
p
u
t
a
t
i
o
n
a
l
o
v
e
r
l
o
a
d
.
A
g
e
n
t
-
b
a
se
d
a
r
c
h
i
t
e
c
t
u
r
e
M
u
l
t
i
-
a
g
e
n
t
s
y
st
e
ms
a
r
e
u
se
d
f
o
r
d
i
s
t
r
i
b
u
t
e
d
c
o
n
t
r
o
l
[
1
0
]
,
[
1
5
]
,
[
1
6
]
,
[
1
8
]
.
M
i
c
r
o
s
e
r
v
i
c
e
s
c
o
l
l
a
b
o
r
a
t
e
f
o
r
l
e
a
r
n
i
n
g
-
b
a
se
d
,
a
u
t
o
n
o
mo
u
s,
se
l
f
-
o
r
g
a
n
i
z
i
n
g
serv
i
c
e
c
o
mp
o
s
i
t
i
o
n
.
F
a
u
l
t
t
o
l
e
r
a
n
c
e
a
n
d
re
-
b
o
n
d
i
n
g
I
f
t
h
e
ser
v
i
c
e
c
o
m
p
o
s
i
t
i
o
n
s
a
r
e
f
r
a
g
i
l
e
,
f
a
i
l
u
r
e
s
c
a
n
c
a
u
se
a
c
o
m
p
l
e
t
e
b
r
e
a
k
d
o
w
n
[
6
]
,
[
1
0
]
.
Th
e
f
a
l
l
b
a
c
k
m
e
c
h
a
n
i
s
m
i
s
i
m
p
l
e
m
e
n
t
e
d
d
u
r
i
n
g
b
o
n
d
i
n
g
.
R
e
-
b
o
n
d
i
n
g
o
f
f
a
i
l
e
d
ser
v
i
c
e
s
i
s
e
n
a
b
l
e
d
u
si
n
g
a
mem
o
r
y
b
u
f
f
e
r
t
o
e
n
su
r
e
g
r
a
c
e
f
u
l
r
e
c
o
v
e
r
y
.
S
e
r
v
i
c
e
a
g
g
r
e
g
a
t
i
o
n
a
n
d
c
o
m
p
o
si
t
i
o
n
S
e
r
v
i
c
e
s
a
r
e
o
f
t
e
n
i
n
v
o
k
e
d
i
n
i
so
l
a
t
i
o
n
,
l
e
a
d
i
n
g
t
o
mu
l
t
i
p
l
e
i
n
s
t
a
n
c
e
s
o
f
t
h
e
sam
e
s
e
r
v
i
c
e
[
1
1
]
,
[
1
2
]
.
A
g
g
r
e
g
a
t
e
s
o
v
e
r
l
a
p
p
i
n
g
s
e
r
v
i
c
e
s
a
c
r
o
ss
t
r
e
a
t
m
e
n
t
p
l
a
n
s
,
r
e
d
u
c
i
n
g
r
e
d
u
n
d
a
n
c
y
a
n
d
e
n
a
b
l
i
n
g
d
e
c
e
n
t
r
a
l
i
z
e
d
c
o
m
p
o
si
t
i
o
n
.
M
o
n
i
t
o
r
i
n
g
a
n
d
a
d
a
p
t
a
t
i
o
n
l
o
o
p
F
e
w
sy
s
t
e
m
s
l
i
k
e
[
1
7
]
e
x
p
l
i
c
i
t
l
y
mo
d
e
l
t
h
e
m
o
n
i
t
o
r
–
a
n
a
l
y
z
e
–
p
l
a
n
–
e
x
e
c
u
t
e
–
k
n
o
w
l
e
d
g
e
(
M
A
P
E
-
K
)
l
o
o
p
.
A
g
e
n
t
s
i
m
p
l
i
c
i
t
l
y
p
e
r
f
o
r
m
t
h
e
p
r
o
c
e
sses
i
n
v
o
l
v
e
d
i
n
a
M
A
P
E
-
K
c
y
c
l
e
.
3.
SE
L
F
-
O
RG
ANIZ
I
NG
M
I
C
RO
SE
RV
I
C
E
CO
M
P
O
S
I
T
I
O
N
M
O
DE
L
Self
-
o
r
g
an
izatio
n
is
a
well
-
k
n
o
wn
b
o
tto
m
-
u
p
ap
p
r
o
ac
h
t
h
at
ca
n
b
e
u
s
ed
to
s
o
lv
e
t
h
e
in
h
er
e
n
t
p
r
o
b
lem
s
i
n
an
I
o
T
s
y
s
tem
[
8
]
.
T
h
is
r
esear
ch
p
r
o
p
o
s
es
m
o
d
ellin
g
u
s
in
g
a
g
en
t
-
b
ased
s
y
s
tem
s
.
Mu
lti
-
ag
en
t
s
y
s
tem
s
ar
e
a
p
r
ec
is
e
m
atch
to
r
e
p
r
esen
t
t
h
e
s
elf
-
o
r
g
an
i
zin
g
m
icr
o
s
er
v
ice
c
o
m
p
o
s
itio
n
m
o
d
el.
Sev
er
al
p
r
o
p
er
ties
o
f
m
u
lti
-
ag
e
n
ts
m
ak
e
th
is
m
eth
o
d
m
o
s
t
s
u
itab
le
t
o
b
e
u
tili
ze
d
in
th
e
p
r
o
p
o
s
ed
m
o
d
el.
Mu
lti
-
ag
en
ts
em
u
late
in
tellig
en
ce
as
th
ey
lear
n
co
n
tin
u
o
u
s
ly
f
r
o
m
th
e
en
v
ir
o
n
m
en
t
an
d
ar
e
well
-
s
u
i
ted
f
o
r
au
to
m
ated
ap
p
licatio
n
s
.
T
h
ey
ar
e
au
to
n
o
m
o
u
s
an
d
ca
p
a
b
le
o
f
m
ak
i
n
g
r
ea
ctiv
e
o
r
p
r
o
ac
tiv
e
d
ec
i
s
io
n
s
b
ased
o
n
th
e
en
v
ir
o
n
m
en
t.
Mu
lti
-
ag
e
n
ts
also
m
ak
e
co
llectiv
e
co
llab
o
r
at
io
n
s
b
y
co
m
m
u
n
icatin
g
with
o
th
er
ag
e
n
ts
in
th
e
en
v
ir
o
n
m
en
t a
n
d
p
r
o
v
id
e
s
er
v
i
ce
s
to
th
e
en
d
u
s
er
[
1
9
]
.
I
n
an
I
o
T
en
v
ir
o
n
m
e
n
t,
m
icr
o
s
er
v
ic
es a
r
e
to
u
ted
as th
e
ap
p
r
o
p
r
iate
ar
ch
itectu
r
e
to
r
e
p
r
esen
t
th
e
s
er
v
ices
an
d
d
ata
p
r
o
v
id
e
d
b
y
th
e
I
o
T
d
ev
ices.
