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Design of Aided Decision-Making Program for Prioritizing Construction Projects in Urban Road Network Planning
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作者 任刚 王炜 顾志康 《Journal of Southeast University(English Edition)》 EI CAS 2002年第3期249-253,共5页
The importance and complexity of prioritizing construction projects (PCP) in urban road network planning lead to the necessity to develop an aided decision making program (ADMP). Cost benefit ratio model and stage rol... The importance and complexity of prioritizing construction projects (PCP) in urban road network planning lead to the necessity to develop an aided decision making program (ADMP). Cost benefit ratio model and stage rolled method are chosen as the theoretical foundations of the program, and then benefit model is improved to accord with the actuality of urban traffic in China. Consequently, program flows, module functions and data structures are designed, and particularly an original data structure of road ... 展开更多
关键词 prioritizing construction projects program design urban road network planning aided decision making
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Research on Big Data and Artificial Intelligence Aided Decision-Making Mechanism with the Applications on Video Website Homemade Program Innovation 被引量:1
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作者 Ting Li 《International Journal of Technology Management》 2016年第3期21-23,共3页
In this paper, we conduct research on the big data and the artificial intelligence aided decision-making mechanism with the applications on video website homemade program innovation. Make homemade video shows new medi... In this paper, we conduct research on the big data and the artificial intelligence aided decision-making mechanism with the applications on video website homemade program innovation. Make homemade video shows new media platform site content production with new possible, as also make the traditional media found in Internet age, the breakthrough point of the times. Site homemade video program, which is beneficial to reduce copyright purchase demand, reduce the cost, avoid the homogeneity competition, rich advertising marketing at the same time, improve the profit pattern, the organic combination of content production and operation, complete the strategic transformation. On the basis of these advantages, once the site of homemade video program to form a brand and a higher brand influence. Our later research provides the literature survey for the related issues. 展开更多
关键词 Bid Data Artificial Intelligence decision-making Video Website Program Innovation.
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Hybrid Pythagorean Fuzzy Decision-Making Framework for Sustainable Urban Planning under Uncertainty
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作者 Sana Shahab Vladimir Simic +2 位作者 Ashit Kumar Dutta Mohd Anjum Dragan Pamucar 《Computer Modeling in Engineering & Sciences》 2026年第1期892-925,共34页
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
关键词 Sustainable urban planning criterion importance assessment two-step normalization environmental impact decision-making
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An Integrated Approach to Condition-Based Maintenance Decision-Making of Planetary Gearboxes: Combining Temporal Convolutional Network Auto Encoders with Wiener Process
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作者 Bo Zhu Enzhi Dong +3 位作者 Zhonghua Cheng Xianbiao Zhan Kexin Jiang Rongcai Wang 《Computers, Materials & Continua》 2026年第1期661-686,共26页
