Background:Despite the promise shown by large language models(LLMs)for standardized tasks,their multidimensional performance in real-world oncology decision-making remains unevaluated.This study aims to introduce a fr...Background:Despite the promise shown by large language models(LLMs)for standardized tasks,their multidimensional performance in real-world oncology decision-making remains unevaluated.This study aims to introduce a framework for evaluating LLMs and physician decisions in challenging lung cancer cases.Methods:We curated 50 challenging lung cancer cases(25 local and 25 published)classified as complex,rare,or refractory.Blinded three-dimensional,five-point Likert evaluations(1–5 for comprehensiveness,specificity,and readability)compared standalone LLMs(DeepSeek R1,Claude 3.5,Gemini 1.5,and GPT-4o),physicians by experience level(junior,intermediate,and senior),and AI-assisted juniors;intergroup differences and augmentation effects were analyzed statistically.Results:Of 50 challenging cases(18 complex,17 rare,and 15 refractory)rated by three experts,DeepSeek R1 achieved scores of 3.95±0.33,3.71±0.53,and 4.26±0.18 for comprehensiveness,specificity,and readability,respectively,positioning it between intermediate(3.68,3.68,3.75)and senior(4.50,4.64,4.53)physicians.GPT-4o and Claude 3.5 reached intermediate physician–level comprehensiveness(3.76±0.39,3.60±0.39)but junior-to-intermediate physician–level specificity(3.39±0.39,3.39±0.49).All LLMs scored higher on rare cases than intermediate physicians but fell below junior physicians in refractory-case specificity.AIassisted junior physicians showed marked gains in rare cases,with comprehensiveness rising from 2.32 to 4.29(84.8%),specificity from 2.24 to 4.26(90.8%),and readability from 2.76 to 4.59(66.0%),while specificity declined by 3.2%(3.17 to 3.07)in refractory cases.Error analysis showed complementary strengths,with physicians demonstrating reasoning stability and LLMs excelling in knowledge updating and risk management.Conclusions:LLMs performed variably in clinical decision-making tasks depending on case type,performing better in rare cases and worse in refractory cases requiring longitudinal reasoning.Complementary strengths between LLMs and physicians support case-and task-tailored human–AI collaboration.展开更多
Environmental problems are intensifying due to the rapid growth of the population,industry,and urban infrastructure.This expansion has resulted in increased air and water pollution,intensified urban heat island effect...Environmental problems are intensifying due to the rapid growth of the population,industry,and urban infrastructure.This expansion has resulted in increased air and water pollution,intensified urban heat island effects,and greater runoff from parks and other green spaces.Addressing these challenges requires prioritizing green infrastructure and other sustainable urban development strategies.This study introduces a novel Integrated Decision Support System that combines Pythagorean Fuzzy Sets with the Advanced Alternative Ranking Order Method allowing for Two-Step Normalization(AAROM-TN),enhanced by a dual weighting strategy.The weighting approach integrates the Criteria Importance Through Intercriteria Correlation(CRITIC)method with the Criteria Importance through Means and Standard Deviation(CIMAS)technique.The originality of the proposed framework lies in its ability to objectively quantify criteria importance using CRITIC,incorporate decision-makers’preferences through CIMAS,and capture the uncertainty and hesitation inherent in human judgment via Pythagorean Fuzzy Sets.A case study evaluating green infrastructure alternatives in metropolitan regions demonstrates the applicability and effectiveness of the framework.A sensitivity analysis is conducted to examine how variations in criteria weights affect the rankings and to evaluate the robustness of the results.Furthermore,a comparative analysis highlights the practical and financial implications of each alternative by assessing their respective strengths and weaknesses.展开更多
With the rapid development of artificial intelligence,intelligent air combat maneuver decision-making(ACMD)has garnered global attention.Although deep reinforcement learning provides a promising approach to ACMD,exist...With the rapid development of artificial intelligence,intelligent air combat maneuver decision-making(ACMD)has garnered global attention.Although deep reinforcement learning provides a promising approach to ACMD,existing methods often suffer from rigid reward functions and limited adaptability to evolving adversarial strategies.Moreover,most research assumes open airspace,overlooking the influence of potential obstacles.In this paper,we address one-on-one within-visual-range ACMD in obstructed environments,and propose an improved Soft Actor-Critic(SAC)algorithm trained under a curriculum self-play framework.A maneuver strategy mirroring inference module is integrated to estimate each other's likely positions when visual obstruction occurs.By leveraging curriculum learning to guide progressive experience accumulation and self-play for adversarial evolution,our method enhances both training efficiency and tactical diversity.We further integrate an attention mechanism that dynamically adjusts the weights of sub-rewards,enabling the learned policy to adapt to rapidly changing air combat situations.Numerical simulations demonstrate that our enhanced SAC converges more quickly and achieves higher win rates than other baseline methods.An animation is available at bilibili.com/video/BV1BHVszHE98 for better illustration.展开更多