Mic
r
o
s
er
v
ices
ca
n
f
u
n
ctio
n
well
as a
g
en
ts
in
I
o
T
s
y
s
tem
s
a
s
th
ey
h
av
e
m
an
y
s
im
ilar
ities
to
ag
en
ts
;
th
ey
ar
e
d
is
tr
ib
u
ted
,
m
o
d
u
lar
,
au
to
n
o
m
o
u
s
,
an
d
ca
n
c
o
llab
o
r
ate
with
o
th
er
m
icr
o
s
er
v
ices
an
d
ar
e
ca
p
ab
le
o
f
lear
n
in
g
a
n
d
ad
ap
tatio
n
,
also
d
u
e
to
th
eir
p
r
o
ac
tiv
e
o
r
r
ea
ctiv
e
p
r
o
p
er
ties
[
20
]
.
I
n
th
is
m
o
d
el,
m
icr
o
s
er
v
ices
ar
e
d
e
p
lo
y
ed
as
a
g
en
ts
to
r
ep
r
esen
t
s
ev
er
al
f
u
n
ctio
n
aliti
es
o
f
th
e
m
o
d
el.
T
h
e
m
o
tiv
atio
n
f
o
r
u
s
in
g
m
icr
o
s
er
v
ices
a
s
lo
o
s
ely
co
u
p
le
d
ag
en
ts
in
th
is
m
o
d
el
is
th
eir
ab
ilit
y
to
f
u
n
ctio
n
in
a
h
eter
o
g
en
eo
u
s
en
v
ir
o
n
m
e
n
t
s
u
ch
as
an
I
o
T
ec
o
s
y
s
tem
,
en
h
an
cin
g
th
e
s
ca
lab
ilit
y
an
d
ad
ap
tab
ilit
y
o
f
s
er
v
ice
co
m
p
o
s
itio
n
m
eth
o
d
s
.
3
.
1
.
M
icro
s
er
v
ice
re
po
s
it
o
ry
in
t
he
s
elf
-
o
rg
a
nizin
g
mo
d
e
l
T
h
e
m
icr
o
s
er
v
ice
r
e
p
o
s
ito
r
y
r
eg
is
ter
s
an
d
m
an
ag
es
av
ailab
le
s
er
v
ices.
I
t
en
s
u
r
es
th
at
s
e
r
v
ices
ar
e
d
is
co
v
er
ab
le,
co
m
p
o
s
ab
le,
an
d
f
ail
-
s
af
e.
New
s
er
v
ices
ca
n
b
e
ad
d
ed
d
y
n
am
ically
to
th
e
r
ep
o
s
ito
r
y
,
an
d
th
e
ac
tiv
e
s
er
v
ices
ca
n
b
o
n
d
b
ased
o
n
th
e
c
o
n
d
itio
n
a
n
d
s
h
ar
e
d
v
itals
.
I
f
an
ac
tiv
e
s
er
v
ice
f
ail
s
,
it
is
r
ep
lace
d
with
a
s
im
ilar
o
n
e.
An
e
x
am
p
le
r
e
p
r
esen
tatio
n
o
f
a
m
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o
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{
"Name":
"Oxygen
Delivery
",
"Type":
"Respiratory",
"Required
vitals":
["
F
i
O
2
",
"
S
a
O
2
"],
"Execution
t
ime": (0.6,0.9), # in milliseconds
"Failure
p
robability":
0.05 , #5% failure rate
"Alternatives":
["Nasal
Prong
Oxygen",
"Ventilation
Setup"]
}
T
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SOM)
in
teg
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in
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el
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T
h
e
co
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p
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er
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u
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en
co
m
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ar
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r
c
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estra
tio
n
[
2
1
].
3
.
2
.
Co
m
po
nents o
f
t
he
m
ic
ro
s
er
v
ice
co
m
po
s
it
io
n mo
del
T
h
e
s
e
l
f
-
o
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a
n
i
z
i
n
g
m
i
c
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e
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v
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o
m
p
o
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t
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o
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m
o
d
e
l
h
a
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l
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e
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t
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a
p
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e
a
r
c
h
a
r
t
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e
[
2
0
]
,
a
n
d
a
b
r
i
e
f
d
e
s
c
r
i
p
t
i
o
n
o
f
t
h
e
m
o
d
e
l
h
a
s
b
e
e
n
p
r
o
v
i
d
e
d
b
e
l
o
w
.
T
h
e
m
o
d
e
l
’
s
c
o
m
p
o
n
e
n
t
s
a
r
e
:
i)
A
m
ac
h
in
e
lear
n
in
g
-
b
ased
class
if
ier
,
in
teg
r
atin
g
r
an
d
o
m
f
o
r
est
(
R
F)
an
d
XG
B
o
o
s
t,
h
as
b
ee
n
em
p
lo
y
e
d
to
ac
cu
r
ately
class
if
y
v
ar
i
o
u
s
n
eo
n
atal
co
n
d
itio
n
s
an
d
r
ec
o
m
m
en
d
c
o
r
r
esp
o
n
d
in
g
tr
ea
tm
en
t
p
lan
s
.
T
h
e
m
o
d
el
is
ev
alu
ated
u
s
in
g
a
r
ea
l
-
wo
r
ld
n
eo
n
atal
p
h
y
s
io
lo
g
ical
d
ataset
co
llected
r
etr
o
s
p
ec
tiv
ely
u
n
d
e
r
eth
ical
clea
r
an
ce
f
r
o
m
th
e
NI
C
U
o
f
SKS
Ho
s
p
ital
an
d
Po
s
t
g
r
ad
u
ate
Me
d
ical
I
n
s
titu
te,
Salem
,
I
n
d
ia.
T
h
e
d
ataset
co
n
tain
s
co
n
tin
u
o
u
s
s
ec
o
n
d
-
wis
e
d
ata
o
f
k
ey
p
h
y
s
i
o
lo
g
ical
p
ar
am
ete
r
s
s
u
ch
as
h
ea
r
t
r
ate
(
HR
)
,
b
lo
o
d
p
r
ess
u
r
e
(
B
P),
r
esp
ir
at
o
r
y
r
ate
(
R
R
)
,
o
x
y
g
e
n
s
atu
r
atio
n
(
S
a
O
2
)
,
o
x
y
g
en
co
n
ce
n
tr
atio
n
(
FiO
2
)
,
a
n
d
tem
p
er
atu
r
e
(
T
e
m
p
)
r
e
co
r
d
e
d
d
u
r
in
g
t
h
e
f
ir
s
t
8
h
o
u
r
s
o
f
life
f
r
o
m
ten
m
ec
h
an
ically
v
e
n
tilated
n
eo
n
ates
,
co
m
p
r
is
in
g
o
v
e
r
2
5
0
,
0
0
0
tim
estam
p
ed
r
ec
o
r
d
s
.
