Using Features of Arden Syntax with Object-Oriented
Medical Data Models for Guideline Modeling
Mor Peleg, Ph.D.1, Omolola Ogunyemi, Ph.D.2, Samson Tu, M.S. 1,
Aziz A. Boxwala, M.B.B.S., Ph.D.2, Qing Zeng, Ph.D.2,
Robert A. Greenes, M.D., Ph.D.2, Edward H. Shortliffe, M.D., Ph.D.3 1Stanford Medical Informatics, Stanford University School of Medicine, Stanford, CA
2Decision Systems Group, Harvard Medical School, Brigham & Women’s Hospital, Boston, MA; 3 Department of Medical Informatics, Columbia University, New York, NY
Computer-interpretable guidelines (CIGs) can d e-liver patient-specific decision support at the point of care. CIGs base their recommendations on eligibility and decision criteria that relate medical concepts to patient data. CIG models use expression languages for specifying these criteria, and define models for medical data to which the expressions can refer. In developing version 3 of the GuideLine Interchange Format (GLIF3), we used existing standards as the medical data model and expression language. We investigated the object-oriented HL7 Reference I n-formation Model (RIM) as a default data model. We developed an expression language, called GEL, based on Arden Syntax’s logic grammar. Together with other GLIF constructs, GEL reconciles incom-patibilities between the data models of Arden Syntax and the HL7 RIM. These incompatibilities include Arden’s lack of support for complex data types and time intervals, and the mismatch between Arden’s single primary time and multiple time attributes of the HL7 RIM.
1 Introduction
Computer-interpretable guidelines (CIGs) that are linked to electronic medical records (EMRs) are a means for providing patient-specific advice automati-cally at the point-of-care. There are several method-ologies for encoding guidelines to make them com-puter-interpretable.1-4 All of these methodologies have constructs for defining criteria that relate medical concepts to patient data. While each methodology has different constructs, they all use some sort of expres-sion language for specifying logical decision and eligibility criteria, and a data model for medical con-cepts and patient data.
GLIF is a format for encoding and sharing computer-interpretable clinical guidelines developed by the InterMed Collaboratory, a joint project of medical informatics groups at Harvard, Stanford, and Colum-bia universities. GLIF34 is GLIF’s third version. This paper discusses the approach that InterMed has used to design a data model and expression language for GLIF3. GLIF3 is designed to support computer-based execu-tion, with integration into clinical systems environ-ments and access to data in the EMR. While the con-trol-flow of the GLIF model was already formally expressed in GLIF2, decision and eligibility criteria, and patient data, were expressed in natural language that did not support execution.4 Therefore, our goals for GLIF3 were to develop: (1) a formal expression language that allows computation on time-stamped data, and (2) a data model that specifies a hierarchy of classes, which represent medical concepts and data and defines their characterizing attributes, including timing aspects.
GLIF3 enables a guideline specification to be com-putable by formally specifying patient data items, action specifications, decision criteria, and eligibility criteria. For patient data items, there must be a defini-tion of medical concepts to which the data refer. This definition is given by a medical ontology, which con-tains the clinical meaning of the concepts as well as their structure, or data model. As an example, a test result should have at least two attributes, one that represents the test value and one for the biologically-relevant time of the test. Defining medical concepts in relation to standard medical vocabularies allows the guideline encoding to contain concepts that are institution-independent. Mapping to institution-dependent EMR codes and procedures can therefore be specified in another level.
The GLIF3 guideline model uses the medical ontol-ogy in two ways. First, action specifications such as recommended test orders or notifications are defined in terms of formal medical concepts contained in the medical ontology. Second, a formal expression lan-guage uses data item names that are defined by the medical ontology. The expression language is used to express decision criteria, eligibility criteria, and p a-tient states.
2 Background
In creating GLIF3, we have tried to build on stan-dards so as to avoid duplicating the work of others.
Toward this end, we determined that working with the HL7 organization would be desirable. The Clini-cal Guidelines Special Interest Group in HL7 was formed this year, to move toward a standardized rep-resentation for computer-based guidelines. To fur-ther the harmonization with ongoing HL7 efforts, we developed an expression language derived from Ar-den Syntax’s logic grammar. Arden Syntax is a stan-dard of the American Society for Testing and Materi-als6 and is being further developed under HL7. We used standard controlled medical vocabularies to de-fine medical concepts. We investigated the HL7 RIM version 1.0 as a default medical data model, as GLIF3 allows a guideline encoder to use any object-oriented (OO) model for defining the structure of the concepts used by the guideline.
2.1 HL7’s Reference Information Model
The clinical part of HL7’s RIM version 1.05 can model medical knowledge and patient data uni-formly. All clinical data are specified as Act objects, or Acts. Acts have attributes that provide information about clinical concepts they represent and their tim-ing. Relationships are used to model the Act circum-stances and allow grouping the Acts and reasoning about them. Acts are specialized into procedures per-formed on a patient, observations about the patient, medications given to the patient, and other kinds of services. Different sub-classes contain additional attributes that help characterize an Act. For example, Observation has a value attribute, whereas Medica-tion has attributes about dosage and route of admini-stration. Act objects have a mood that distinguishes the ways in which they can be conceived: as an event that occurred, a definition, intent, order, etc.5
2.2 Arden Syntax
Arden Syntax is used to compose Medical Logic Modules (MLMs), each of which represents a single medical decision. Arden Syntax assumes a simple data model. It supports the following simple types: null, Boolean, number, time (timestamp), duration, and string. In addition, it supports a list of simple types and a query result, which is a list whose values are associated with a primary time – the medically relevant time of occurrence. An element of a list or a query result can have only one data value; no com-plex data values are supported. For example, a drug’s administration route and dose must be represented as different variables.