Hydraulic asphalt concrete(HAC)has been increasingly employed as an appropriate impervious structure in hydraulic and hydropower engineering.However,asphalt mortar,usually seen as the matrix of HAC composite,is partic...Hydraulic asphalt concrete(HAC)has been increasingly employed as an appropriate impervious structure in hydraulic and hydropower engineering.However,asphalt mortar,usually seen as the matrix of HAC composite,is particularly prone to damage under combined stress and seepage interactions,and the mesoscale investigations on the damage-seepage coupling behavior of HAC under complex stress states remain limited.This research develops a numerical three-dimensional mesoscale model composed of asphalt mortar and polyhedral aggregate to investigate the stress-damage-seepage coupling behavior in HAC.In this model,asphalt mortar yields the viscoelastic continuum damage law and aggregate obeys the Mazars’elastic-brittle damage law;simultaneously,the effective permeability coefficient of asphalt mortar is assumed to follow an exponential function of damage.The predicted deviatoric stress-strain and hydraulic gradient-seepage curves both are in good agreement with the reported experimental results,which shows the proposed model is valid and reasonable.The simulated results indicate that the damaged asphalt mortar can induce localized areas of high permeability,which in turn affects the overall impervious performance of HAC.展开更多
Although traditional gamma-gamma density(GGD)logging technology is widely utilized,its potential environmental risks have prompted the development of more environmentally friendly neutron-gamma density(NGD)logging tec...Although traditional gamma-gamma density(GGD)logging technology is widely utilized,its potential environmental risks have prompted the development of more environmentally friendly neutron-gamma density(NGD)logging technology.However,NGD measurements are influenced by both neutron and gamma radiations.In the logging environment,variations in the formation composition indicate different elemental compositions,which affect the neutron-gamma reaction cross-sections and gamma generation.Compared to traditional gamma sources such as Cs-137,these changes significantly affect the generation and transport of neutron-induced inelastic gamma rays and hinder accurate measurements.To address this,a novel method is proposed that incorporates the mass attenuation coefficient function to account for the effects of various lithologies and pore contents on gamma-ray attenuation,thereby achieving more accurate density measurements by clarifying the transport processes of inelastic gamma rays with varying energies and spatial distributions in varied logging environments.The proposed method avoids the complex correction of neutron transport and is verified through Monte Carlo simulations for its applicability across various lithologies and pore contents,demonstrating absolute density errors that are less than 0.02 g/cm^(3)in clean formations and indicating good accuracy.This study clarifies the NGD mechanism and provides theoretical guidance for the application of NGD logging methods.Further studies will be conducted on extreme environmental conditions and tool calibration.展开更多
With the increasing complexity of industrial automation,planetary gearboxes play a vital role in largescale equipment transmission systems,directly impacting operational efficiency and safety.Traditional maintenance s...With the increasing complexity of industrial automation,planetary gearboxes play a vital role in largescale equipment transmission systems,directly impacting operational efficiency and safety.Traditional maintenance strategies often struggle to accurately predict the degradation process of equipment,leading to excessive maintenance costs or potential failure risks.However,existing prediction methods based on statistical models are difficult to adapt to nonlinear degradation processes.To address these challenges,this study proposes a novel condition-based maintenance framework for planetary gearboxes.A comprehensive full-lifecycle degradation experiment was conducted to collect raw vibration signals,which were then processed using a temporal convolutional network autoencoder with multi-scale perception capability to extract deep temporal degradation features,enabling the collaborative extraction of longperiod meshing frequencies and short-term impact features from the vibration signals.Kernel principal component analysis was employed to fuse and normalize these features,enhancing the characterization of degradation progression.A nonlinear Wiener process was used to model the degradation trajectory,with a threshold decay function introduced to dynamically adjust maintenance strategies,and model parameters optimized through maximum likelihood estimation.Meanwhile,the maintenance strategy was optimized to minimize costs per unit time,determining the optimal maintenance timing and preventive maintenance threshold.The comprehensive indicator of degradation trends extracted by this method reaches 0.756,which is 41.2%higher than that of traditional time-domain features;the dynamic threshold strategy reduces the maintenance cost per unit time to 55.56,which is 8.9%better than that of the static threshold optimization.Experimental results demonstrate significant reductions in maintenance costs while enhancing system reliability and safety.This study realizes the organic integration of deep learning and reliability theory in the maintenance of planetary gearboxes,provides an interpretable solution for the predictive maintenance of complex mechanical systems,and promotes the development of condition-based maintenance strategies for planetary gearboxes.展开更多
Reconfigurable array architecture has become an important hardware platform for edge-side deployment of convolutional neural networks due to their high parallelism and flexible programmability.However,traditional mult...Reconfigurable array architecture has become an important hardware platform for edge-side deployment of convolutional neural networks due to their high parallelism and flexible programmability.However,traditional multi-branch convolutional networks suffer from computational redundancy,high memory access overhead,and inefficient branch fusion.Therefore,this paper proposes an adaptive multi-branch convolutional module(AMBC)that integrates software-hardware co-optimization.During training,the learnable fusion coefficients are introduced to enable adaptive fusion of multi-scale features,while in the inference phase,the multiple branches and their normalization parameters are merged with the fusion coefficients into a single 3×3 convolutional kernel through operator fusion.On the SIREA-288 reconfigurable platform,compared with unoptimized multi-branch networks,the proposed AMBC reduces external memory accesses by 47.91%and inference latency by 47.20%,achieving a 1.90×speedup.This approach maximizes the utilization of the reconfigurable logic while minimizing both reconfiguration and data-movement overheads in edge inference.展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforce...To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.展开更多