T
h
e
co
m
p
lete
d
escr
ip
tio
n
o
f
th
e
h
y
b
r
id
m
o
d
e
l
(
RF
+X
G
B
o
o
s
t)
is
d
i
s
cu
s
s
ed
e
x
ten
s
iv
ely
in
a
s
ep
ar
ate
p
ap
er
.
W
h
ile
th
at
ar
ticle
f
o
cu
s
es
o
n
th
e
wo
r
k
in
g
o
f
th
e
m
ac
h
in
e
lear
n
in
g
m
o
d
el
to
class
if
y
co
n
d
itio
n
s
an
d
r
ec
o
m
m
en
d
t
r
ea
tm
en
ts
,
th
e
p
r
esen
t
wo
r
k
b
u
ild
s
u
p
o
n
it
by
d
etailin
g
th
e
s
elf
-
o
r
g
an
izin
g
s
er
v
ice
co
m
p
o
s
itio
n
p
r
o
ce
s
s
th
at
is
tr
i
g
g
er
ed
o
n
ce
a
n
eo
n
atal
co
n
d
itio
n
is
d
etec
ted
.
ii)
T
h
e
B
I
OC
OR
E
ag
en
t
co
m
p
r
is
es
th
e
m
icr
o
s
er
v
ices
o
f
s
p
r
ea
d
in
g
,
ag
g
r
eg
atio
n
,
ev
a
p
o
r
atio
n
,
an
d
b
o
n
d
in
g
,
aid
in
g
s
elf
-
o
r
g
an
izatio
n
.
T
h
e
s
e
m
icr
o
s
er
v
ices
ar
e
th
e
b
asi
s
o
f
th
e
s
elf
–
o
r
g
a
n
izin
g
r
u
le
s
th
at
g
o
v
e
r
n
th
e
s
y
s
tem
.
T
h
ese
m
icr
o
s
er
v
ices
r
ea
ct
b
ased
o
n
th
e
d
ata
(
n
eo
n
atal
v
itals
)
th
at
h
av
e
b
ee
n
class
if
ied
as c
o
n
d
itio
n
s
.
iii)
A
d
ee
p
lear
n
in
g
ag
e
n
t
th
at
en
ab
les
b
o
n
d
in
g
o
f
r
elev
a
n
t
s
er
v
ices,
wh
ile
lear
n
in
g
f
r
o
m
co
r
r
ec
t
an
d
in
co
r
r
ec
t b
o
n
d
in
g
an
d
ad
ap
tin
g
d
y
n
am
ically
to
s
er
v
ice
f
ailu
r
es.
T
h
e
d
ee
p
lear
n
in
g
ag
en
t
is
s
u
p
p
o
r
ted
b
y
u
n
s
u
p
e
r
v
i
s
e
d
l
e
a
r
n
i
n
g
t
h
r
o
u
g
h
t
h
e
S
O
M
.
SO
M
i
d
e
n
t
i
f
i
e
s
p
a
tte
r
n
s
(
c
l
u
s
te
r
s
)
t
h
a
t
c
a
n
b
e
r
eu
s
ed
,
p
r
o
v
id
i
n
g
em
er
g
en
ce
a
n
d
ad
a
p
tab
ilit
y
.
iv
)
An
an
t
a
g
en
t
will
be
in
teg
r
ated
in
to
th
e
m
o
d
el
to
o
p
t
im
ize
th
e
b
io
-
in
s
p
ir
ed
m
ec
h
an
is
m
s
u
s
in
g
p
h
er
o
m
o
n
e
-
b
a
s
e
d
s
t
r
a
t
e
g
i
es
.
I
t
w
il
l
e
f
f
i
c
i
e
n
tl
y
p
r
o
p
a
g
a
t
e
in
f
o
r
m
a
t
i
o
n
t
o
r
e
l
e
v
a
n
t
s
e
r
v
i
ce
s
,
a
g
g
r
e
g
a
te
f
u
n
c
t
i
o
n
a
l
l
y
s
i
m
i
lar
m
icr
o
s
er
v
ices,
an
d
elim
i
n
ate
o
u
t
d
ate
d
s
er
v
ice
p
ath
s
.
T
h
is
m
in
i
m
izes
n
etwo
r
k
b
o
ttlen
ec
k
s
,
r
ed
u
ce
s
s
ea
r
ch
tim
e,
en
h
an
ce
s
s
ca
lab
ilit
y
,
an
d
en
s
u
r
es
co
n
tin
u
o
u
s
ad
ap
tatio
n
to
d
y
n
am
i
c
I
o
T
en
v
ir
o
n
m
en
ts
,
co
llectiv
ely
im
p
r
o
v
i
n
g
th
e
e
f
f
icien
cy
o
f
s
er
v
ice
co
m
p
o
s
itio
n
.
v)
An
o
p
tim
izatio
n
ag
e
n
t
th
at
s
elec
ts
th
e
o
p
tim
al
m
icr
o
s
er
v
i
ce
co
m
p
o
s
itio
n
s
b
y
m
in
im
izi
n
g
e
x
ec
u
ti
o
n
tim
e,
r
ed
u
cin
g
co
s
t,
an
d
m
a
x
im
izin
g
r
eliab
ilit
y
.
I
t
u
s
es
a
m
u
lti
-
o
b
jectiv
e
ap
p
r
o
ac
h
(
NSGA
-
I
I
+H
C
)
to
en
s
u
r
e
ef
f
icien
t,
s
ca
lab
le,
an
d
q
u
ality
o
f
s
er
v
ice
(
Qo
S)
-
awa
r
e
s
er
v
ice
co
m
p
o
s
itio
n
in
d
y
n
am
ic
I
o
T
h
ea
lth
ca
r
e
en
v
i
r
o
n
m
e
n
ts
.
T
h
e
s
y
s
tem
ar
ch
itectu
r
e
o
f
th
e
s
elf
-
o
r
g
an
izin
g
m
icr
o
s
er
v
ice
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m
p
o
s
itio
n
m
o
d
el
is
d
ep
icted
in
Fig
u
r
e
2
.
Fig
u
r
e
2
.
Sy
s
tem
ar
c
h
itectu
r
e
(
s
elf
-
o
r
g
an
izin
g
m
icr
o
s
er
v
ice
co
m
p
o
s
itio
n
m
o
d
el)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
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3
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3
.