An MLM has logic and data slots that define its deci-sion logic and the medical data items it uses. These slots use expressions whose syntax is defined by a grammar that we refer to as “Arden Syntax l o gic grammar”. The data slot of an MLM in Arden Syntax specifies how data are retrieved from an EMR. How-ever, only part of this specification is defined by the syntax. Mapping the MLM variables to the institu-tional EMR must be defined in a non-standard way within curly braces, a difficulty that is called the curly braces problem in the Arden community. This problem implies that sharing an MLM among differ-ent institutions requires adapting the MLMs to local systems and terminology standards.
3 GLIF3’s expression language and its interaction with the medical data model
We used Arden Syntax’s logic grammar as our basis for developing GLIF3’s expression language, as Ar-den Syntax has been accepted as a standard for deliv-ering alerts and reminders and is a m ature language that has been implemented and tested by multiple academic groups and commercial vendors.
In developing GLIF3’s domain ontology, we used an OO data model because of the advantages it provides. One advantage is that an OO data model encapsulates the attributes of a patient data item into a single com-plex data object. For example, an HL7 Medication object can specify the particular medication used, the dose, the route of administration, the time period for which it was prescribed, and the date of first prescrip-tion, among other things. Encapsulation i m proves data integrity and makes conceptualizing easier. An-other advantage of an OO data model is that it e n-ables a declarative way of specifying medical con-cepts and data items used by a guideline. This method could facilitate mapping concepts and data items to institutional EMRs, thus addressing Arden’s curly braces problem, as suggested by Jenders et al 7. HL7 RIM is suitable as a medical data model for GLIF3 because it is general enough to represent the data structures for a wide range of medical data and concepts in a uniform manner while using a small number of classes.5 Moreover, HL7 is creating stan-dards for messaging interfaces for EMRs based on the RIM.
Figure 1 shows an example of the definition of a GLIF3 data item representing an ACE Inhibitor treatment that uses the HL7 RIM Medication object.
3.1 Incompatibilities between Arden Syntax logic grammar and the HL7 RIM
Using Arden Syntax’s logic grammar in the context of a complex OO data model is not straightforward, as there are several incompatibilities between the two models. As mentioned, the major incompatibility is that Arden Syntax has a simple data model, whereas the HL7 RIM model is object oriented. Thus, many
of the standard operators for Arden Syntax’s logic grammar cannot be used compatibly with the HL7 RIM.
Another incompatibility is that Arden’s data model does not contain intervals as a data type, whereas the data model in the HL7 RIM and in GLIF3 allows expression of temporal and other types of intervals. In addition, HL7 RIM data model classes can have many different times associated with them, while Arden Syntax is limited to a single timestamp. For example, in HL7 RIM, an Act data model c lass may be associated with an activity time interval that repre-sents the time that the medical action took place, a critical time interval that represents the biologically relevant time period for the action, and a recording (availability) timestamp of the action. Arden Syntax defines many operators (e.g., latest) that assume that each data value can be associated with at most one time stamp. Clearly, this compatibility issue between the two models is problematic.
(Instance of Variable_Data_Item)
{name: ACEI_Item
concept: {(instance of Concept)
concept_name: ACEI;
concept_id: C0003015;
concept_source: UMLS}
data_model_class_id: Medication
data_model_source_id: HL7-RIM
data_value: {(instance of Medication)
service_cd: ACEI concept;
mood_cd: event;
critical_time: {low: null;
high: null;}…} } Figure 1. A variable data item that defines ACE In-hibitor treatment. Attribute names are on the left, followed by their values. Complex values are in curly braces. The ACEI data specify the appropriate UMLS code and HL7 RIM class (Medication). The figure shows two attributes of Medication. Other attributes include dosage_quantity, rate_quantity, and route_code.
3.2 The GLIF3 approach for using Arden Syn-tax’s logic grammar with the HL7 RIM
To address the incompatibilities, we created an e x-pression language that we call the Guideline Expres-sion Language (GEL). GEL is based on Arden Syn-tax’s logic grammar but supports (1) complex data structures; (2) timestamp, numeric, and duration i n-tervals; and (3) function definitions. In addition, we created constructs in GLIF3 that extract patient data taken from the EMR as HL7 RIM objects and trans-form them into GEL-compatible data structures. This solution allows an Arden-derived expression lan-guage to be used with an object-oriented data model. Examples of this approach follow.
3.2.1 GEL
In addition to supporting Arden Syntax’s basic data types, GEL supports complex data types, intervals, lists of these new types, and query results, the data values of which can be a complex type or an interval.
A complex data type can have any number of attrib-utes, each of which is a GEL data type.
GEL supports most of the Arden Syntax logic gram-mar operators1, and it also provides a mechanism for users to define functions. This feature is important for facilitating GLIF3’s support for user-defined data model classes and instances. A user may want to de-fine a data model in which primary time has no spe-cial meaning, but in which other meaningful relation-ships might be semantically important. For example, inheritance relationships among concepts (e.g., drug hierarchies) might be a central part of the data model. GEL supports complex data types, but their attributes are treated equally a nd do not convey any special semantic meaning. A way to restore such semantics is to define GEL functions. For example, a function can be defined that would deduce the children of a con-cept based on inheritance relationships. This a p-proach would restore the semantics of a “parent” at-tribute of a concept class.
Adding several functions that can be used by GLIF3 when writing GEL expressions is useful. The most important of these functions, selectAttribute is analo-gous to the “dot” operator of OO languages, which is used to access an object’s attributes. For example, if currentACEI has a complex data type and one of its attributes is critical_time, then the value of criti-cal_time can be extracted by the following GEL e x-pression: “SelectAttribute(“critical_time”, currentACEI)”.