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
关键词 Temporal convolutional network autoencoder full lifecycle degradation experiment nonlinear Wiener process condition-based maintenance decision-making fault monitoring
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玉树市社会组织参与HIV/AIDS患者随访管理模式实践
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作者 董世存 赵金星 +6 位作者 宋成玺 马海军 匡嘉影 梁达 李积平 孙玉兰 黎晓晶 《中国艾滋病性病》 北大核心 2026年第1期88-90,共3页
青海省玉树市通过创新HIV/AIDS患者随访管理模式,推动本地社会组织参与HIV/AIDS患者随访工作,建立“疾控-公安-医院-社会组织”协同机制,聚焦“疾控技术支撑+社会组织精准服务”模式。通过部门协作、分层随访、心理社会支持体系建设等策... 青海省玉树市通过创新HIV/AIDS患者随访管理模式,推动本地社会组织参与HIV/AIDS患者随访工作,建立“疾控-公安-医院-社会组织”协同机制,聚焦“疾控技术支撑+社会组织精准服务”模式。通过部门协作、分层随访、心理社会支持体系建设等策略,使患者抗病毒治疗比例、规范随访率和在治患者病毒载量检测率明显提升。本文系统总结该模式的实践路径与实施成效,为牧业地区艾滋病防控提供经验范式。 展开更多
关键词 艾滋病病毒感染者/艾滋病患者 随访 社会组织
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云南省玉溪市HIV/AIDS抗病毒治疗后CD4/CD8比值与非艾滋病相关疾病死亡的关联分析
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作者 董文斌 李世福 +7 位作者 赵金仙 王晓雯 李泽 罗阳 朱永芬 刘小春 吴强 祁昆 《预防医学情报杂志》 2026年第1期7-13,121,共8页
目的 探讨云南省玉溪市HIV/AIDS抗病毒治疗(ART)后CD4/CD8比值与非艾滋病相关疾病死亡的相关性,为艾滋病防治策略的改善提供理论依据。方法 在国家艾滋病综合防治数据信息管理系统中下载1995年1月1日至2021年12月31日玉溪市、审核标志... 目的 探讨云南省玉溪市HIV/AIDS抗病毒治疗(ART)后CD4/CD8比值与非艾滋病相关疾病死亡的相关性,为艾滋病防治策略的改善提供理论依据。方法 在国家艾滋病综合防治数据信息管理系统中下载1995年1月1日至2021年12月31日玉溪市、审核标志为“已终审卡”的HIV/AIDS病例报告卡(病例数据库)、抗病毒治疗库及随访数据库的相关资料,采用Logistic回归模型分析HIV/AIDS患者ART后CD4/CD8+T淋巴细胞计数比值与非艾滋病相关死亡的关联,使用限制性立方样条函数(RCS)绘制剂量-反应关系曲线,构建χ2自动交互检测法(CHAID)决策树模型探索治疗时年龄、感染途径和最近1次CD4值对CD4/CD8比值与非艾滋病相关死亡关联之间的修饰作用。采用SAS 9.4和SPSS 26.0软件完成统计分析,以P<0.05为差异有统计学意义。结果 2 890例HIV/AIDS中,4.36%(126/2 890)的患者ART后死于非艾滋病相关性疾病。调整相关混杂因素后,相较于CD4/CD8比值<0.30组,比值为0.30~0.45组(OR=0.36,95%CI:0.19~0.68)和> 0.45组(OR=0.34,95%CI:0.16~0.71)非艾滋病相关死亡风险降低。剂量-反应关系曲线显示,CD4/CD8比值与非艾滋病相关死亡呈“L”型关联。决策树模型显示,在治疗时年龄≥50岁组中,CD4/CD8比值<0.30者非艾滋病相关死亡率由10.23%升至19.33%。结论 HIV/AIDS患者ART后CD4/CD8比值恢复正常有利于降低非艾滋病相关死亡风险。 展开更多
关键词 艾滋病病毒感染者/艾滋病患者 抗逆转录病毒治疗 CD4/CD8比值 非艾滋病相关疾病死亡
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广西地区HIV/AIDS患者大肠息肉和大肠癌肠镜检出情况分析
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作者 彭认平 邹俊 +4 位作者 刘夏 王秋东 杨丹 农术玉 蓝苹 《中国艾滋病性病》 北大核心 2026年第1期1-5,共5页
目的本研究旨在通过结肠镜检查,分析广西地区HIV/AIDS患者大肠息肉和大肠癌的检出情况。方法回顾性收集2023年7月至2024年6月在南宁市第四人民医院接受结肠镜检查的307例HIV/AIDS患者临床资料,分析息肉及肿瘤的检出率、部位和病理特征,... 目的本研究旨在通过结肠镜检查,分析广西地区HIV/AIDS患者大肠息肉和大肠癌的检出情况。方法回顾性收集2023年7月至2024年6月在南宁市第四人民医院接受结肠镜检查的307例HIV/AIDS患者临床资料,分析息肉及肿瘤的检出率、部位和病理特征,并比较不同CD4细胞水平及不同cART状态下病变检出差异。结果307例HIV/AIDS患者结肠镜检查总病变检出率74.9%(230/307),大肠息肉检出率51.5%(158/307),其中腺瘤性息肉检出率35.8%(110/307),大肠癌检出率5.2%(16/307),息肉以多发为主,大肠息肉和大肠癌左半结肠和直肠多见。CD4<200个/μL组与≥200个/μL组、cART组与非cART组之间,息肉、腺瘤和腺癌的检出率差异均无统计学意义(P均>0.05)。CD4<200个/μL组溃疡病变检出率(18.5%)高于CD4≥200个/μL组(6.5%),而cART组糜烂和溃疡病变检出率则低于非cART组(P均<0.05)。结论广西地区HIV/AIDS患者大肠息肉及大肠癌检出率高;息肉病理以增生性和低级别管状腺瘤为主,息肉以多发为主,大肠息肉和大肠癌以左半结肠和直肠多见。临床应重视HIV/AIDS患者结肠镜检查。 展开更多
关键词 艾滋病病毒感染 艾滋病 大肠息肉 大肠癌 肠镜 检出情况
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Voices that matter:The impact of patient-reported outcome measures on clinical decision-making 被引量:1
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作者 Naveen Jeyaraman Madhan Jeyaraman +2 位作者 Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu 《World Journal of Methodology》 2025年第2期54-61,共8页
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
关键词 Patient-reported outcome measures Clinical decision-making Patient-centered care Healthcare technology Data management Policy development
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Rule-Guidance Reinforcement Learning for Lane Change Decision-making:A Risk Assessment Approach 被引量:1