Self
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o
rg
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nizin
g
B
I
O
CO
RE
T
h
e
p
r
o
p
o
s
ed
s
elf
-
o
r
g
a
n
izin
g
m
icr
o
s
er
v
ice
m
o
d
el
in
teg
r
ates
th
e
B
I
O
C
OR
E
with
s
er
v
ic
es
s
u
ch
as
s
p
r
ea
d
in
g
,
ev
ap
o
r
atio
n
,
b
o
n
d
i
n
g
,
a
n
d
a
g
g
r
e
g
atio
n
,
a
n
d
an
an
t
ag
en
t
t
o
o
p
tim
ize
th
ese
s
er
v
ices,
wh
ile
th
is
ap
p
r
o
ac
h
s
u
p
p
o
r
ts
d
ec
e
n
tr
alize
d
in
ter
ac
tio
n
s
,
em
er
g
e
n
ce
,
a
n
d
s
elf
-
o
r
g
an
izatio
n
.
SOM
p
r
o
v
id
es
s
u
p
p
o
r
t
to
t
h
e
B
I
OC
O
R
E
as
a
r
o
b
u
s
t
b
ac
k
b
o
n
e,
en
ab
lin
g
th
e
d
is
co
v
e
r
y
o
f
em
er
g
en
t
s
er
v
ice
g
r
o
u
p
in
g
s
[
2
2
]
.
SOM
is
u
s
ed
to
clu
s
ter
th
e
s
er
v
ices
th
at
h
av
e
co
m
m
o
n
v
itals
.
T
h
is
clu
s
ter
o
f
s
er
v
ices
co
r
r
esp
o
n
d
s
to
a
p
ar
ticu
lar
tr
ea
tm
en
t
p
lan
an
d
is
tr
ain
e
d
to
au
t
o
m
at
ically
cr
ea
te
b
o
n
d
s
am
o
n
g
th
e
s
er
v
ices
(
in
th
e
clu
s
ter
)
.
SO
M
is
also
u
tili
ze
d
to
clu
s
ter
th
e
s
er
v
ices
f
o
r
m
u
ltip
le
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ea
tm
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t
p
la
n
s
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e
n
ab
le
c
o
n
tex
t
-
awa
r
e
s
er
v
ice
s
h
ar
in
g
.
Alo
n
g
with
SOM,
a
g
r
ap
h
-
b
ased
r
u
le
en
g
in
e
is
u
s
ed
to
g
en
er
ate
v
alid
s
er
v
ice
s
eq
u
en
ce
s
f
o
r
th
e
tr
ea
tm
e
n
t
p
lan
,
en
ab
lin
g
th
e
em
er
g
en
ce
a
n
d
v
alid
ity
o
f
th
e
co
m
p
o
s
ed
s
er
v
ice.
T
h
e
SOM
is
tr
ain
ed
o
n
b
in
a
r
y
-
e
n
co
d
e
d
v
ec
to
r
s
o
f
s
er
v
ice
d
ep
en
d
e
n
cies,
b
ased
o
n
s
h
ar
ed
v
itals
b
y
th
e
s
er
v
ices.
T
h
is
u
n
s
u
p
e
r
v
is
ed
lear
n
in
g
p
r
o
ce
s
s
en
ab
les
th
e
em
er
g
e
n
ce
o
f
in
itial
s
er
v
ice
g
r
o
u
p
in
g
s
,
w
h
ich
s
er
v
e
as
ca
n
d
id
ate
b
u
ild
in
g
b
lo
ck
s
f
o
r
m
o
r
e
co
m
p
lex
co
m
p
o
s
itio
n
s
.
Ser
v
ice
s
eq
u
en
ce
s
ar
e
g
e
n
er
ated
u
s
in
g
in
itial
s
er
v
ice
g
r
o
u
p
i
n
g
p
r
im
a
r
ily
to
s
u
p
p
o
r
t
s
elf
-
o
r
g
an
izin
g
m
icr
o
s
er
v
ice
co
m
p
o
s
itio
n
.
T
h
e
g
e
n
er
ated
s
eq
u
en
ce
s
co
n
s
is
t
o
f
ato
m
ic
s
er
v
ices,
w
h
er
e
ea
ch
s
eq
u
en
ce
h
as
o
n
e
s
er
v
ice,
an
d
co
m
p
o
s
ite
s
er
v
ices,
wh
er
e
th
e
s
er
v
ice
s
eq
u
en
ce
is
f
o
r
m
ed
b
y
a
s
et
o
f
co
n
tex
t
u
ally
r
elate
d
s
er
v
ices.
A
d
ir
ec
ted
s
er
v
ice
g
r
ap
h
is
u
s
ed
to
ex
p
an
d
th
e
p
ath
s
b
ased
o
n
th
e
tr
ea
t
m
e
n
t
p
lan
s
,
en
s
u
r
in
g
m
ed
ical
r
elev
a
n
ce
.
B
r
ea
d
th
-
f
ir
s
t
s
ea
r
ch
is
ap
p
lied
to
th
e
g
r
ap
h
to
g
en
er
ate
v
alid
tr
ea
tm
en
t
s
eq
u
en
ce
s
.
A
lis
t
o
f
k
n
o
wn
in
v
al
id
o
r
r
is
k
y
s
eq
u
e
n
ce
s
is
m
ain
tain
ed
to
r
em
o
v
e
clin
ically
u
n
s
af
e
o
r
lo
g
ically
in
co
n
s
is
ten
t
p
at
h
s
.
T
h
e
s
er
v
ice
s
eq
u
en
ce
s
ar
e
f
u
r
th
er
cla
s
s
if
ied
to
p
r
o
v
id
e
tr
ea
tm
en
ts
ac
co
r
d
in
g
to
th
e
s
e
v
er
ity
o
f
th
e
co
n
d
itio
n
.
3
.
4
.
O
pera
t
io
na
l o
v
er
v
iew
o
f
t
he
deep
lea
rning
a
g
ent
Dee
p
lear
n
in
g
h
as
b
ee
n
wid
el
y
u
s
ed
f
o
r
d
y
n
am
ic
a
n
d
a
d
ap
t
iv
e
s
er
v
ice
co
m
p
o
s
itio
n
[
2
3
]
.
T
h
e
ag
en
t
in
teg
r
ates
u
n
s
u
p
e
r
v
is
ed
lear
n
i
n
g
an
d
r
ein
f
o
r
ce
m
e
n
t
lear
n
i
n
g
to
cr
ea
te
a
n
ad
a
p
tiv
e
co
m
p
o
s
i
tio
n
m
o
d
el
s
u
itab
le
f
o
r
th
e
d
y
n
a
m
ic
an
d
u
n
ce
r
tai
n
en
v
ir
o
n
m
en
t
o
f
n
eo
n
atal
in
ten
s
iv
e
ca
r
e.