3.2.2 GLIF3 constructs that return data consistent with the GEL data model
GLIF3’s Get_Data_Action retrieves patient data from the EMR as HL7 RIM objects and transforms them to query result data types. It allows a mapping to be specified from GLIF3’s default data model, the HL7 RIM, to GEL’s data model. A guideline author can use Get_Data_Action to specify that an attribute of a complex RIM class is the source of data values for the query result, and that values of another attribute serve as the primary time in the query result. Thus, the query result is a list of value and primary time 1 GEL currently does not support all of the numeric functions of Arden Syntax but they can be defined by GEL functions.
pairs similar to Arden’s query result data type. How-ever, the value attribute in GEL’s query result holds a simple or a complex GEL type. Get_Data_Action specifies which data item from the EMR will serve as the source of data, and which attribute will be s e-lected from the data item. In this way, specific attrib-utes of the data item can serve as the source of the data, rather than the entire data item. For ex ample, Get_Data_Action can retrieve all instances of Medi-cation data items that refer to ACE Inhibitor treat-ments (Figure 2). It can assign the value of their data value attribute, which is a RIM Medication o bject (Figure 1), to the query result’s “value” attribute, and assign the end time of each Medication treatment (critical_time.high) to the “primary time” attribute of the query result elements.
(Instance of Get_Data_Action)
data_item: ACEI_Item
attribute_to_be_assigned: data_value
variable_name: ACEI
primary_time: data_value.critical_time.high
(Instance of Query_Result)
value: (Medication instance) value: (Medication instance) .. primary_time: 2002-01-08 primary_time: 1999-03-02
Figure 2. The Get_Data_Action and its query result that holds ACEI Medication objects data values and their primary times. In this example, the latest query result element has the primary_time 2002-01-08.
Because GEL query results have the same data model as Arden query results, many Arden operators can be used in GEL expressions. For example, GEL expres-sions can be written to select the latest element in an ACEI query result, to check that the latest prescrip-tion applies to the current date, or to form a list of current medications given to a patient out of single current medications. The Assignment_Action of GLIF3 can be used to set a variable with a result of a GEL expression. For example, a variable called cur-rent ACEI can be assigned with a GEL expression that returns the value of the “value” attribute of the latest ACEI element of the query result in Figure 2, provided its primary time is current (>= now), i.e., the medication prescription is still active. In the e x-ample shown in Figure 2, the primary time of the latest ACEI query result element is 2002-01-08. Fig-ure 3(a) shows the GEL expression.
(a) CurrentACEI := SelectAttribute(“value”, latest ACEI
where time of it >= now)
(b) ACEIStartTime := SelectAttribute(“low”,
SelectAttribute(“critical_time”, currentACEI)); ACEIStartTime < (now – 4 weeks)
Figure 3. GEL expressions The variables that hold results of Get_Data and As-signment_Action can be u sed within decision and eligibility criteria expressed in GEL. Figure 3(b) specifies an expression and a criterion in GEL. The expression extracts the start time (critical_time.low) of the current ACE Inhibitor prescription from the value of variable currentACEI, extracted by the e x-pression shown in Figure 3(a). The criterion checks whether an ACE Inhibitor was prescribed before 4 weeks ago.
4 Discussion
Our solutions can help guide others who are seeking to use Arden Syntax as an expression language that will be used with object-oriented EMR models. HL-7, within which both the RIM and Arden Syntax are being developed, is also seeking ways in which the two models can be harmonized. Our suggestions can provide possible direction to this effort.
The InterMed Collaboratory has explored the possi-bility of reconciling Arden Syntax’s logical grammar with domain concepts and patient data represented as complex objects. GEL takes a conservative approach to reconciling the difference between Arden Syntax’s data model and object-oriented medical data models. It does so by augmenting the data model in a limited way and adding several functions that enable (1) ex-traction of attributes from the complex data types, and (2) operations on lists of complex data values, while maintaining the existing Arden operators. GEL’s data model allows complex data types. How-ever, GEL’s expression language does not directly support the object-oriented model. Instead, the selec-tAttribute function of GEL is used to extract attribute values from complex types. In addition, user-defined functions can be used to convey the semantics of re-lationships provided by the OO model, such as the inheritance relationship discussed in Section 3.2.1. They can also be used to implement methods of ob-ject-oriented classes.
A disadvantage of GEL is its limitation for specifying expressions that relate to more than one of an object’s attributes. For example, in a query result of Amo x-icillinPrescriptions where the result values have a dose of 500 mg and an oral route, it is useful to write an expression that selects the start time from the val-ues of the result. The “where” part of the expression would ideally be written as “where selectAttrib-ute(“route”, it) = “oral”…”. However, “it” cannot be an argument of a GEL function because the function needs to get the entire list or query result as a parameter. This restriction bars writing “where” clauses that use GEL functions. As a result, “where”
cannot be used to check constraints on specific a t-tribute values other than primary_time. Instead, there is a need to specify a loop that looks at single ele-ments in the list or query result, and evaluates criteria imposed on the element’s attribute values. Alterna-tively, specific GEL functions can be written to i m-plement such loops for special cases.
We used GLIF3 for encoding two clinical guidelines: management of chronic cough and hypertension management. GEL was sufficient to encode the cough guidelines, but we had to add a special GEL function for encoding the hypertension guideline. While the special function allowed us to encode the second guideline, adding special-purpose functions is not a principled approach and there are likely to be additional expressions that cannot be encoded with-out adding more functions into GEL.
Other studies have tried to reconcile different data models. One study described a translation between complex data models using an intermediate OO rule-based approach.8 When they translate an OO model into a non-OO model, the methods in the OO model cannot be translated, and they show up as a discrep-ancy between the two models. Another group devel-oped a translation of high-order object queries to first-order relational queries.9 We did not find pub-lished work that tried to reconcile an OO data model with an expression language that does not support operators on relations between attributes of complex schema/objects.
We are developing an OO expression language that can associate methods with each class in the OO medical data model. Binding methods with the data will provide a more systematic and scalable approach to defining an expression language. The OO expres-sion language can have several predefined classes, such as List and Math, which contain Arden’s list and numeric operators. For example, merge will be a method of the List class, whereas sin will be a method of the Math class. In addition to the built-in classes, the medical domain ontology classes will likely define methods to which the OO expression language can refer.