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作者 Lu Xiong Zhuoren Li +2 位作者 Danyang Zhong Puhang Xu Chen Tang 《Chinese Journal of Mechanical Engineering》 2025年第2期344-359,共16页
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
关键词 Autonomous driving Reinforcement learning decision-making Risk assessment Safety filter
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心理资本在HIV/AIDS患者领悟社会支持和自我管理的中介效应
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作者 谭苗 吴桂芳 +3 位作者 吴松杰 冯玲 汤星星 胡慧 《护理学报》 2026年第2期54-57,共4页
目的调查HIV/AIDS患者的领悟社会支持、心理资本和自我管理现状,分析HIV/AIDS患者的心理资本在领悟社会支持和自我管理中的中介效应。方法采用便利抽样法选取武汉市某三级甲等医院住院的HIV/AIDS患者作为研究对象。采用领悟社会支持量... 目的调查HIV/AIDS患者的领悟社会支持、心理资本和自我管理现状,分析HIV/AIDS患者的心理资本在领悟社会支持和自我管理中的中介效应。方法采用便利抽样法选取武汉市某三级甲等医院住院的HIV/AIDS患者作为研究对象。采用领悟社会支持量表、心理资本问卷、自我管理量表对其进行调查。采用SPSS 26.0分析心理资本在领悟社会支持和自我管理中的中介效应。结果本组HIV/AIDS患者的领悟社会支持总分为(58.97±13.85)分,心理资本总分为(127.41±19.24)分,领悟社会支持总分与心理资本总分呈正相关(r=0.515,P<0.001),与自我管理总分得分呈正相关(r=0.404,P<0.001),心理资本总分与自我管理得分呈正相关(r=0.555,P<0.001)。心理资本在领悟社会支持和自我管理之间有中介作用,中介效应为0.585(P<0.001),占比60.8%。结论本组HIV/AIDS患者的领悟社会支持总分处于中等水平,HIV/AIDS患者领悟社会支持可以直接促进患者自我管理能力提高,也可以通过心理资本发挥作用。建议构建社会支持系统,减轻或消除人们对艾滋病感染者存在恐惧、排斥和歧视,通过自身提高自我管理能力,促进患者提升自我效能、能够积极乐观的面对疾病和热爱生活。 展开更多
关键词 HIV/aidS患者 心理资本 领悟社会支持 自我管理 中介效应
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HAART对HIV/AIDS患者实验室指标影响的回顾性研究
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作者 赵妮 田文广 +2 位作者 田苗 廖娟 万克强 《现代医药卫生》 2026年第1期108-112,共5页
目的旨在探讨高效抗逆转录病毒疗法(HAART)对人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者血常规、肝肾功能、血脂、血糖的影响,为临床治疗提供指导。方法回顾性分析不同治疗方案的6组患者在6个随访时间点(0M、3M、6M、12M、18... 目的旨在探讨高效抗逆转录病毒疗法(HAART)对人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者血常规、肝肾功能、血脂、血糖的影响,为临床治疗提供指导。方法回顾性分析不同治疗方案的6组患者在6个随访时间点(0M、3M、6M、12M、18M、24M)的实验室指标变化。结果共纳入806例患者,白细胞计数在D组6M、12M和E组12M、18M时低于基线,差异均有统计学意义(P<0.05);血红蛋白在A组3M、6M和E组6M、12M时低于基线,差异均有统计学意义(P<0.05);血小板计数在E组6M、12M、18M时低于基线,差异均有统计学意义(P<0.05)。天门冬氨酸氨基转移酶在A、B组部分时间点和E组6M、12M、18M高于基线,差异均有统计学意义(P<0.05);丙氨酸氨基转移酶在A组、E组、F组部分时间点高于基线,差异均有统计学意义(P<0.05)。肌酐在C组6M、12M、18M和B、D、F组部分时间点高于基线,差异均有统计学意义(P<0.05)。空腹血糖在A、B、D、E组部分时间点和C组12M、18M、24M高于基线,差异均有统计学意义(P<0.05);总胆固醇在B、C、D、E、F组部分时间点高于基线,差异均有统计学意义(P<0.05);甘油三酯在C组12M、18M、24M和A、B、D、F组部分时间点高于基线,差异均有统计学意义(P<0.05)。结论不同HAART方案对实验室指标的影响各异,需根据患者个体情况选择方案,并定期监测以处理不良反应。 展开更多
关键词 HIV感染者/aidS患者 高效抗逆转录病毒疗法 实验室指标
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A Synergistic Multi-Attribute Decision-Making Method for Educational Institutions Evaluation Using Similarity Measures of Possibility Pythagorean Fuzzy Hypersoft Sets
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作者 Khuram Ali Khan Saba Mubeen Ishfaq +1 位作者 Atiqe Ur Rahman Salwa El-Morsy 《Computer Modeling in Engineering & Sciences》 SCIE EI 2025年第1期501-530,共30页
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
关键词 Hypersoft set Pythagorean fuzzy hypersoft set computational complexity multi-attribute decision-making optimization similarity measures uncertainty
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Medical Diagnosis Based on Multi-Attribute Group Decision-Making Using Extension Fuzzy Sets,Aggregation Operators and Basic Uncertainty Information Granule
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作者 Anastasios Dounis Ioannis Palaiothodoros Anna Panagiotou 《Computer Modeling in Engineering & Sciences》 SCIE EI 2025年第1期759-811,共53页
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
关键词 Medical diagnosis multi-attribute group decision-making(MAGDM) q-ROFS IVq-ROFS BUI aggregation operators similarity measures inverse score function