I
n
itial
lear
n
in
g
b
y
th
e
d
ee
p
lear
n
in
g
ag
en
t
is
en
ab
led
b
y
u
n
s
u
p
e
r
v
is
ed
lear
n
in
g
,
with
th
e
h
elp
o
f
th
e
SOM
clu
s
ter
in
g
th
e
s
er
v
ices
b
ased
o
n
th
e
co
m
m
o
n
v
itals
f
o
r
a
co
n
d
itio
n
.
T
h
e
g
r
ap
h
-
b
ased
r
u
le
en
g
in
e
g
en
e
r
ates
v
alid
s
eq
u
en
c
es
f
o
r
a
p
ar
ticu
lar
tr
ea
tm
en
t
p
lan
.
T
h
ese
v
alid
s
e
q
u
en
ce
s
ar
e
u
s
ed
b
y
t
h
e
d
ee
p
lear
n
in
g
ag
e
n
t
to
d
y
n
am
ically
co
m
p
o
s
e
s
er
v
ices
b
y
p
r
ed
ictin
g
th
e
m
o
s
t
ap
p
r
o
p
r
iate
n
ex
t
m
icr
o
s
er
v
ice
at
ea
c
h
s
tep
.
As
s
u
cc
ess
f
u
l
co
m
p
o
s
i
tio
n
s
ar
e
ex
ec
u
ted
,
r
ein
f
o
r
ce
m
e
n
t
lear
n
in
g
tak
es
o
v
er
b
y
r
ewa
r
d
in
g
th
e
co
r
r
ec
t
co
m
p
o
s
itio
n
s
eq
u
en
ce
s
(
v
alid
s
eq
u
en
ce
s
)
f
o
r
th
e
tr
ea
tm
en
t
p
lan
an
d
p
e
n
alizin
g
th
e
in
v
alid
o
n
es.
E
m
er
g
en
t
b
eh
av
io
r
is
a
n
atu
r
al
o
u
tc
o
m
e
o
f
s
elf
-
o
r
g
an
izatio
n
.
T
h
e
d
ee
p
lear
n
in
g
ag
e
n
t
u
s
es
r
ein
f
o
r
ce
m
en
t
lear
n
in
g
to
ev
alu
ate
th
e
ef
f
ec
tiv
en
ess
o
f
n
ewly
d
is
co
v
er
ed
em
er
g
en
t
an
d
v
alid
s
er
v
ice
s
eq
u
en
ce
s
th
at
ar
e
n
o
t
e
x
p
licitly
d
ef
in
ed
.
I
f
a
n
in
co
r
r
ec
t
s
eq
u
e
n
ce
is
d
etec
ted
,
th
e
s
er
v
ice
co
m
b
in
atio
n
is
f
lag
g
e
d
as
in
co
r
r
ec
t
an
d
is
r
ep
lace
d
with
a
v
alid
em
er
g
en
t
o
r
r
u
le
-
b
ased
s
eq
u
en
ce
r
etr
iev
ed
f
r
o
m
t
h
e
m
em
o
r
y
b
u
f
f
er
.
T
h
is
m
eth
o
d
e
n
s
u
r
es
co
n
tin
u
ity
i
n
th
e
s
er
v
ice
co
m
p
o
s
itio
n
s
.
Po
s
itiv
e
r
ewa
r
d
s
ar
e
ass
ig
n
ed
f
o
r
b
ette
r
o
u
tco
m
es
d
r
iv
en
b
y
e
m
er
g
e
n
t
b
eh
av
i
o
r
,
a
n
d
th
e
i
n
ter
n
al
p
o
licy
o
f
t
h
e
s
y
s
tem
is
u
p
d
ated
to
ev
o
lv
e
d
y
n
am
i
c
co
m
p
o
s
itio
n
s
tr
ateg
ies
at
r
u
n
tim
e.
Un
s
u
p
er
v
is
ed
lear
n
in
g
is
em
p
lo
y
ed
to
d
is
co
v
er
em
er
g
e
n
t
s
er
v
ice
s
eq
u
en
ce
s
f
o
r
tr
ea
t
m
en
t
p
lan
s
,
wh
ile
r
ein
f
o
r
ce
m
e
n
t
lear
n
in
g
is
u
s
ed
to
r
ef
in
e
th
e
s
elec
tio
n
an
d
b
o
n
d
in
g
o
f
v
al
id
an
d
o
p
tim
al
s
er
v
ice
s
eq
u
e
n
ce
s
.
T
h
e
s
y
s
tem
p
r
o
g
r
ess
iv
ely
lear
n
s
ef
f
ec
tiv
e
s
er
v
ice
co
m
p
o
s
itio
n
p
atter
n
s
t
h
r
o
u
g
h
r
ewa
r
d
s
an
d
p
en
alties.
T
h
e
p
a
r
am
eter
s
u
s
ed
b
y
th
e
d
ee
p
lear
n
in
g
ag
e
n
t
ar
e
tab
u
lated
in
T
ab
le
3
.
T
h
e
l
ea
r
n
in
g
p
ar
am
eter
s
ar
e
o
f
th
e
d
ee
p
lear
n
in
g
ag
e
n
t
ar
e
c
h
o
s
en
b
ased
o
n
p
r
e
v
io
u
s
r
esear
ch
in
[
1
1
]
.
T
ab
le
3
.
L
ea
r
n
in
g
p
ar
am
eter
s
o
f
th
e
d
ee
p
lear
n
i
n
g
ag
e
n
t
P
a
r
a
m
e
t
e
r
V
a
l
u
e
D
e
s
c
r
i
p
t
i
o
n
A
l
p
h
a
0
.
3
Le
a
r
n
i
n
g
r
a
t
e
G
a
m
m
a
0
.
9
D
i
sco
u
n
t
f
a
c
t
o
r
f
o
r
f
u
t
u
r
e
r
e
w
a
r
d
s
E
p
s
i
l
o
n
0
.
2
I
n
i
t
i
a
l
e
x
p
l
o
r
a
t
i
o
n
r
a
t
e
(
ϵ
-
g
r
e
e
d
y
p
o
l
i
c
y
)
Ep
si
l
o
n
d
e
c
a
y
0
.
9
9
5
G
r
a
d
u
a
l
s
h
i
f
t
f
r
o
m
e
x
p
l
o
r
a
t
i
o
n
to
e
x
p
l
o
i
t
a
t
i
o
n
R
e
p
l
a
y
M
e
m
o
r
y
D
e
q
u
e
(
m
a
x
l
e
n
=
1
,
0
0
0
)
S
t
o
r
e
s
p
a
s
t
e
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p
e
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n
c
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f
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st
a
b
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t
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a
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O
p
t
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m
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A
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m
A
d
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p
t
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M
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t
Q
-
v
a
l
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e
s
3
.