We have found that the Arden community also de-sires development of an expression language that can work with the object-oriented HL7 RIM data model. As part of the Arden and Clinical Guidelines special interest groups in HL7, we will be further developing the expression language that will work with the RIM. For the reasons we have outlined in this paper, we believe that designing an expression syntax that is designed from the outset to be compatible with the object-oriented data model is preferable to trying to reconcile two radically different data mo dels.
Acknowledgements
Supported in part by Grant LM06594 with support from the Department of the Army, Agency for Healthcare Research and Quality, and the National Library of Medicine.
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with复合结构专项练习（二） 一请选择最佳答案 1）With nothing_______to burn，the fire became weak and finally died out. A.leaving B.left C.leave D.to leave 2）The girl sat there quite silent and still with her eyes_______on the wall. A.fixing B.fixed C.to be fixing D.to be fixed 3）I live in the house with its door_________to the south.（这里with结构作定语） A.facing B.faces C.faced D.being faced 4）They pretended to be working hard all night with their lights____. A.burn B.burnt C.burning D.to burn 二：用with复合结构完成下列句子 1）_____________（有很多工作要做），I couldn't go to see the doctor. 2）She sat__________（低着头）。 3）The day was bright_____.（微风吹拂） 4）_________________________，（心存梦想）he went to Hollywood. 三把下列句子中的划线部分改写成with复合结构。 1）Because our lessons were over，we went to play football. _____________________________. 2）The children came running towards us and held some flowers in their hands. _____________________________. 3）My mother is ill，so I won't be able to go on holiday. _____________________________. 4）An exam will be held tomorrow，so I couldn't go to the cinema tonight. _____________________________.
1. with+宾语+形容词。比如：. The boy wore a shirt with the neck open, showing his bare chest. 那男孩儿穿着一件衬衫，颈部敞开，露出光光的胸膛。Don’t talk with your mouth full. 嘴里有食物时不要讲话。 2. with+宾语+副词。比如：She followed the guide with her head down. 她低着头，跟在导游之后。 What a lonely world it will be with you away. 你不在，多没劲儿呀！ 3. with+宾语+过去分词。比如：He was listening to the music with his eyes half closed. 他眼睛半闭着听音乐。She sat with her head bent. 她低着头坐着。 4. with+宾语+现在分词。比如：With winter coming, it’s time to buy warm clothes. 冬天到了，该买些保暖的衣服了。 He soon fell asleep with the light still burning. 他很快就睡着了，（可）灯还亮着。 5. with+宾语+介词短语。比如：He was asleep with his head on his arms. 他的头枕在臂膀上睡着了。 The young lady came in, with her two- year-old son in her arms. 那位年轻的女士进来了，怀里抱着两岁的孩子。 6. with+宾语+动词不定式。比如： With nothing to do in the afternoon, I went to see a film. 下午无事可做，我就去看了场电影。Sorry, I can’t go out with all these dishes to wash. 很抱歉，有这么多盘子要洗，我不能出去。 7. with+宾语+名词。比如： He died with his daughter yet a school-girl.他去逝时，女儿还是个小学生。 He lived a luxurious life, with his old father a beggar . 他过着奢侈的生活，而他的老父亲却沿街乞讨。(8)With so much work to do ,I can't go swimming with you. (9)She stood at the door,with her back towards us. (10)He entered the room,with his nose red with cold. with复合结构与分词做状语有啥区别 [ 标签：with, 复合结构, 分词状语] Ciro Ferrara 2009-10-18 16:17 主要是分词形式与主语的关系 满意答案好评率：100%
基本用法 它是由介词with或without+复合结构构成，复合结构作介词with或without的复合宾语，复合宾语中第一部分宾语由名词或代词充当，第二部分补足语由形容词、副词、介词短语或非谓语动词充当 一、with或without+名词/代词+形容词 例句:1.I like to sleep with the windows open. 我喜欢把窗户开着睡觉。(伴随情况) 2.With the weather so close and stuffy, ten to one it'll rain presently. 大气这样闷，十之八九要下雨(原因状语) 二、with或without+名词/代词+副词 例句:1.She left the room with all the lights on. 她离开了房间，灯还亮着。(伴随情况) 2.The boy stood there with his head down. 这个男孩低头站在那儿。(伴随情况) 三、with或without+名词/代词+介词短语 例句:1.He walked into the dark street with a stick in his hand. 他走进黑暗的街道时手里拿着根棍子。(伴随情况) 2. With the children at school, we can't take our vacation when we want to. 由于孩子们在上学，所以当我们想度假时而不能去度假。(原因状语) 四、with或without+名词/代词+非谓语动词 1、with或without+名词/代词+动词不定式，此时，不定式表示将发生的动作。 例句: 1.With no one to talk to, John felt miserable. 由于没人可以说话的人，约翰感到很悲哀。(原因状语)
With的用法全解 with结构是许多英语复合结构中最常用的一种。学好它对学好复合宾语结构、不定式复合结构、动名词复合结构和独立主格结构均能起很重要的作用。本文就此的构成、特点及用法等作一较全面阐述，以帮助同学们掌握这一重要的语法知识。 一、 with结构的构成 它是由介词with或without+复合结构构成，复合结构作介词with或without的复合宾语，复合宾语中第一部分宾语由名词或代词充当，第二部分补足语由形容词、副词、介词短语、动词不定式或分词充当，分词可以是现在分词，也可以是过去分词。With结构构成方式如下： 1. with或without-名词/代词+形容词； 2. with或without-名词/代词+副词； 3. with或without-名词/代词+介词短语； 4. with或without-名词/代词 +动词不定式； 5. with或without-名词/代词 +分词。 下面分别举例： 1、 She came into the room，with her nose red because of cold.（with+名词+形容词，作伴随状语）
2、 With the meal over ， we all went home.（with+名词+副词，作时间状语） 3、The master was walking up and down with the ruler under his arm。（with+名词+介词短语，作伴随状语。） The teacher entered the classroom with a book in his hand. 4、He lay in the dark empty house，with not a man ，woman or child to say he was kind to me.（with+名词+不定式，作伴随状语）He could not finish it without me to help him.（without+代词 +不定式，作条件状语） 5、She fell asleep with the light burning.（with+名词+现在分词，作伴随状语） Without anything left in the with结构是许多英 语复合结构中最常用的一种。学好它对学好复合宾语结构、不定式复合结构、动名词复合结构和独立主格结构均能起很重要的作用。本文就此的构成、特点及用法等作一较全面阐述，以帮助同学们掌握这一重要的语法知识。 二、with结构的用法 with是介词，其意义颇多，一时难掌握。为帮助大家理清头绪，以教材中的句子为例，进行分类，并配以简单的解释。在句子中with结构多数充当状语，表示行为方式，伴随情况、时间、原因或条件（详见上述例句）。 1.带着，牵着…… (表动作特征)。如： Run with the kite like this.