The morphological distribution of absorbent in composites is equally important with absorbents for the overall electromagnetic properties,but it is often ignored.Herein,a comprehensive consideration including electrom...The morphological distribution of absorbent in composites is equally important with absorbents for the overall electromagnetic properties,but it is often ignored.Herein,a comprehensive consideration including electromagnetic component regulation,layered arrangement structure,and gradient concentration distribution was used to optimize impedance matching and enhance electromagnetic loss.On the microscale,the incorporation of magnetic Ni nanoparticles into MXene nanosheets(Ni@MXene)endows suitable intrinsic permittivity and permeability.On the macroscale,the layered arrangement of Ni@MXene increases the effective interaction area with electromagnetic waves,inducing multiple reflection/scattering effects.On this basis,according to the analysis of absorption,reflection,and transmission(A-R-T)power coefficients of layered composites,the gradient concentration distribution was constructed to realize the impedance matching at low-concentration surface layer,electromagnetic loss at middle concentration interlayer and microwave reflection at high-concentration bottom layer.Consequently,the layered gradient composite(LG5-10-15)achieves complete absorption coverage of X-band at thickness of 2.00-2.20 mm with RL_(min) of-68.67 dB at 9.85 GHz in 2.05 mm,which is 199.0%,12.6%,and 50.6%higher than non-layered,layered and layered descending gradient composites,respectively.Therefore,this work confirms the importance of layered gradient structure in improving absorption performance and broadens the design of high-performance microwave absorption materials.展开更多
Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pP...Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.展开更多
As the first gold mine discovered at the sea in China and the only coastal gold mine currently mined there,Sanshandao Gold Mine faces unique challenges.The mine's safety is under continual threat from its faulted ...As the first gold mine discovered at the sea in China and the only coastal gold mine currently mined there,Sanshandao Gold Mine faces unique challenges.The mine's safety is under continual threat from its faulted structure coupled with the overlying water.As the mining proceeds deeper,the risk of water inrush increases.The mine's maximum water yield reaches 15000 m3/day,which is attributable to water channels present in fault zones.Predominantly composed of soil–rock mixtures(SRM),these fault zones'seepage characteristics significantly impact water inrush risk.Consequently,investigating the seepage characteristics of SRM is of paramount importance.However,the existing literature mostly concentrates on a single stress state.Therefore,this study examined the characteristics of the permeability coefficient under three distinct stress states:osmotic,osmotic–uniaxial,and osmotic–triaxial pressure.The SRM samples utilized in this study were extracted from in situ fault zones and then reshaped in the laboratory.In addition,the micromechanical properties of the SRM samples were analyzed using computed tomography scanning.The findings reveal that the permeability coefficient is the highest under osmotic pressure and lowest under osmotic–triaxial pressure.The sensitivity coefficient shows a higher value when the rock block percentage ranges between 30%and 40%,but it falls below 1.0 when this percentage exceeds 50%under no confining pressure.Notably,rock block percentages of 40%and 60%represent the two peak points of the sensitivity coefficient under osmotic–triaxial pressure.However,SRM samples with a 40%rock block percentage consistently show the lowest permeability coefficient under all stress states.This study establishes that a power function can model the relationship between the permeability coefficient and osmotic pressure,while its relationship with axial pressure can be described using an exponential function.These insights are invaluable for developing water inrush prevention and control strategies in mining environments.展开更多
In order to solve the problem of the variable coefficient ordinary differen-tial equation on the bounded domain,the Lagrange interpolation method is used to approximate the exact solution of the equation,and the error...In order to solve the problem of the variable coefficient ordinary differen-tial equation on the bounded domain,the Lagrange interpolation method is used to approximate the exact solution of the equation,and the error between the numerical solution and the exact solution is obtained,and then compared with the error formed by the difference method,it is concluded that the Lagrange interpolation method is more effective in solving the variable coefficient ordinary differential equation.展开更多
BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral...BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.展开更多