5
.
T
he
ro
le
o
f
t
he
a
nt
a
g
ent
T
h
e
an
t
ag
en
t
o
p
tim
izes
th
e
s
er
v
ices
p
r
o
v
id
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b
y
th
e
B
I
O
C
OR
E
,
n
am
ely
s
p
r
ea
d
in
g
,
ag
g
r
eg
atio
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,
ev
ap
o
r
atio
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,
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d
b
o
n
d
i
n
g
.
A
d
ap
tiv
e
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n
in
g
o
f
th
e
p
ar
am
ete
r
s
o
f
th
e
an
t
ag
e
n
t
[
2
4
]
aid
s
t
h
e
o
p
tim
izatio
n
o
f
th
ese
p
atter
n
s
.
T
h
e
p
r
o
p
o
s
ed
m
o
d
el
in
c
o
r
p
o
r
ates
th
e
B
I
O
C
OR
E
an
d
an
t
ag
en
t,
wh
ic
h
wer
e
in
ten
d
e
d
to
f
ac
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b
io
in
s
p
ir
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m
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i
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m
s
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in
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,
ev
a
p
o
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,
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b
o
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d
in
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.
T
h
e
co
m
p
lete
m
o
d
el
in
teg
r
ati
n
g
th
e
B
I
OC
OR
E
an
d
an
t
ag
en
t
o
p
tim
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is
u
n
d
er
d
ev
elo
p
m
en
t.
T
h
e
cu
r
r
en
t
m
o
d
el
im
p
lem
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tatio
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d
ep
lo
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s
a
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to
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u
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o
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f
u
n
ctio
n
alities
o
f
th
e
B
I
OC
OR
E
an
d
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t
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8
9
3
8
I
n
tellig
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t self
-
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a
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iz
in
g
mic
r
o
s
ervice
co
mp
o
s
itio
n
u
s
in
g
h
yb
r
id
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r
n
in
g
fo
r
…
(
S
h
a
r
o
n
P
o
o
r
n
ima
)
1103
ag
en
t.
T
h
e
SOM
n
o
w
s
er
v
es
as
a
f
o
u
n
d
atio
n
al
b
u
ild
in
g
b
lo
ck
,
i
n
f
o
r
m
in
g
t
h
e
s
tr
u
ctu
r
e
an
d
b
eh
av
i
o
r
o
f
em
er
g
en
t
s
er
v
ice
co
m
p
o
s
itio
n
s
.
T
h
is
in
ter
m
ed
iate
im
p
lem
e
n
tatio
n
p
r
o
v
id
es
a
c
r
itical
b
asis
f
o
r
th
e
o
n
g
o
in
g
in
teg
r
atio
n
o
f
th
e
B
I
OC
OR
E
an
d
an
t A
g
e
n
t in
to
th
e
co
m
p
let
e
p
r
o
p
o
s
ed
m
o
d
el.
4.
E
XP
E
R
I
M
E
N
T
A
L
SE
T
UP
AND
O
UT
CO
M
E
S
T
h
is
m
o
d
el
is
esp
ec
ially
d
e
v
e
lo
p
ed
f
o
r
s
u
g
g
esti
n
g
tr
ea
tm
en
t
p
lan
s
b
ased
o
n
th
e
co
n
d
itio
n
s
d
etec
ted
in
th
e
n
eo
n
ates.
T
h
e
m
o
d
el
ca
n
d
etec
t
m
u
ltip
le
co
-
o
cc
u
r
r
in
g
co
n
d
itio
n
s
,
aid
in
g
p
h
y
s
ician
s
in
d
ec
id
in
g
cr
itical
ca
r
e
tr
ea
tm
en
t
p
la
n
s
b
ased
o
n
ch
an
g
in
g
clin
ical
c
o
n
d
itio
n
s
.
T
h
e
m
o
d
el
is
tr
ain
ed
a
n
d
test
ed
o
n
s
ev
er
al
tr
ea
tm
en
t
p
lan
s
.
T
h
e
s
am
p
le
s
ize
was
s
elec
ted
to
en
s
u
r
e
s
u
f
f
icien
t
r
ep
r
esen
tatio
n
o
f
b
o
th
in
d
i
v
id
u
al
a
n
d
co
ex
is
tin
g
n
eo
n
atal
co
n
d
itio
n
s
.
Ap
p
r
o
x
im
ately
2
,
0
0
0
s
am
p
les
wer
e
u
s
ed
f
o
r
tr
ain
in
g
in
d
iv
id
u
al
co
n
d
itio
n
s
,
an
d
3
,
5
0
0
s
am
p
les
wer
e
u
s
ed
f
o
r
tr
ain
in
g
ea
c
h
m
u
ltip
le
c
o
n
d
itio
n
,
th
e
r
eb
y
e
n
ab
lin
g
im
p
r
o
v
e
d
lear
n
in
g
o
f
co
m
p
lex
s
er
v
ice
b
o
n
d
i
n
g
p
att
er
n
s
.
T
wo
co
m
m
o
n
ly
o
c
cu
r
r
i
n
g
co
n
d
itio
n
s
ar
e
d
escr
ib
ed
b
el
o
w,
alo
n
g
with
th
e
p
r
o
ce
s
s
o
f
s
elf
-
o
r
g
an
izin
g
s
er
v
ice
co
m
p
o
s
itio
n
.
4
.
1
.
I
llu
s
t
ra
t
io
n o
f
direct
bo
nd
ing
in a
ct
io
n
W
h
en
a
s
in
g
le
co
n
d
itio
n
o
cc
u
r
s
,
d
ir
ec
t
b
o
n
d
in
g
tak
es
p
lace
.
T
h
e
co
n
tin
u
o
u
s
ly
m
o
n
ito
r
ed
v
itals
tr
ig
g
er
an
ale
r
t
wh
e
n
th
e
th
r
es
h
o
ld
v
alu
es
ar
e
b
r
ea
ch
ed
.
As
an
ex
a
m
p
le,
co
n
s
id
er
th
e
f
o
llo
win
g
s
ce
n
ar
io
.
T
h
e
Vital
s
ig
n
r
ea
d
in
g
of
FiO
2
is
5
5
%,
ca
u
s
in
g
th
e
c
o
n
d
itio
n
to
be
d
etec
ted
a
s
:
C
1
: m
ild
r
esp
ir
a
to
r
y
d
i
s
t
r
e
s
s
.
All
o
th
er
v
ital
s
ig
n
r
ea
d
in
g
s
ar
e
in
th
e
n
o
r
m
al
r
a
n
g
e.
I
n
c
o
n
d
itio
n
C
1
,
th
e
d
o
m
in
a
n
t
v
it
al
is
FiO
2
,
m
ak
in
g
it
th
e
ce
n
tr
al
r
ef
er
en
c
e
p
o
in
t
f
o
r
s
er
v
ice
b
o
n
d
in
g
.