With的复合结构 介词with without +宾语+宾语的补足语可以构成独立主格结构，上面讨论过的独立主格结构的几种情况在此结构中都能体现。 1. with+名词代词+形容词 He doesn’t like to sleep with the windows open. = He doesn’t like to sleep when the windows are open. He stood in the rain, with his clothes wet. = He stood in the rain, and his clothes were wet. With his father well-known, the boy didn’t want to study. 2. with+名词代词+副词 Our school looks even more beautiful with all the lights on. = Our school looks even more beautiful if when all the lights are on. The boy was walking, with his father ahead. = The boy was walking and his father was ahead. 3. with+名词代词+介词短语 He stood at the door, with a computer in his hand. He stood at the door, computer in hand. = He stood at the door, and a computer was in his hand. Vincent sat at the desk, with a pen in his mouth. Vincent sat at the desk, pen in mouth. = Vincent sat at the desk, and he had a pen in his mouth. 4. with+名词代词+动词的-ed形式 With his homework done, Peter went out to play. = When his homework was done, Peter went out to play. With the signal given, the train started. = After the signal was given, the train started. I wouldn’t dare go home without the job finished. = I wouldn’t dare go home because the job was not finish ed. 5. with+名词代词+动词的-ing形式 The girl hid her box without anyone knowing where it was. = The girl hid her box and no one knew where it was. Without anyone noticing, he slipped through the window. = When no one was noticing, he slipped through the window. 6. with+名词代词+动词不定式 The little boy looks sad, with so much homework to do. = The little boy looks sad because he has so much homework to do. with the window closed with the light on with a book in her hand with a cat lying in her arms with the problem solved with the new term to begin
with+复合宾语的用法 一、with的复合结构的构成 二、所谓"with的复合结构”即是"with+复合宾语”也即"with +宾语+宾语补足语” 的结构。其中的宾语一般由名词充当（有时也可由代词充当）；而宾语补足语则是根据 具体的需要由形容词，副词、介词短语，分词短语（包括现在分词和过去分词）及不定式短语充当。下面结合例句就这一结构加以具体的说明。 三、1、with +宾语+形容词作宾补 四、①He slept well with all the windows open.（82 年高考题） 上面句子中形容词open作with的宾词all the windows的补足语， ②It' s impolite to talk with your mouth full of food. 形容词短语full of food 作宾补。Don't sleep with the window ope n in win ter 2、with+宾语+副词作宾补 with Joh n away, we have got more room. He was lying in bed with all his clothes on. ③Her baby is used to sleeping with the light on.句中的on 是副词，作宾语the light 的补足语。 ④The boy can t play with his father in.句中的副词in 作宾补。 3、with+宾语+介词短语。 we sat on the grass with our backs to the wall. his wife came dow n the stairs,with her baby in her arms. They stood with their arms round each other. With tears of joy in her eyes ,she saw her daughter married. ⑤She saw a brook with red flowers and green grass on both sides. 句中介词短语on both sides 作宾语red flowersandgreen grass 的宾补， ⑥There were rows of white houses with trees in front of them.，介词短语in front of them 作宾补。 4、with+宾词+分词（短语 这一结构中作宾补用的分词有两种，一是现在分词，二是过去分词，一般来说，当分词所表 示的动作跟其前面的宾语之间存在主动关系则用现在分词，若是被动关系，则用过去分词。 ⑦In parts of Asia you must not sit with your feet pointing at another person.（高一第十课），句中用现在分词pointing at…作宾语your feet的补足语，是因它们之间存在主动关系，或者说point 这一动作是your feet发出的。 All the after noon he worked with the door locked. She sat with her head bent. She did not an swer, with her eyes still fixed on the wall. The day was bright,with a fresh breeze（微风）blowing. I won't be able to go on holiday with my mother being ill. With win ter coming on ,it is time to buy warm clothes. He soon fell asleep with the light still bur ning. ⑧From space the earth looks like ahuge water covered globe,with a few patches of land stuk ing out above the water而在下面句子中因with的宾语跟其宾补之间存在被动关系，故用过去分词作宾补：