The scale effect on shear strength of rock joints is well-documented.However,whether scale effects are negative,positive,or even exist or not is still controversial.Joint roughness significantly influences the shear s...The scale effect on shear strength of rock joints is well-documented.However,whether scale effects are negative,positive,or even exist or not is still controversial.Joint roughness significantly influences the shear strength of rock joints.Compared to the shear tests,using the joint roughness coefficient(JRC)and its roughness parameters offers a more convenient method for describing the scale effect on shear strength.However,it is crucial to understand that the scale effect mechanisms of JRC are distinct from those of shear strength.Therefore,this paper aims to clarify these distinct mechanisms.By digitally extracting roughness parameters from granite samples,it is found that the scale effect of roughness parameters mainly comes from the sampling methods and the geometric characteristics of parameters.Furthermore,a full data sampling method considering heterogeneity is proposed to obtain more representative roughness parameters.To reveal the scale effect mechanisms of shear strength,Gaussian filtering is firstly used to separate the waviness and unevenness components of roughness,facilitating a deeper understanding of the geometric characteristics of roughness.It is suggested that the wavelength of the waviness component can reflect the scale effect on shear strength.Secondly,numerical simulations of ideal artificial joint models are conducted to validate that the wavelength of the waviness component serves as the dividing point between positive and negative scale effects.The mechanical mechanisms of positive and negative scale effects are also interpreted.Finally,these mechanisms successfully elucidate the occurrence patterns of the scale effect on natural joint profiles.展开更多
Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective to...Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.展开更多
Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)sc...Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)scores remain ambiguous.Methods:To explore the decision-making capacity of Generative Pretrained Transformer-4(GPT-4)for automated prostate biopsy recommendations,we included 2299 individuals who underwent prostate biopsy from 2018 to 2023 in 3 large medical centers,with available mpMRI before biopsy and documented clinical-histopathological records.GPT-4 generated structured reports with given prompts.The performance of GPT-4 was quantified using confusion matrices,and sensitivity,specificity,as well as area under the curve were calculated.Multiple artificial evaluation procedures were conducted.Wilcoxon’s rank sum test,Fisher’s exact test,and Kruskal-Wallis tests were used for comparisons.Results:Utilizing the largest sample size in the Chinese population,patients with moderate PI-RADS scores(scores 3 and 4)accounted for 39.7%(912/2299),defined as the subset-of-interest(SOI).The detection rates of clinically significant PCa corresponding to PI-RADS scores 2-5 were 9.4%,27.3%,49.2%,and 80.1%,respectively.Nearly 47.5%(433/912)of SOI patients were histopathologically proven to have undergone unnecessary prostate biopsies.With the assistance of GPT-4,20.8%(190/912)of the SOI population could avoid unnecessary biopsies,and it performed even better[28.8%(118/410)]in the most heterogeneous subgroup of PI-RADS score 3.More than 90.0%of GPT-4-generated reports were comprehensive and easy to understand,but less satisfied with the accuracy(82.8%).GPT-4 also demonstrated cognitive potential for handling complex problems.Additionally,the Chain of Thought method enabled us to better understand the decision-making logic behind GPT-4.Eventually,we developed a ProstAIGuide platform to facilitate accessibility for both doctors and patients.Conclusions:This multi-center study highlights the clinical utility of GPT-4 for prostate biopsy decision-making and advances our understanding of the latest artificial intelligence implementation in various medical scenarios.展开更多
BACKGROUND Various stone factors can affect the net results of shock wave lithotripsy(SWL).Recently a new factor called variation coefficient of stone density(VCSD)is being considered to have an impact on stone free r...BACKGROUND Various stone factors can affect the net results of shock wave lithotripsy(SWL).Recently a new factor called variation coefficient of stone density(VCSD)is being considered to have an impact on stone free rates.AIM To assess the role of VCSD in determining success of SWL in urinary calculi.METHODS Charts review was utilized for collection of data variables.The patients were subjected to SWL,using an electromagnetic lithotripter.Mean stone density(MSD),stone heterogeneity index(SHI),and VCSD were calculated by generating regions of interest on computed tomography(CT)images.Role of these factors were determined by applying the relevant statistical tests for continuous and categorical variables and a P value of<0.05 was gauged to be statistically significant.RESULTS There were a total of 407 patients included in the analysis.The mean age of the subjects in this study was 38.89±14.61 years.In total,165 out of the 407 patients could not achieve stone free status.The successful group had a significantly lower stone volume as compared to the unsuccessful group(P<0.0001).Skin to stone distance was not dissimilar among the two groups(P=0.47).MSD was significantly lower in the successful group(P<0.0001).SHI and VCSD were both significantly higher in the successful group(P<0.0001).CONCLUSION VCSD,a useful CT based parameter,can be utilized to gauge stone fragility and hence the prediction of SWL outcomes.展开更多
Joint roughness coefficient(JRC)is the most commonly used parameter for quantifying surface roughness of rock discontinuities in practice.The system composed of multiple roughness statistical parameters to measure JRC...Joint roughness coefficient(JRC)is the most commonly used parameter for quantifying surface roughness of rock discontinuities in practice.The system composed of multiple roughness statistical parameters to measure JRC is a nonlinear system with a lot of overlapping information.In this paper,a dataset of eight roughness statistical parameters covering 112 digital joints is established.Then,the principal component analysis method is introduced to extract the significant information,which solves the information overlap problem of roughness characterization.Based on the two principal components of extracted features,the white shark optimizer algorithm was introduced to optimize the extreme gradient boosting model,and a new machine learning(ML)prediction model was established.The prediction accuracy of the new model and the other 17 models was measured using statistical metrics.The results show that the prediction result of the new model is more consistent with the real JRC value,with higher recognition accuracy and generalization ability.展开更多
BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpfu...BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.展开更多
文摘Background:Despite the promise shown by large language models(LLMs)for standardized tasks,their multidimensional performance in real-world oncology decision-making remains unevaluated.This study aims to introduce a framework for evaluating LLMs and physician decisions in challenging lung cancer cases.Methods:We curated 50 challenging lung cancer cases(25 local and 25 published)classified as complex,rare,or refractory.Blinded three-dimensional,five-point Likert evaluations(1–5 for comprehensiveness,specificity,and readability)compared standalone LLMs(DeepSeek R1,Claude 3.5,Gemini 1.5,and GPT-4o),physicians by experience level(junior,intermediate,and senior),and AI-assisted juniors;intergroup differences and augmentation effects were analyzed statistically.Results:Of 50 challenging cases(18 complex,17 rare,and 15 refractory)rated by three experts,DeepSeek R1 achieved scores of 3.95±0.33,3.71±0.53,and 4.26±0.18 for comprehensiveness,specificity,and readability,respectively,positioning it between intermediate(3.68,3.68,3.75)and senior(4.50,4.64,4.53)physicians.GPT-4o and Claude 3.5 reached intermediate physician–level comprehensiveness(3.76±0.39,3.60±0.39)but junior-to-intermediate physician–level specificity(3.39±0.39,3.39±0.49).All LLMs scored higher on rare cases than intermediate physicians but fell below junior physicians in refractory-case specificity.AIassisted junior physicians showed marked gains in rare cases,with comprehensiveness rising from 2.32 to 4.29(84.8%),specificity from 2.24 to 4.26(90.8%),and readability from 2.76 to 4.59(66.0%),while specificity declined by 3.2%(3.17 to 3.07)in refractory cases.Error analysis showed complementary strengths,with physicians demonstrating reasoning stability and LLMs excelling in knowledge updating and risk management.Conclusions:LLMs performed variably in clinical decision-making tasks depending on case type,performing better in rare cases and worse in refractory cases requiring longitudinal reasoning.Complementary strengths between LLMs and physicians support case-and task-tailored human–AI collaboration.
基金supported by the Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2026R259)Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.Ashit Kumar Dutta would like to thank AlMaarefa University for supporting this research under project number MHIRSP2025017.
文摘Environmental problems are intensifying due to the rapid growth of the population,industry,and urban infrastructure.This expansion has resulted in increased air and water pollution,intensified urban heat island effects,and greater runoff from parks and other green spaces.Addressing these challenges requires prioritizing green infrastructure and other sustainable urban development strategies.This study introduces a novel Integrated Decision Support System that combines Pythagorean Fuzzy Sets with the Advanced Alternative Ranking Order Method allowing for Two-Step Normalization(AAROM-TN),enhanced by a dual weighting strategy.The weighting approach integrates the Criteria Importance Through Intercriteria Correlation(CRITIC)method with the Criteria Importance through Means and Standard Deviation(CIMAS)technique.The originality of the proposed framework lies in its ability to objectively quantify criteria importance using CRITIC,incorporate decision-makers’preferences through CIMAS,and capture the uncertainty and hesitation inherent in human judgment via Pythagorean Fuzzy Sets.A case study evaluating green infrastructure alternatives in metropolitan regions demonstrates the applicability and effectiveness of the framework.A sensitivity analysis is conducted to examine how variations in criteria weights affect the rankings and to evaluate the robustness of the results.Furthermore,a comparative analysis highlights the practical and financial implications of each alternative by assessing their respective strengths and weaknesses.
基金support of the National Key Research and Development Plan(No.2021YFB3302501)the financial support of the National Science Foundation of China(No.12161076)the financial support of the Fundamental Research Funds for the Central Universities(No.DUT25GF207).
文摘With the rapid development of artificial intelligence,intelligent air combat maneuver decision-making(ACMD)has garnered global attention.Although deep reinforcement learning provides a promising approach to ACMD,existing methods often suffer from rigid reward functions and limited adaptability to evolving adversarial strategies.Moreover,most research assumes open airspace,overlooking the influence of potential obstacles.In this paper,we address one-on-one within-visual-range ACMD in obstructed environments,and propose an improved Soft Actor-Critic(SAC)algorithm trained under a curriculum self-play framework.A maneuver strategy mirroring inference module is integrated to estimate each other's likely positions when visual obstruction occurs.By leveraging curriculum learning to guide progressive experience accumulation and self-play for adversarial evolution,our method enhances both training efficiency and tactical diversity.We further integrate an attention mechanism that dynamically adjusts the weights of sub-rewards,enabling the learned policy to adapt to rapidly changing air combat situations.Numerical simulations demonstrate that our enhanced SAC converges more quickly and achieves higher win rates than other baseline methods.An animation is available at bilibili.com/video/BV1BHVszHE98 for better illustration.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFC3005603-01)the Natural Science Foundation Science of Anhui Province(Grant No.2308085US02).