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Improving the Position Accuracy and Computational Efficiency of UAV Terrain Aided Navigation Using a Two-Stage Hybrid Fuzzy Particle Filtering Method
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作者 Sofia Yousuf Muhammad Bilal Kadri 《Computers, Materials & Continua》 SCIE EI 2025年第1期1193-1210,共18页
Terrain Aided Navigation(TAN)technology has become increasingly important due to its effectiveness in environments where Global Positioning System(GPS)is unavailable.In recent years,TAN systems have been extensively r... Terrain Aided Navigation(TAN)technology has become increasingly important due to its effectiveness in environments where Global Positioning System(GPS)is unavailable.In recent years,TAN systems have been extensively researched for both aerial and underwater navigation applications.However,many TAN systems that rely on recursive Unmanned Aerial Vehicle(UAV)position estimation methods,such as Extended Kalman Filters(EKF),often face challenges with divergence and instability,particularly in highly non-linear systems.To address these issues,this paper proposes and investigates a hybrid two-stage TAN positioning system for UAVs that utilizes Particle Filter.To enhance the system’s robustness against uncertainties caused by noise and to estimate additional system states,a Fuzzy Particle Filter(FPF)is employed in the first stage.This approach introduces a novel terrain composite feature that enables a fuzzy expert system to analyze terrain non-linearities and dynamically adjust the number of particles in real-time.This design allows the UAV to be efficiently localized in GPS-denied environments while also reducing the computational complexity of the particle filter in real-time applications.In the second stage,an Error State Kalman Filter(ESKF)is implemented to estimate the UAV’s altitude.The ESKF is chosen over the conventional EKF method because it is more suitable for non-linear systems.Simulation results demonstrate that the proposed fuzzy-based terrain composite method achieves high positional accuracy while reducing computational time and memory usage. 展开更多
关键词 Sensor fusion fuzzy logic particle filter composite feature terrain aided navigation
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Artificial intelligence-aided optical biopsy improves the diagnosis of esophageal squamous neoplasm 被引量:1
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作者 Tian Ma Guan-Qun Liu +5 位作者 Jing Guo Rui Ji Xue-Jun Shao Yan-Qing Li Zhen Li Xiu-Li Zuo 《World Journal of Gastroenterology》 2025年第13期89-99,共11页
BACKGROUND Early detection of esophageal squamous neoplasms(ESN)is essential for improving patient prognosis.Optical diagnosis of ESN remains challenging.Probebased confocal laser endomicroscopy(pCLE)enables accurate ... BACKGROUND Early detection of esophageal squamous neoplasms(ESN)is essential for improving patient prognosis.Optical diagnosis of ESN remains challenging.Probebased confocal laser endomicroscopy(pCLE)enables accurate in vivo histological observation and optical biopsy of ESN.However,interpretation of pCLE images requires histopathological expertise and extensive training.Artificial intelligence(AI)has been widely applied in digestive endoscopy;however,AI for pCLE diagnosis of ESN has not been reported.AIM To develop a pCLE computer-aided diagnostic system for ESN and assess its diagnostic performance and assistant efficiency for nonexpert endoscopists.METHODS The intelligent confocal laser endomicroscopy(iCLE)system consists of image recognition(based on