复合材料结构设计的特点 (1) 复合材料既是一种材料又是一种结构 (2) 复合材料具有可设计性 (3) 复合材料结构设计包含材料设计 复合材料区别于传统材料的根本特点之一可设计性好（设计人员可根据所需制品对力学及其它性能的要求，对结构设计的同时对材料本身进行设计） 具体体现在两个方面1力学设计——给制品一定的强度和刚度、2功能设计——给制品除力学性能外的其他性能 复合材料力学性能的特点 (1) 各向异性性能材料弹性主方向：模量较大的一个主方向称为纵向，用字母L表示，与其垂直的另一主方向称为横向，用字母T表示。通常的各向同性材料中，表达材料弹 )和ν(泊松比)或剪切弹性模量G。 对于复合材料中的每个单层，纵向弹性模量E L、横向弹性模量E T、纵向泊松比νL (或横向泊松比νT)、面内剪切弹性模量G LT。 耦合现象：拉剪耦合与剪拉耦合、弯扭耦合与扭弯耦合 (2) 非均质性 耦合变形：层合结构复合材料在一种外力作用下，除了引起本身的基本变形外，还可能引起其他基本变形。 (3)层间强度低 在结构设计时，应尽量减小层间应力，或采取某些构造措施，以避免层间分层破坏。 研究复合材料的刚度和强度时，基本假设： (1) 假设层合板是连续的。由于连续性假设，使数学分析中的一些连续性概念、极限概念以及微积分等数学工具都能应用于力学分析中。 (2）假设单向层合板是均匀的，多向层合板是分段均匀的。 (3) 假设限于单向层合板是正交各向异性的：即认为单向层合板具有两个相互垂直的弹性对称面。 (4) 假设限于层合板是线弹性的：即认为层合板在外力作用下产生的变形与外力成正比关系，且当外力移去后，层合板能够完全恢复其原来形状。 (5) 假设层合板的变形是很小的。 上述五个基本假设，只有多向层合板的分段均匀性假设和单向层合板的正交各向异性假设，与材料力学中的均匀性假设和各向同性假设有区别。 平面应力状态与平面应变状态 平面应力状态：单元体有一对平面上的应力等于0。（σz＝0，τzx＝0，τzy ＝0） 平面应变状态（平面位移）：εz＝0（即ω＝0），τzx＝0(γ31＝0)，τzy ＝0(γ32＝0 )， σz一般不等于0。 复合材料连接方式 复合材料连接方式主要分为两大类：胶接连接与机械连接。胶接连接：受力不大的薄壁结构，尤其是复合材料结构；机械连接：连接构件较厚、受力大的结构。
with复合结构 一. with复合结构的常见形式 1.“with+名词/代词+介词短语”。 The man was walking on the street, with a book under his arm. 那人在街上走着，腋下夹着一本书。 2. “with+名词/代词+形容词”。 With the weather so close and stuffy, ten to one it’ll rain presently. 天气这么闷热，十之八九要下雨。 3. “with+名词/代词+副词”。 The square looks more beautiful than even with all the light on. 所有的灯亮起来，广场看起来更美。 4. “with+名词/代词+名词”。 He left home, with his wife a hopeless soul. 他走了，妻子十分伤心。 5. “with+名词/代词+done”。此结构过去分词和宾语是被动关系，表示动作已经完成。 With this problem solved, neomycin 1 is now in regular production. 随着这个问题的解决，新霉素一号现在已经正式产生。 6. “with+名词/代词+-ing分词”。此结构强调名词是-ing分词的动作的发出者或某动作、状态正在进行。 He felt more uneasy with the whole class staring at him. 全班同学看着他，他感到更不自然了。 7. “with+宾语+to do”。此结构中，不定式和宾语是被动关系，表示尚未发生的动作。 So in the afternoon, with nothing to do, I went on a round of the bookshops. 由于下午无事可做，我就去书店转了转。 二. with复合结构的句法功能 1. with 复合结构，在句中表状态或说明背景情况，常做伴随、方式、原因、条件等状语。With machinery to do all the work, they will soon have got in the crops. 由于所有的工作都是由机器进行，他们将很快收完庄稼。（原因状语） The boy always sleeps with his head on the arm. 这个孩子总是头枕着胳膊睡觉。（伴随状语）The soldier had him stand with his back to his father. 士兵要他背对着他父亲站着。（方式状语）With spring coming on, trees turn green. 春天到了，树变绿了。（时间状语） 2. with 复合结构可以作定语 Anyone with its eyes in his head can see it’s exactly like a rope. 任何一个头上长着眼睛的人都能看出它完全像一条绳子。 【高考链接】 1. ___two exams to worry about, I have to work really hard this weekend.（04北京） A. With B. Besides C. As for D. Because of 【解析】A。“with+宾语+不定式”作状语，表示原因。 2. It was a pity that the great writer died, ______his works unfinished. (04福建) A. for B. with C. from D.of 【解析】B。“with+宾语+过去分词”在句中作状语，表示状态。 3._____production up by 60%, the company has had another excellent year. (NMET) A. As B.For C. With D.Through 【解析】C。“with+宾语+副词”在句中作状语，表示程度。
复合材料力学 论文题目：用氧化铝填充导热和电绝缘环氧 复合材料的无缺陷石墨烯纳米片 院系班级：工程力学1302 姓名：黄义良 学号： 201314060215
用氧化铝填充导热和电绝缘环氧复合材料的无缺陷石墨烯纳米片 孙仁辉1 ，姚华1 ，张浩斌1 ，李越1 ，米耀荣2 ，于中振3 （1.北京化工大学材料科学与工程学院，有机无机复合材料国家重点实验室北京 100029;2.高级材料技术中心（CAMT ），航空航天，机械和机电工程学院J07，悉尼大学;3.北京化工大学软件物理科学与工程北京先进创新中心，北京100029） 摘要：虽然石墨烯由于其高纵横比和优异的导热性可以显着地改善聚合物的导热性，但是其导致电绝缘的严重降低，并且因此限制了其聚合物复合材料在电子和系统的热管理中的广泛应用。为了解决这个问题，电绝缘Al 2O 3用于装饰高质量（无缺陷）石墨烯纳米片（GNP ）。借助超临界二氧化碳（scCO 2），通过Al(NO 3)3 前体的快速成核和水解，然后在600℃下煅烧，在惰性GNP 表面上形成许多Al 2O 3纳米颗粒。或者，通过用缓冲溶液控制Al 2(SO 4)3 前体的成核和水解，Al 2(SO 4)3 缓慢成核并在GNP 上水解以形成氢氧化铝，然后将其转化为Al 2O 3纳米层，而不通过煅烧进行相分离。与在scCO2的帮助下的Al 2O 3@GNP 混合物相比，在缓冲溶液的帮助下制备的混合物高度有效地赋予具有优良导热性的环氧树脂，同时保持其电绝缘。具有12％质量百分比的Al 2O 3@GNP 混合物的环氧复合材料表现出1.49W /（m ·K ）的高热导率，其比纯环氧树脂高677％，表明其作为导热和电绝缘填料用于基于聚合物的功能复合材料。 关键词：聚合物复合基材料（PMCs ） 功能复合材料 电气特性 热性能 Decoration of defect-free graphene nanoplatelets with alumina for thermally conductive and electrically insulating epoxy composites Renhui Sun 1，Hua Yao 1， Hao-Bin Zhang 1，Yue Li 1，Yiu-Wing Mai 2，Zhong-Zhen Yu 3 (1.State Key Laboratory of Organic-Inorganic Composites, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China; 2.Centre for Advanced Materials Technology (CAMT), School of Aerospace, Mechanical and Mechatronic Engineering J07, The University of Sydney, Sydney, NSW 2006, Australia; 3.Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China) Abstract:Although graphene can significantly improve the thermal conductivity of polymers due to its high aspect ratio and excellent thermal conductance, it causes serious reduction in electrical insulation and thus limits the wide applications of its polymer composites in the thermal management of electronics and systems. To solve this problem, electrically insulating Al 2O 3is used to decorate high quality (defect-free) graphene nanoplatelets (GNPs). Aided by supercritical carbon dioxide (scCO 2), numerous Al 2O 3 nanoparticles are formed
With复合结构的用法小结 with结构是许多英语复合结构中最常用的一种。学好它对学好复合宾语结构、不定式复合结构、动名词复合结构和独立主格结构均能起很重要的作用。本文就此的构成、特点及用法等作一较全面阐述，以帮助同学们掌握这一重要的语法知识。 一、with结构的构成 它是由介词with或without+复合结构构成，复合结构作介词with或without的复合宾语，复合宾语中第一部分宾语由名词或代词充当，第二 部分补足语由形容词、副词、介词短语、动词不定式或分词充当，分词可以是现在分词，也可以是过去分词。With结构构成方式如下： 1. with或without-名词/代词+形容词； 2. with或without-名词/代词+副词； 3. with或without-名词/代词+介词短语； 4. with或without-名词/代词+动词不定式； 5. with或without-名词/代词+分词。 下面分别举例： 1、She came into the room，with her nose red because of cold.（with+名词+形容词，作伴随状语） 2、With the meal over ，we all went home.（with+名词+副词，作时间状语） 3、The master was walking up and down with the ruler under his arm。（with+名词+介词短语，作伴随状语。）The teacher entered the classroom with a book in his hand. 4、He lay in the dark empty house，with not a man ，woman or child to say he was kind to me.（with+名词+不定式，作伴随状语）He could not finish it without me to help him.（without+代词+不定式，作条件状语） 5、She fell asleep with the light burning.（with+名词+现在分词，作伴随状语）Without anything left in the cupboard，shewent out to get something to eat.（without+代词+过去分词，作为原因状语） 二、with结构的用法 在句子中with结构多数充当状语，表示行为方式，伴随情况、时间、原因或条件（详见上述例句）。 With结构在句中也可以作定语。例如： 1.I like eating the mooncakes with eggs. 2.From space the earth looks like a huge water-covered globe with a few patches of land sticking out above the water. 3.A little boy with two of his front teeth missing ran into the house. 三、with结构的特点 1. with结构由介词with或without+复合结构构成。复合结构中第一部分与第二部分语法上是宾语和宾语补足语关系，而在逻辑上，却具有主谓关系，也就是说，可以用第一部分作主语，第二部分作谓语，构成一个句子。例如：With him taken care of，we felt quite relieved.（欣慰）→（He was taken good care of.）She fell asleep with the light burning. →（The light was burning.）With her hair gone，there could be no use for them. →（Her hair was gone.） 2. 在with结构中，第一部分为人称代词时，则该用宾格代词。例如：He could not finish it without me to help him. 四、几点说明： 1. with结构在句子中的位置：with 结构在句中作状语，表示时间、条件、原因时一般放在
《复合材料结构设计》习题 §1 绪论 1.1 什么是复合材料？ 1.2 复合材料如何分类？ 1.3 复合材料中主要的增强材料有哪些？ 1.4 复合材料中主要的基体材料有哪些？ 1.5 纤维复合材料力学性能的特点哪些？ 1.6 复合材料结构设计有何特点？ 1.7 根据复合材料力学性能的特点在复合材料结构设计时应特别注意到哪些问题? §2 纤维、树脂的基本力学性能 2.1 玻璃纤维的主要种类及其它们的主要成分的特点是什么？ 2.2 玻璃纤维的主要制品有哪些？玻璃纤维纱和织物规格的表示单位是什么？2.3 有一玻璃纤维纱的规格为2400tex，求该纱的横截面积（取玻璃纤维的密度 为2.54g/cm3）？ 2.4 有一玻璃纤维短切毡其规格为450 g/m2，求该毡的厚度（取玻璃纤维的密 度为2.54g/cm3）？ 2.5 无碱玻璃纤维（E-glass）的拉伸弹性模量、拉伸强度及断裂伸长率的大致 值是多少？ 2.6 碳纤维T-300的拉伸弹性模量、拉伸强度及断裂伸长率的大致值是多少？密 度为多少？ 2.7 芳纶纤维（kevlar纤维）的拉伸弹性模量、拉伸强度及断裂伸长率的大致值 是多少？密度为多少？ 2.8 常用热固性树脂有哪几种？它们的拉伸弹性模量、拉伸强度的大致值是多 少？密度为多少？热变形温度值大致值多少？ 2.9 简述单向纤维复合材料抗拉弹性模量、抗拉强度的估算方法。 2.10 试比较玻璃纤维、碳纤维单向复合材料顺纤维方向拉压弹性模量和强度值，指出其特点。 2.11 简述温度、湿度、大气、腐蚀质对复合材料性能的影响。 2.12 如何确定复合材料的线膨胀系数？ 2.13已知玻璃纤维密度为ρf=2.54g/cm3，树脂密度为ρR=1.20g/cm3，采用规格 为450 g/m2的玻璃纤维短切毡制作内衬时，其树脂含量为70％，这样制作一层其GFRP的厚度为多少? 2.14 采用2400Tex的玻璃纤维（ρf=2.54g/cm3）制造管道，其树脂含量为35％ （ρR=1.20g/cm3），缠绕密度为3股/10 mm，试求缠绕层单层厚度? 2.15 试估算上题中单层板顺纤维方向和垂直纤维方向的抗拉弹性模量和抗拉强度。 2.16已知碳纤维密度为ρf=1.80g/cm3，树脂密度为ρR=1.25g/cm3，采用规格为300 g/m2的碳纤维布制作复合材料时，其树脂含量为32％，这样制作一层其CFRP的厚度为多少?其纤维体积含量为多少？ 2.17 某拉挤构件的腹板，厚度为5mm，采用±45°的玻璃纤维多轴向织物（面密