文摘Hydraulic asphalt concrete(HAC)has been increasingly employed as an appropriate impervious structure in hydraulic and hydropower engineering.However,asphalt mortar,usually seen as the matrix of HAC composite,is particularly prone to damage under combined stress and seepage interactions,and the mesoscale investigations on the damage-seepage coupling behavior of HAC under complex stress states remain limited.This research develops a numerical three-dimensional mesoscale model composed of asphalt mortar and polyhedral aggregate to investigate the stress-damage-seepage coupling behavior in HAC.In this model,asphalt mortar yields the viscoelastic continuum damage law and aggregate obeys the Mazars’elastic-brittle damage law;simultaneously,the effective permeability coefficient of asphalt mortar is assumed to follow an exponential function of damage.The predicted deviatoric stress-strain and hydraulic gradient-seepage curves both are in good agreement with the reported experimental results,which shows the proposed model is valid and reasonable.The simulated results indicate that the damaged asphalt mortar can induce localized areas of high permeability,which in turn affects the overall impervious performance of HAC.
基金supported by the National Natural Science Foundation of China(U23B20151 and 52171253).
文摘Although traditional gamma-gamma density(GGD)logging technology is widely utilized,its potential environmental risks have prompted the development of more environmentally friendly neutron-gamma density(NGD)logging technology.However,NGD measurements are influenced by both neutron and gamma radiations.In the logging environment,variations in the formation composition indicate different elemental compositions,which affect the neutron-gamma reaction cross-sections and gamma generation.Compared to traditional gamma sources such as Cs-137,these changes significantly affect the generation and transport of neutron-induced inelastic gamma rays and hinder accurate measurements.To address this,a novel method is proposed that incorporates the mass attenuation coefficient function to account for the effects of various lithologies and pore contents on gamma-ray attenuation,thereby achieving more accurate density measurements by clarifying the transport processes of inelastic gamma rays with varying energies and spatial distributions in varied logging environments.The proposed method avoids the complex correction of neutron transport and is verified through Monte Carlo simulations for its applicability across various lithologies and pore contents,demonstrating absolute density errors that are less than 0.02 g/cm^(3)in clean formations and indicating good accuracy.This study clarifies the NGD mechanism and provides theoretical guidance for the application of NGD logging methods.Further studies will be conducted on extreme environmental conditions and tool calibration.
基金funded by scientific research projects under Grant JY2024B011.
文摘With the increasing complexity of industrial automation,planetary gearboxes play a vital role in largescale equipment transmission systems,directly impacting operational efficiency and safety.Traditional maintenance strategies often struggle to accurately predict the degradation process of equipment,leading to excessive maintenance costs or potential failure risks.However,existing prediction methods based on statistical models are difficult to adapt to nonlinear degradation processes.To address these challenges,this study proposes a novel condition-based maintenance framework for planetary gearboxes.A comprehensive full-lifecycle degradation experiment was conducted to collect raw vibration signals,which were then processed using a temporal convolutional network autoencoder with multi-scale perception capability to extract deep temporal degradation features,enabling the collaborative extraction of longperiod meshing frequencies and short-term impact features from the vibration signals.Kernel principal component analysis was employed to fuse and normalize these features,enhancing the characterization of degradation progression.A nonlinear Wiener process was used to model the degradation trajectory,with a threshold decay function introduced to dynamically adjust maintenance strategies,and model parameters optimized through maximum likelihood estimation.Meanwhile,the maintenance strategy was optimized to minimize costs per unit time,determining the optimal maintenance timing and preventive maintenance threshold.The comprehensive indicator of degradation trends extracted by this method reaches 0.756,which is 41.2%higher than that of traditional time-domain features;the dynamic threshold strategy reduces the maintenance cost per unit time to 55.56,which is 8.9%better than that of the static threshold optimization.Experimental results demonstrate significant reductions in maintenance costs while enhancing system reliability and safety.This study realizes the organic integration of deep learning and reliability theory in the maintenance of planetary gearboxes,provides an interpretable solution for the predictive maintenance of complex mechanical systems,and promotes the development of condition-based maintenance strategies for planetary gearboxes.
基金Supported by the National Science and Technology Major Project of China(2022ZD0119005)the Natural Science Project of Shaanxi Province(2025JC-YBMS-754,2024JC-YBMS-539)。
文摘Reconfigurable array architecture has become an important hardware platform for edge-side deployment of convolutional neural networks due to their high parallelism and flexible programmability.However,traditional multi-branch convolutional networks suffer from computational redundancy,high memory access overhead,and inefficient branch fusion.Therefore,this paper proposes an adaptive multi-branch convolutional module(AMBC)that integrates software-hardware co-optimization.During training,the learnable fusion coefficients are introduced to enable adaptive fusion of multi-scale features,while in the inference phase,the multiple branches and their normalization parameters are merged with the fusion coefficients into a single 3×3 convolutional kernel through operator fusion.On the SIREA-288 reconfigurable platform,compared with unoptimized multi-branch networks,the proposed AMBC reduces external memory accesses by 47.91%and inference latency by 47.20%,achieving a 1.90×speedup.This approach maximizes the utilization of the reconfigurable logic while minimizing both reconfiguration and data-movement overheads in edge inference.
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
基金Supported by National Key Research and Development Program of China(Grant No.2022YFE0117100)National Science Foundation of China(Grant No.52102468,52325212)Fundamental Research Funds for the Central Universities。
文摘To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.
