BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encoura...BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.展开更多
In order to carry out comprehensive decision-making of multi-class shared parking measures within a region, a bilevel model assisting decision-making is proposed. The upper level selects parkers＇ average satisfaction...In order to carry out comprehensive decision-making of multi-class shared parking measures within a region, a bilevel model assisting decision-making is proposed. The upper level selects parkers＇ average satisfaction and the violation rate during peak hours as indices in object function, and sets probability distribution models describing dynamic parking demand of each site, the feasibility of shared parking scenarios and occupancy requirements during peak hours of each parking lot as restrictions. The simulation model in the lower level sets up rules to assign each parker in the random parking demand series to the proper parking lot. An iterative method is proposed to confirm the state of each parking lot at the start of formal simulations. Besides, two patterns linking initialization and formal simulation are presented to acquire multiple solutions. The results of the numerical examples indicate the effectiveness of the model and solution methods.展开更多
Shared control schemes allow a human driver to work with an automated driving agent in driver-vehicle systems while retaining the driver’s abilities to control.The human driver,as an essential agent in the driver-veh...Shared control schemes allow a human driver to work with an automated driving agent in driver-vehicle systems while retaining the driver’s abilities to control.The human driver,as an essential agent in the driver-vehicle shared control systems,should be precisely modeled regarding their cognitive processes,control strategies,and decision-making processes.The interactive strategy design between drivers and automated driving agents brings an excellent challenge for human-centric driver assistance systems due to the inherent characteristics of humans.Many open-ended questions arise,such as what proper role of human drivers should act in a shared control scheme?How to make an intelligent decision capable of balancing the benefits of agents in shared control systems?Due to the advent of these attentions and questions,it is desirable to present a survey on the decision making between human drivers and highly automated vehicles,to understand their architectures,human driver modeling,and interaction strategies under the driver-vehicle shared schemes.Finally,we give a further discussion on the key future challenges and opportunities.They are likely to shape new potential research directions.展开更多
BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for childre...BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.展开更多
For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making...For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.展开更多
Shared decision-making has been described as allowing patients to gain more control over their life situation and feel less helpless. The aim of this systematic review was to describe the involvement of older patients...Shared decision-making has been described as allowing patients to gain more control over their life situation and feel less helpless. The aim of this systematic review was to describe the involvement of older patients in shared decision-making in community settings. In accordance with the systematic review method, a total of 2468 abstracts were read, after which nine quantitative studies were included. A qualitative thematic analysis was performed and two themes emerged;increased understanding of self-management and a desire to strengthen one’s position in relationship with professionals, both of which were essential for empowering older patients to participate in shared decision-making. Older patients’ shared decision-making was seen as a struggle to maintain their autonomy in different areas of everyday life. Emotional and psychological problems made their position more difficult. In order to empower them in relationships with healthcare professionals, older patients require more knowledge (self-efficacy) and information about their illness, which could strengthen their position in the decision-making process. They also need a greater awareness of decisional conflicts that may arise. Age, gender and health status influence older patients’ chance of being respected and taken seriously in relationship with professionals.展开更多
BACKGROUND There is a lack of studies and educational programs focused on biosimilars and shared decision-making among patients diagnosed with various rheumatic diseases.AIM To improve knowledge and awareness of biosi...BACKGROUND There is a lack of studies and educational programs focused on biosimilars and shared decision-making among patients diagnosed with various rheumatic diseases.AIM To improve knowledge and awareness of biosimilars and shared decision-making among patients attending rheumatology practices in Colorado as well as to assess a rheumatology patient’s interest in discussing biosimilars as well as shared decision-making with others(e.g.,medical professionals,family members,friends).METHODS Our goal was to work with 80 rheumatology teams in Colorado.We developed and distributed 2000 multi-page brochures to each participating office and later conducted an online anonymous survey.RESULTS There were a total of 49(2.5%)rheumatology patients who responded to our survey.After reading our educational booklet,many survey respondents identified the correct answer in most questions focused on biosimilars or shared decision-making.Our survey results suggest that patients attending rheumatology practices in Colorado are generally not involved in discussions with their providers regarding treatment plans or options.The improvement in scores after reading our educational materials was statistically significant for biosimilars and shared decision-making.CONCLUSION Overall,the level of knowledge and awareness of biosimilars and shared decisionmaking among patients attending rheumatology practices in Colorado was low.More educational programs as well as follow up trainings to measure changes in knowledge and awareness regarding biosimilars and shared decision-making among patients attending rheumatology practices are recommended.展开更多