T
h
e
tr
ea
tm
en
t
p
lan
s
f
o
r
co
n
d
i
tio
n
C
1
in
v
o
lv
e
th
e
co
m
p
o
s
itio
n
o
f
s
ev
er
al
m
icr
o
s
er
v
ices
th
at
ar
e
alr
ea
d
y
r
eg
is
ter
ed
in
th
e
m
icr
o
s
er
v
ice
r
ep
o
s
ito
r
y
.
An
in
s
tan
ce
o
f
th
ese
s
er
v
ices is u
s
ed
f
o
r
t
h
e
s
er
v
ice
co
m
p
o
s
itio
n
.
T
h
e
s
er
v
ices r
eq
u
ir
ed
f
o
r
t
h
e
tr
ea
tm
en
t p
lan
(
T
1
)
ar
e:
i)
Mo
n
ito
r
in
g
–
co
n
tin
u
o
u
s
ly
o
b
s
er
v
es FiO
2
lev
els an
d
o
th
er
v
ital p
ar
am
eter
s
.
ii)
Ox
y
g
en
d
eliv
er
y
–
in
cr
ea
s
es th
e
FiO
2
lev
els to
en
h
an
ce
th
e
o
x
y
g
en
co
n
ten
t i
n
in
h
aled
air
.
iii)
S
e
d
a
t
i
o
n
–
m
i
n
i
m
i
z
e
s
d
i
s
c
o
m
f
o
r
t
a
n
d
p
r
e
v
e
n
t
s
d
i
s
t
r
e
s
s
d
u
r
i
n
g
t
h
e
a
d
m
i
n
i
s
t
r
a
t
i
o
n
o
f
r
e
s
p
i
r
a
t
o
r
y
i
n
t
e
r
v
e
n
t
i
o
n
s
.
iv
)
I
n
tu
b
atio
n
-
estab
lis
h
es a
s
ec
u
r
e
air
way
wh
en
n
o
n
-
i
n
v
asiv
e
o
x
y
g
en
d
eliv
er
y
m
et
h
o
d
s
ar
e
i
n
s
u
f
f
icien
t
v)
V
e
n
t
i
l
at
i
o
n
s
e
t
u
p
–
c
o
n
f
i
g
u
r
e
s
v
e
n
t
i
l
a
t
o
r
p
a
r
a
m
et
e
r
s
t
o
d
e
l
i
v
e
r
c
o
n
s
i
s
t
e
n
t
a
n
d
c
o
n
t
r
o
l
le
d
r
e
s
p
i
r
a
t
o
r
y
s
u
p
p
o
r
t
.
T
h
ese
s
er
v
ices
f
o
r
m
th
e
b
o
n
d
s
en
ab
led
b
y
i
n
itial
u
n
s
u
p
e
r
v
i
s
ed
lear
n
in
g
an
d
d
ee
p
lear
n
i
n
g
to
r
ef
in
e
th
e
b
o
n
d
in
g
.
Un
s
u
p
er
v
is
ed
lear
n
in
g
id
en
tifie
s
th
e
in
itial
s
e
r
v
ice
s
et
(
e.
g
.
,
m
o
n
ito
r
in
g
an
d
o
x
y
g
e
n
d
eliv
er
y
)
b
ased
o
n
clu
s
ter
s
f
o
r
m
e
d
b
y
th
e
SOM,
an
d
d
ee
p
lear
n
in
g
id
en
tifie
s
t
h
e
o
p
tim
al
s
er
v
i
ce
s
eq
u
en
ce
s
f
o
r
a
tr
ea
tm
en
t
p
lan
.
T
h
e
s
er
v
ice
co
m
p
o
s
itio
n
g
r
ap
h
as
s
h
o
w
n
in
Fig
u
r
e
3
illu
s
tr
ates
th
e
o
r
d
er
i
n
wh
ich
th
e
s
er
v
ices
ar
e
co
m
p
o
s
ed
f
o
r
th
e
tr
ea
tm
en
t
(
T
1
)
.
T
h
e
m
o
n
ito
r
i
n
g
s
er
v
ice
is
alwa
y
s
ac
tiv
e,
tr
ig
g
e
r
in
g
th
e
o
th
er
s
er
v
ices
as
an
d
wh
e
n
r
e
q
u
ir
ed
.
T
h
e
d
as
h
ed
lin
e
b
etwe
en
(
o
x
y
g
en
d
eliv
er
y
an
d
s
ed
atio
n
)
in
d
icate
s
th
at
th
e
s
ed
atio
n
s
er
v
ice,
f
o
llo
wed
b
y
in
tu
b
ati
o
n
an
d
v
e
n
tilatio
n
s
etu
p
,
will
b
e
in
v
o
k
e
d
o
n
l
y
if
t
h
e
co
n
d
i
tio
n
escalate
s
.
T
h
e
p
atien
t
r
ec
eiv
es
th
e
t
r
ea
tm
e
n
t
p
lan
(
T
1
)
,
wh
ich
is
class
if
ied
as
m
ild
an
d
s
ev
er
e
b
ased
o
n
t
h
e
FiO
2
lev
els.
T
h
e
s
er
v
ice
s
eq
u
en
ce
f
o
r
th
e
c
o
n
d
i
tio
n
C
1
an
d
tr
ea
tm
e
n
t p
lan
(
T
1
)
is
as:
Mild
:
m
o
n
ito
r
i
n
g
→o
x
y
g
en
d
e
l
i
v
e
r
y
.
S
e
v
e
r
e
:
m
o
n
it
o
r
i
n
g
→
o
x
y
g
e
n
d
e
l
i
v
e
r
y
→s
e
d
a
t
i
o
n
→
i
n
t
u
b
a
ti
o
n
→
v
e
n
t
i
l
at
i
o
n
s
et
u
p
.
Fig
u
r
e
3
.
Ser
v
ice
co
m
p
o
s
itio
n
g
r
ap
h
(
d
ir
ec
t
b
o
n
d
in
g
)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
9
3
8
I
n
t J Ar
tif
I
n
tell
,
Vo
l.
15
,
No
.
2
,
Ap
r
il
20
26
:
109
7
-
1
1
0
8
1104
4
.
2
.
Sh
a
re
d bo
nd
ing
a
nd
a
g
g
re
g
a
t
ed
s
er
v
ice
co
m
po
s
it
io
n
I
n
n
eo
n
atal
cr
itical
ca
r
e,
a
s
in
g
le
p
atien
t
m
ay
ex
h
i
b
it
m
u
ltip
le
co
ex
is
tin
g
co
n
d
itio
n
s
th
at
s
h
ar
e
v
ital
in
d
icato
r
s
.