基金support for this work by Key Research and Development Project of Henan Province(Grant.No.241111232300)the National Natural Science Foundation of China(Grant.No.52273085 and 52303113)the Open Fund of Yaoshan Laboratory(Grant.No.2024003).
文摘The morphological distribution of absorbent in composites is equally important with absorbents for the overall electromagnetic properties,but it is often ignored.Herein,a comprehensive consideration including electromagnetic component regulation,layered arrangement structure,and gradient concentration distribution was used to optimize impedance matching and enhance electromagnetic loss.On the microscale,the incorporation of magnetic Ni nanoparticles into MXene nanosheets(Ni@MXene)endows suitable intrinsic permittivity and permeability.On the macroscale,the layered arrangement of Ni@MXene increases the effective interaction area with electromagnetic waves,inducing multiple reflection/scattering effects.On this basis,according to the analysis of absorption,reflection,and transmission(A-R-T)power coefficients of layered composites,the gradient concentration distribution was constructed to realize the impedance matching at low-concentration surface layer,electromagnetic loss at middle concentration interlayer and microwave reflection at high-concentration bottom layer.Consequently,the layered gradient composite(LG5-10-15)achieves complete absorption coverage of X-band at thickness of 2.00-2.20 mm with RL_(min) of-68.67 dB at 9.85 GHz in 2.05 mm,which is 199.0%,12.6%,and 50.6%higher than non-layered,layered and layered descending gradient composites,respectively.Therefore,this work confirms the importance of layered gradient structure in improving absorption performance and broadens the design of high-performance microwave absorption materials.
基金supported by the Deanship of Graduate Studies and Scientific Research at Qassim University(QU-APC-2024-9/1).
文摘Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.
基金State Key Research Development Program of China,Grant/Award Number:2021YFC3001301。
文摘As the first gold mine discovered at the sea in China and the only coastal gold mine currently mined there,Sanshandao Gold Mine faces unique challenges.The mine's safety is under continual threat from its faulted structure coupled with the overlying water.As the mining proceeds deeper,the risk of water inrush increases.The mine's maximum water yield reaches 15000 m3/day,which is attributable to water channels present in fault zones.Predominantly composed of soil–rock mixtures(SRM),these fault zones'seepage characteristics significantly impact water inrush risk.Consequently,investigating the seepage characteristics of SRM is of paramount importance.However,the existing literature mostly concentrates on a single stress state.Therefore,this study examined the characteristics of the permeability coefficient under three distinct stress states:osmotic,osmotic–uniaxial,and osmotic–triaxial pressure.The SRM samples utilized in this study were extracted from in situ fault zones and then reshaped in the laboratory.In addition,the micromechanical properties of the SRM samples were analyzed using computed tomography scanning.The findings reveal that the permeability coefficient is the highest under osmotic pressure and lowest under osmotic–triaxial pressure.The sensitivity coefficient shows a higher value when the rock block percentage ranges between 30%and 40%,but it falls below 1.0 when this percentage exceeds 50%under no confining pressure.Notably,rock block percentages of 40%and 60%represent the two peak points of the sensitivity coefficient under osmotic–triaxial pressure.However,SRM samples with a 40%rock block percentage consistently show the lowest permeability coefficient under all stress states.This study establishes that a power function can model the relationship between the permeability coefficient and osmotic pressure,while its relationship with axial pressure can be described using an exponential function.These insights are invaluable for developing water inrush prevention and control strategies in mining environments.
文摘In order to solve the problem of the variable coefficient ordinary differen-tial equation on the bounded domain,the Lagrange interpolation method is used to approximate the exact solution of the equation,and the error between the numerical solution and the exact solution is obtained,and then compared with the error formed by the difference method,it is concluded that the Lagrange interpolation method is more effective in solving the variable coefficient ordinary differential equation.
基金Supported by the Shaanxi Provincial Key Research and Development Plan Project,No.2020ZDLSF01-02.
文摘BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.
基金funded by the National Natural Science Foundation Projects(Grant Nos.41772287 and 42277132)the Key R&D Project of Zhejiang Province(Grant No.2021C03159).
文摘The scale effect on shear strength of rock joints is well-documented.However,whether scale effects are negative,positive,or even exist or not is still controversial.Joint roughness significantly influences the shear strength of rock joints.Compared to the shear tests,using the joint roughness coefficient(JRC)and its roughness parameters offers a more convenient method for describing the scale effect on shear strength.However,it is crucial to understand that the scale effect mechanisms of JRC are distinct from those of shear strength.Therefore,this paper aims to clarify these distinct mechanisms.By digitally extracting roughness parameters from granite samples,it is found that the scale effect of roughness parameters mainly comes from the sampling methods and the geometric characteristics of parameters.Furthermore,a full data sampling method considering heterogeneity is proposed to obtain more representative roughness parameters.To reveal the scale effect mechanisms of shear strength,Gaussian filtering is firstly used to separate the waviness and unevenness components of roughness,facilitating a deeper understanding of the geometric characteristics of roughness.It is suggested that the wavelength of the waviness component can reflect the scale effect on shear strength.Secondly,numerical simulations of ideal artificial joint models are conducted to validate that the wavelength of the waviness component serves as the dividing point between positive and negative scale effects.The mechanical mechanisms of positive and negative scale effects are also interpreted.Finally,these mechanisms successfully elucidate the occurrence patterns of the scale effect on natural joint profiles.