inception-ResNet V2),video diagnosis,and quality judgment modules.This system was developed using pCLE images and videos and evaluated through image and prospective video recognition tests.Patients between June 2020 and January 2023 were prospectively enrolled.Expert and nonexpert endoscopists and the iCLE independently performed diagnoses for pCLE videos,with histopathology as the gold standard.Thereafter,the non-expert endoscopists performed a second assessment with iCLE assistance.RESULTS A total of 25056 images from 2803 patients were selected for iCLE training and validation.Another 2442 images from 226 patients were used for testing.iCLE achieved a high accuracy of 98.3%,sensitivity of 95.3%and specificity of 98.8%for diagnosing ESN images.A total of 2581 patients underwent upper gastrointestinal pCLE examination and were prospectively screened;54 patients with suspected ESN were enrolled.Overall,187 videos from 67 lesions were assessed by iCLE,three nonexpert and three expert endoscopists.iCLE achieved a high accuracy,sensitivity and specificity of 90.9%,92.0%,and 90.2%,respectively.Compared to experts,iCLE showed significantly higher sensitivity(92.0%vs 80.4%;P<0.001)and negative predictive value(94.4%vs 87.7%;P=0.003).With iCLE assistance,nonexpert endoscopists showed significant improvements in accuracy(from 83.6%to 88.6%)and sensitivity(from 76.0%to 89.8%).CONCLUSION iCLE system demonstrated high diagnostic performance for ESN.It can assist nonexpert endoscopists in improving the diagnostic efficiency of pCLE for ESN and has the potential for reducing unnecessary biopsies. 展开更多
关键词 Esophageal squamous neoplasm Probe-based confocal laser endomicroscopy Optical biopsy Artificial intelligence Computer aided diagnosis
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Healthcare providers’perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic:An international pilot survey
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作者 Sonali Vadi Neha Sanwalka Pramod Thaker 《World Journal of Critical Care Medicine》 2025年第1期100-110,共11页
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
关键词 SURVEY Clinical decision-making COVID-19 pandemic
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HIV/AIDS患者合并非结核分枝杆菌感染诊治专家共识
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作者 中国性病艾滋病防治协会HIV合并结核病专业委员会 沈银忠 +7 位作者 卢洪洲 付亮 史怀芳 刘莉 陈培芬 屈佳肴 赵方 张秋月 《中国艾滋病性病》 北大核心 2026年第1期91-107,共17页
非结核分枝杆菌(NTM)感染已成为HIV/AIDS患者住院率及病死率显著上升的重要独立危险因素,其临床诊治因HIV感染的特殊病理生理状态而呈现显著特异性:在病原学层面,不同NTM菌种具有独特的耐药谱系和药物敏感性特征;在临床表现上,既可表现... 非结核分枝杆菌(NTM)感染已成为HIV/AIDS患者住院率及病死率显著上升的重要独立危险因素,其临床诊治因HIV感染的特殊病理生理状态而呈现显著特异性:在病原学层面,不同NTM菌种具有独特的耐药谱系和药物敏感性特征;在临床表现上,既可表现为局限性肺部感染,也可发展为播散性多系统累及;在治疗策略上,需综合考虑抗NTM治疗与cART的协同性、药物间相互作用以及个体化疗程制定等关键问题。基于我国艾滋病合并NTM感染的流行病学特征、国际权威指南的循证证据以及最新临床研究进展,中国性病艾滋病防治协会HIV合并结核病专业委员会组织多学科专家对该领域诊治共识进行了系统修订,旨在为临床实践提供涵盖病原诊断、药物选择及治疗监测的全流程规范化指导。 展开更多
关键词 艾滋病病毒 艾滋病 非结核分枝杆菌感染 诊治 共识
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The relationship between proxy decision-making content and cues by families of patients with malignant brain tumor: A descriptive qualitative study
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作者 Runa Tokunaga Fumiyo Ishikawa 《International Journal of Nursing Sciences》 2025年第2期169-175,共7页
Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues le... Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions. 展开更多
关键词 Brain neoplasms FAMILY Nurses CUES Proxy decision-making
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Sexually differentiated decision-making involves faster recruitment in the early stages for the Tibetan antelopes Pantholops hodgsonii