Contemporary autonomous-driving technology relies on good environmental-perception systems and high-precision maps.For unknown environments or scenarios where perception fails,a human-in-the-loop remote-driving system...Contemporary autonomous-driving technology relies on good environmental-perception systems and high-precision maps.For unknown environments or scenarios where perception fails,a human-in-the-loop remote-driving system can effectively complement common solutions,although safety remains an issue for its application.A haptic shared-control algorithm based on non-cooperative game theory is presented in this paper.The algorithm generates collision-free reference paths with model predictive control and predicts the driver’s path using a two-point preview model.Man-machine torque interaction is modeled as a Nash game,and the assist system’s degree of intervention is regulated in real time,according to assessments of collision risk and the driver’s concentration.Simulations of several representative scenarios demonstrate how the proposed method improves driving safety,while respecting driver decisions.展开更多
This paper explores the decision-making mechanism of the consuming behavior hidden behind the sudden popularity of the Oriental Selection Company in terms of the mental accounting theory.Firstly,according to the“Non-...This paper explores the decision-making mechanism of the consuming behavior hidden behind the sudden popularity of the Oriental Selection Company in terms of the mental accounting theory.Firstly,according to the“Non-alternative”characteristics of mental accounting,this paper expounds how the strategy of the bilingual live-streaming of Oriental Selection promoters stimulates consumers’desire to buy the advertised products and services whilst using the utility theory of mental accounting to analyze how Oriental Selection promoters improve consumers’acquisition utility and total utility.Secondly,we sum up the successful experiences of Oriental Selection:The live-streaming industry should apply the theory of mental accounting in effectively overcoming the shortcomings of the live-streamed marketing by stimulating consumers’desire and influencing their decision-making behavior through the streaming of content that triggers them to make purchases.This is achievable by abandoning the traditional ways of loudly urging consumers to buy goods.Finally,this paper puts forward some suggestions on how to use the mental accounting theory in promoting sustainable consumption and points out the prospects for Oriental Selection.展开更多
Throughout this work,we explore the uniqueness properties of meromorphic functions concerning their interactions with complex differential-difference polynomial.Under the condition of finite order,we establish three d...Throughout this work,we explore the uniqueness properties of meromorphic functions concerning their interactions with complex differential-difference polynomial.Under the condition of finite order,we establish three distinct uniqueness results for a meromorphic function f associated with the differential-difference polynomial L_(η)^(n)f=Σ_(k=0)^(n)a_(k)f (z+k_(η))+a_(-1)f′.These results lead to a refined characterization of f (z)≡L_(η)^(n)f (z).Several illustrative examples are provided to demonstrate the sharpness and precision of the results obtained in this study.展开更多
Clinical decision-making and judgment is an essential skill that should be acquired by nursing interns.However,many studies reveal that a large proportion of nursing interns have difficulty in meeting the basic expect...Clinical decision-making and judgment is an essential skill that should be acquired by nursing interns.However,many studies reveal that a large proportion of nursing interns have difficulty in meeting the basic expectation of clinical decision-making.This article begins with a brief review of some theories related to clinical decision-making.Then it takes a case,for example,to show how the wrong decision is made.Furthermore,it makes a general analysis on the case drawing on the concept of bounded rationality,dual-process model,and skills acquisition theory.This article ends with some reflections from the case,to improve the consciousness and skills in decision-making for nursing interns.展开更多
Using the dynamic optimization theory, we described a decision-making model for farmer choosing land use when there are several different kinds of uses for land. To obtain an empirical model that could be easily appli...Using the dynamic optimization theory, we described a decision-making model for farmer choosing land use when there are several different kinds of uses for land. To obtain an empirical model that could be easily applied, decision rules for farmer with a single static expectation were given.展开更多
Determining the travel intention of residents with shared electric vehicles(EVs)is significant for promoting the development of low-carbon transportation,considering that common problems such as high idle rate and lac...Determining the travel intention of residents with shared electric vehicles(EVs)is significant for promoting the development of low-carbon transportation,considering that common problems such as high idle rate and lack of attractiveness still exist.To this end,a structural equation model(SEM)based on the theory of multiple motivations is proposed in this paper.First,the influencing motivations for EV sharing are divided into three categories:consumer-driven,program-driven,and enterprise-driven motivations.Then,the intentions of residents in Shanghai to travel with shared EVs are obtained through a survey questionnaire.Finally,an SEM is constructed to analyze quantitatively the impact of different motivations on the travel intention.The results show that consumer-driven motivations with impact weights from 0.14 to 0.63 have the overwhelming impact on travel intention,compared to program-driven motivations with impact weights from−0.14 to 0.15 and enterprise-driven motivations with impact weights from 0.02 to 0.06.In terms of consumer-driven motivations,the weight of green travel awareness is the highest.The implications of these results on the policy to enable large-scale implementation of shared EVs are discussed from the perspectives of the resident,enterprise,and government.展开更多
If one uses a theoretic system to put into nutshell diplomatic thought of General-Secretary Xi Jinping since the 18th CPC National Congress,then he will use the theory of community of shared future of mankind,which ca...If one uses a theoretic system to put into nutshell diplomatic thought of General-Secretary Xi Jinping since the 18th CPC National Congress,then he will use the theory of community of shared future of mankind,which can also be described as'to fly the banner of the doctrine of international winwin cooperation and to take the road of building a community of shared展开更多