With 复合结构用法小结 “With + 复合结构”又称为“with结构”，在句中表状态或说明背景情况，常做伴随，方式，原因，条件等状语。具体结构如下： 1. With + 名词 + 介词短语? (1) He was asleep with his head on his arm. ? (2) The man came in with a whip in his hand. ? 在书面语中。上句也可以说成：The man came in, whip in hand. 2．with + 名词 + 形容词（强调名词的特性或状态）? (1)With the weather so close and stuffy, ten to one it'll rain presently.天气这么闷热，十之八九要下雨。? (2)He used to sleep with the windows open. 3. With + 名词 + 副词? (1)With John away, we've got more room. 约翰走了，我们的地方大了一些。? (2)The square looks more beautiful than ever with all the light on. 4. With + 名词 + -ed 分词（强调名词是 -ed分词动作的承受者或动作已经发生） ?(1)With this problem solved, neopenicillin 1 is now in regular production. 随着这个问题的解决，新霉素一号现在已正式生产。 ?(2)All the afternoon he worked with the door locked. 5. with + 名词 + -ing分词（强调名词是 -ing分词的动作的发出者或某动作，状态正在进行）? (1)I won’t be able to go on holiday with my mother being ill. ? (2)He felt more uneasy with the whole class staring at him. ? (3)With the field leveled and irrigation channels controlling the volume of water(水量), no such problem arose again. 6. with + 名词 + to do （不定式动作尚未发生）? (1)So in the afternoon, with nothing to do, I went on a round of the bookshops. 由于下午无事可做，我就去书店转了转。 ?(2)I can't go out with all these dishes to wash. 一、 with结构的构成 它是由介词with或without+复合结构构成，复合结构作介词with或without 的复合宾语，复合宾语中第一部分宾语由名词或代词充当，第二部分补足语由形容词、副词、介词短语、动词不定式或分词充当，分词可以是现在分词，也可以是过去分词。With结构构成方式如下： 1. with或without-名词/代词+形容词； 2. with或without-名词/代词+副词； 3. with或without-名词/代词+介词短语； 4. with或without-名词/代词 +动词不定式； 5. with或without-名词/代词 +分词。 下面分别举例： 1、 She came into the room，with her nose red because of cold.（with+名词+形容词，作伴随状语） 2、 With the meal over ， we all went home.（with+名词+副词，作时间状语） 3、The master was walking up and down with the ruler under his arm。（with+名词+介词短语，作伴随状语。） The teacher entered the classroom with a book in his hand. 4、He lay in the dark empty house，with not a man ，woman or child to say he was kind to me.（with+名词+不定式，作伴随状语） He could not finish it without me to help him.（without+代词 +不定式，作条件状语） 5、She fell asleep with the light burning.（with+名词+现在分词，作伴随状语） Without anything left in the with结构是许多英语复合结构中最
with without 引导的独立主格结构 介词with without +宾语+宾语的补足语可以构成独立主格结构，上面讨论过的独立主格结构的几种情况在此结构中都能体现。 A．with+名词代词+形容词 He doesn’t like to sleep with the windows open. 他不喜欢开着窗子睡觉。 = He doesn’t like to sleep when the windows are open. He stood in the rain, with his clothes wet. 他站在雨中，衣服湿透了。 = He stood in the rain, and his clothes were wet. 注意： 在“with+名词代词+形容词”构成的独立主格结构中，也可用已形容词化的-ing 形式或-ed形式。 With his son so disappointing，the old man felt unhappy. 由于儿子如此令人失望,老人感到很不快乐。 With his father well-known, the boy didn’t want to study. 父亲如此出名，儿子不想读书。 B．with+名词代词+副词 Our school looks even more beautiful with all the lights on. 所有的灯都打开时，我们的学校看上去更美。 = Our school looks even more beautiful if when all the lights are on. The boy was walking, with his father ahead. 父亲在前，小孩在后走着。 = The boy was walking and his father was ahead. C．with+名词代词+介词短语 He stood at the door, with a computer in his hand. 或 He stood at the door, computer in hand. 他站在门口，手里拿着一部电脑。 = He stood at the door, and a computer was in his hand. Vincent sat at the desk, with a pen in his mouth. 或 Vincent sat at the desk, pen in mouth. 文森特坐在课桌前，嘴里衔着一支笔。 = Vincent sat at the desk, and he had a pen in his mouth. D．with+名词代词+动词的-ed形式 With his homework done, Peter went out to play. 作业做好了，彼得出去玩了。 = When his homework was done, Peter went out to play. With the signal given, the train started. 信号发出了，火车开始起动了。 = After the signal was given, the train started. I wouldn’t dare go home without the job finished. 工作还没完成，我不敢回家。 = I wouldn’t dare go home because the job was not finished.