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作者 Qin Zhu Jian Guan +6 位作者 Tianya Lei Kun Xuan Sile Guo Yumeng Zhao Changjian Fu Le Yang Zhongqiu Li 《Current Zoology》 2025年第1期124-135,共12页
Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studie... Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studies on collective behavior in small animals such as fish and insects are well-established,similar research on large wild animals remains challenging due to the limited availability of sufficient and systematic field data.Here,we aimed to explore the collective decision-making pattern and its sexual difference for the dimorphic Tibetan antelopes Pantholops hodgsonii(chiru)in Xizang Autonomous Region,China,by analyzing individual leadership distribution,as well as the joining process,considering factors such as calving stages and joining ranks.The distinct correlations of decision participants’ratio with group size and decision duration underscore the trade-off between accuracy and speed in decision-making.Male antelopes display a more democratic decision-making pattern,while females exhibit more prompt responses after calving at an early stage.This study uncovers a partially shared decision-making strategy among Tibetan antelopes,suggesting flexible self-organization in group decision processes aligned with animal life cycle progression. 展开更多
关键词 calving stage decision-making LEADERSHIP sexual differences Tibetan antelopes
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Data-Driven Component-Level Decision-Making for Online Remanufacturing of Gas-Insulated Switchgear
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作者 Hansam Cho Seokho Moon +2 位作者 Sunhyeok Hwang Seoung Bum Kim Younghoon Kim 《Computer Modeling in Engineering & Sciences》 2025年第11期1941-1967,共27页
Accurately determining when and what to remanufacture is essential for maximizing the lifecycle value of industrial equipment.However,existing approaches face three significant limitations:(1)reliance on predefined ma... Accurately determining when and what to remanufacture is essential for maximizing the lifecycle value of industrial equipment.However,existing approaches face three significant limitations:(1)reliance on predefined mathematical models that often fail to capture equipment-specific degradation,(2)offline optimization methods that assume access to future data,and(3)the absence of component-level guidance.To address these challenges,we propose a data-driven framework for component-level decision-making.The framework leverages streaming sensor data to predict the remaining useful life(RUL)without relying on mathematical models,employs an online optimization algorithm suitable for practical settings,and,through remanufacturing simulations,provides guidance on which components should be replaced.In a case study on gas-insulated switchgear,the proposed framework achieved RUL prediction performance comparable to an oracle model in an online setting without relying on predefined mathematical models.Furthermore,by employing online optimization,it determined a remanufacturing timing close to the global optimum using only past and current data.In addition,unlike previous studies,the framework enables component-level decision-making,allowing for more detailed and actionable remanufacturing guidance in practical applications. 展开更多
关键词 REMANUFACTURING online decision-making gas-insulated switchgear online learning
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