文摘Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.
基金supported by the Beijing Key Clinical Specialty Project(20240930)the National Natural Science Foundation of China(NSFC 82373436)+7 种基金the Beijing Hospitals Authority’Youth Program(BHAYP,QML20230114)the Beijing Natural Science Foundation(BNSF Z200027)the Beijing Chaoyang Hospital Multi-disciplinary Team Program(CYDXK202204),the NSFC(62331001)the BNSF(Z200027)the NSFC(82202097)the BHAYP(QML20230113)the Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University(CCMU2022ZKYXY010)the Beijing Scholars Program(No.[2015]160).
文摘Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)scores remain ambiguous.Methods:To explore the decision-making capacity of Generative Pretrained Transformer-4(GPT-4)for automated prostate biopsy recommendations,we included 2299 individuals who underwent prostate biopsy from 2018 to 2023 in 3 large medical centers,with available mpMRI before biopsy and documented clinical-histopathological records.GPT-4 generated structured reports with given prompts.The performance of GPT-4 was quantified using confusion matrices,and sensitivity,specificity,as well as area under the curve were calculated.Multiple artificial evaluation procedures were conducted.Wilcoxon’s rank sum test,Fisher’s exact test,and Kruskal-Wallis tests were used for comparisons.Results:Utilizing the largest sample size in the Chinese population,patients with moderate PI-RADS scores(scores 3 and 4)accounted for 39.7%(912/2299),defined as the subset-of-interest(SOI).The detection rates of clinically significant PCa corresponding to PI-RADS scores 2-5 were 9.4%,27.3%,49.2%,and 80.1%,respectively.Nearly 47.5%(433/912)of SOI patients were histopathologically proven to have undergone unnecessary prostate biopsies.With the assistance of GPT-4,20.8%(190/912)of the SOI population could avoid unnecessary biopsies,and it performed even better[28.8%(118/410)]in the most heterogeneous subgroup of PI-RADS score 3.More than 90.0%of GPT-4-generated reports were comprehensive and easy to understand,but less satisfied with the accuracy(82.8%).GPT-4 also demonstrated cognitive potential for handling complex problems.Additionally,the Chain of Thought method enabled us to better understand the decision-making logic behind GPT-4.Eventually,we developed a ProstAIGuide platform to facilitate accessibility for both doctors and patients.Conclusions:This multi-center study highlights the clinical utility of GPT-4 for prostate biopsy decision-making and advances our understanding of the latest artificial intelligence implementation in various medical scenarios.
文摘BACKGROUND Various stone factors can affect the net results of shock wave lithotripsy(SWL).Recently a new factor called variation coefficient of stone density(VCSD)is being considered to have an impact on stone free rates.AIM To assess the role of VCSD in determining success of SWL in urinary calculi.METHODS Charts review was utilized for collection of data variables.The patients were subjected to SWL,using an electromagnetic lithotripter.Mean stone density(MSD),stone heterogeneity index(SHI),and VCSD were calculated by generating regions of interest on computed tomography(CT)images.Role of these factors were determined by applying the relevant statistical tests for continuous and categorical variables and a P value of<0.05 was gauged to be statistically significant.RESULTS There were a total of 407 patients included in the analysis.The mean age of the subjects in this study was 38.89±14.61 years.In total,165 out of the 407 patients could not achieve stone free status.The successful group had a significantly lower stone volume as compared to the unsuccessful group(P<0.0001).Skin to stone distance was not dissimilar among the two groups(P=0.47).MSD was significantly lower in the successful group(P<0.0001).SHI and VCSD were both significantly higher in the successful group(P<0.0001).CONCLUSION VCSD,a useful CT based parameter,can be utilized to gauge stone fragility and hence the prediction of SWL outcomes.
基金funding from the National Natural Science Foundation of China (Grant No.42277175)the pilot project of cooperation between the Ministry of Natural Resources and Hunan Province“Research and demonstration of key technologies for comprehensive remote sensing identification of geological hazards in typical regions of Hunan Province” (Grant No.2023ZRBSHZ056)the National Key Research and Development Program of China-2023 Key Special Project (Grant No.2023YFC2907400).
文摘Joint roughness coefficient(JRC)is the most commonly used parameter for quantifying surface roughness of rock discontinuities in practice.The system composed of multiple roughness statistical parameters to measure JRC is a nonlinear system with a lot of overlapping information.In this paper,a dataset of eight roughness statistical parameters covering 112 digital joints is established.Then,the principal component analysis method is introduced to extract the significant information,which solves the information overlap problem of roughness characterization.Based on the two principal components of extracted features,the white shark optimizer algorithm was introduced to optimize the extreme gradient boosting model,and a new machine learning(ML)prediction model was established.The prediction accuracy of the new model and the other 17 models was measured using statistical metrics.The results show that the prediction result of the new model is more consistent with the real JRC value,with higher recognition accuracy and generalization ability.
文摘BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.