On
e
f
r
eq
u
e
n
tly
o
cc
u
r
r
in
g
co
ex
is
tin
g
co
n
d
itio
n
i
n
clu
d
es
:
C
1
:
m
ild
r
esp
ir
ato
r
y
d
is
tr
ess
(
tr
ig
g
er
ed
wh
en
FiO
2
≥30%
–
6
0
%)
.
C
4
:
m
ild
h
y
p
o
x
em
ia
(
tr
ig
g
er
e
d
wh
en
SaO
2
≤
9
0
%).
Fig
u
r
e
4
illu
s
tr
ates
th
e
s
er
v
ice
co
m
p
o
s
itio
n
g
r
a
p
h
o
f
tr
ea
t
m
en
t
p
lan
s
(
T
1
+T
4
)
f
o
r
th
e
co
ex
is
tin
g
co
n
d
itio
n
s
o
f
(
C
1
an
d
C
4
)
.
T
h
e
b
lu
e
n
o
d
es
in
d
icate
th
e
s
e
r
v
ices
th
at
ar
e
co
m
p
o
s
ed
as
p
ar
t
o
f
t
h
e
p
r
im
a
r
y
in
ter
v
en
tio
n
tr
ea
tm
e
n
t p
lan
,
a
n
d
th
e
r
ed
n
o
d
es in
d
icate
th
at
m
o
r
e
s
er
v
ices h
av
e
b
ee
n
ad
d
e
d
to
th
e
co
m
p
o
s
itio
n
wh
en
th
e
co
n
d
itio
n
escalate
s
.
T
h
e
d
ash
ed
lin
es
in
d
icate
f
r
o
m
(
o
x
y
g
e
n
d
eliv
er
y
to
s
ed
atio
n
)
in
d
icate
s
th
at
th
e
co
n
d
itio
n
o
f
th
e
in
f
a
n
t
h
as
r
ap
id
ly
d
eter
io
r
ated
,
r
eq
u
ir
in
g
im
m
ed
iate
cr
itical
ca
r
e.
I
f
th
e
co
n
d
itio
n
is
s
tab
le,
th
en
th
e
r
esp
ir
ato
r
y
s
u
p
p
o
r
t
s
er
v
ices
ar
e
co
m
p
o
s
ed
.
I
f
th
e
c
o
n
d
itio
n
wo
r
s
en
s
d
esp
ite
r
esp
ir
ato
r
y
s
u
p
p
o
r
t,
th
e
s
er
v
ices
(
in
tu
b
atio
n
,
v
en
tilatio
n
s
u
p
p
o
r
t,
v
e
n
tilatio
n
c
o
n
tr
o
l,
an
d
cr
itical
ca
r
e
)
a
r
e
d
y
n
a
m
ically
ad
d
e
d
to
th
e
s
er
v
ice
co
m
p
o
s
itio
n
.
T
h
is
ad
a
p
tiv
e
b
eh
a
v
io
r
is
en
a
b
led
b
y
m
ec
h
an
is
m
s
o
f
em
e
r
g
en
ce
an
d
d
ee
p
lear
n
in
g
an
d
en
s
u
r
es
tim
ely
an
d
ap
p
r
o
p
r
iate
cr
itical
ca
r
e
f
o
r
th
e
in
f
an
t.
T
h
e
tr
ea
tm
en
t
p
lan
(
T
1
+T
4
)
is
co
m
p
o
s
ed
b
ased
o
n
th
e
co
n
d
itio
n
o
f
t
h
e
p
atien
t.
T
h
e
s
er
v
ice
s
eq
u
en
ce
s
f
o
r
m
ild
an
d
s
ev
er
e
tr
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4
.
3
.
Sim
ula
t
i
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n o
f
m
icro
s
er
v
ice
co
m
po
s
it
io
ns
T
h
is
s
ec
tio
n
p
r
esen
ts
th
e
s
i
m
u
latio
n
o
u
tc
o
m
es
o
f
th
e
p
r
o
p
o
s
ed
s
elf
-
o
r
g
a
n
izin
g
m
i
cr
o
s
er
v
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co
m
p
o
s
itio
n
m
o
d
el.
T
h
e
m
o
d
el
is
im
p
lem
en
ted
u
s
in
g
an
ag
en
t
-
b
ased
lo
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ed
d
ed
with
d
y
n
am
ic
b
o
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d
in
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m
ec
h
an
is
m
s
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h
e
m
o
d
el
s
im
u
lates
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o
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d
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d
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io
r
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em
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en
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a
n
d
lear
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in
g
.
4
.
3
.
1
.
M
icro
s
er
v
ice
co
m
po
s
it
io
n a
nd
ex
ec
utio
n t
im
e
A
s
am
p
le
s
ize
o
f
ap
p
r
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x
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at
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2
,
0
0
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s
es
h
a
v
in
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th
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co
n
d
itio
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C
1
alo
n
e
w
as
u
s
ed
to
tr
ain
th
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m
o
d
el,
e
n
s
u
r
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s
u
f
f
icien
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lear
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m
p
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s
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p
atter
n
s
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r
th
at
co
n
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n
.
Su
b
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tly
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ain
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ly
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1
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ased
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elate
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in
im
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e
[
2
5
]
.
Fo
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Ser
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er
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ices in
to
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p
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ite
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er
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4
.
3
.
2
.
Serv
ice
co
m
po
s
it
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n f
o
r
direct
bo
nd
ing
T
h
e
d
ee
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lear
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g
en
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ain
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m
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s
e
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er
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ice
s
eq
u
en
ce
s
to
p
r
o
v
id
e
th
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ea
t
m
en
t
p
lan
(
T
1
)
f
o
r
b
o
th
m
ild
a
n
d
s
ev
er
e
ca
s
es.
T
h
e
s
er
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m
p
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s
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n
tim
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d
th
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n
tim
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ch
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r
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s
2
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ea
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n
t
p
lan
s
f
o
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th
e
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ately
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m
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ld
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p
lan
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T
1
-
m
ild
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an
d
th
e
s
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er
e
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ea
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en
t
p
lan
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T
1
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e
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.
T
h
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Ser
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s
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ch
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ild
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T
ab
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s
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m
m
ar
izes th
e
d
etails o
f
th
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co
m
p
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s
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n
t p
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.
T
ab
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Av
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Us.
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ci
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r
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ar
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s
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im
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ased
o
n
au
th
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n
tic
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ata,
s
h
o
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s
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g
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tim
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g
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er
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m
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itio
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.
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h
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m
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t
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tial
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t
in
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r
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s
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e
m
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el
o
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le
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r
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I
o
T
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ir
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r
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ate
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ar
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Gr
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Me
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Evaluation Warning : The document was created with Spire.PDF for Python.