Autonomy, a key property associated with the agent, is an important topic in the current research of the agent theory. Although no definition of the agent autonomy is universally accepted, an important aspect of the a...Autonomy, a key property associated with the agent, is an important topic in the current research of the agent theory. Although no definition of the agent autonomy is universally accepted, an important aspect of the agent autonomy is the decision-making capability of the agents. This paper investigates the autonomy of the agent, presents a framework for autonomous agent and discusses its decision-making process. Started with introducing a language for representing autonomous agent, a framework is proposed for modeling autonomous agent based on a BDI model and the situation calculus. Finally, a kind of decision-making process of the autonomous agent is presented.展开更多
Game theory can be applied to the air combat decision-making problem of multiple unmanned combat air vehicles(UCAVs).However,it is difficult to have satisfactory decision-making results completely relying on air comba...Game theory can be applied to the air combat decision-making problem of multiple unmanned combat air vehicles(UCAVs).However,it is difficult to have satisfactory decision-making results completely relying on air combat situation information,because there is a lot of time-sensitive information in a complex air combat environment.In this paper,a constraint strategy game approach is developed to generate intelligent decision-making for multiple UCAVs in complex air combat environment with air combat situation information and time-sensitive information.Initially,a constraint strategy game is employed to model attack-defense decision-making problem in complex air combat environment.Then,an algorithm is proposed for solving the constraint strategy game based on linear programming and linear inequality(CSG-LL).Finally,an example is given to illustrate the effectiveness of the proposed approach.展开更多
Coordinated mission decision-making is one of the core steps to effectively exploit the capabilities of cooperative attack of multiple aircrafts. However, the situational assessment is an essential base to realize the...Coordinated mission decision-making is one of the core steps to effectively exploit the capabilities of cooperative attack of multiple aircrafts. However, the situational assessment is an essential base to realize the mission decision-making. Therefore, in this paper, we develop a mission decision-making method of multi-aircraft cooperatively attacking multi-target based on situational assessment. We have studied the situational assessment mathematical model based on the Dempster-Shafer(D-S) evidence theory and the mission decision-making mathematical model based on the game theory. The proposed mission decision-making method of antagonized airfight is validated by some simulation examples of a swarm of unmanned combat aerial vehicles(UCAVs)that carry out the mission of the suppressing of enemy air defenses(SEAD).展开更多
BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture...BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.展开更多
Background Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-...Background Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement （TAVR）. Methods Qualitative study entailing semi-structured interviews of a purposive sample often older （range 73-89, median 83.5 years） adults after TAVR （median 23 days）. The study setting was a cardiac department at a university hospital performing TAVR since 2010. Analysis was by systematic text condensation. Results Even when choice seemed hard or absent, TAVR-patients deliberately took the chance offered them by processing risk assessment, ambivalence and fate. They regarded declining the treatment to be worse than accepting the risk related to the procedure. The experience of being thoroughly advised by their physician formed the basis of an autonomous trust. The trust they felt for the physicians＇ recommendations mitigated ambivalence about the procedure and risks. TAVR patients expressed feelings consistent with self-empowerment and claimed that it had to be their decision. Even so, choosing the intervention as an obligation to their family or passively accepting it was also reported. Conclusions Older TAVR patients＇ experience of an autonomous decision may encompass frank tradeoff; deliberate physician dependency as well as a resilient self-view. Physicians should be especially aware of how older adults＇ subtle cognitive declines and inclinations to preserve their identities which can influence their medical decision making when obtaining in- formed consent. Cardiologists and other providers may also use these insights to develop new strategies that better respond to such inherent complexities.展开更多
As to oppositional, multi-objective and hierarchical characteristic of air formation to ground attackdefends campaign, and using dynamic space state model of military campaign, this article establishes a principal and...As to oppositional, multi-objective and hierarchical characteristic of air formation to ground attackdefends campaign, and using dynamic space state model of military campaign, this article establishes a principal and subordinate hierarchical interactive decision-making way, the Nash-Stackelberg-Nash model, to solve the problems in military operation, and find out the associated best strategy in hierarchical dynamic decision-making. The simulating result indicate that when applying the model to air formation to ground attack-defends decision-making system, it can solve the problems of two hierarchies, dynamic oppositional decision-making favorably, and reach preferable effect in battle. It proves that the model can provide an effective way for analyzing a battle,展开更多
文摘BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.
基金The Planning Program of Science and Technology of Ministry of Housing and Urban-Rural Development of China (No. 2010-K5-16)
文摘In order to carry out comprehensive decision-making of multi-class shared parking measures within a region, a bilevel model assisting decision-making is proposed. The upper level selects parkers＇ average satisfaction and the violation rate during peak hours as indices in object function, and sets probability distribution models describing dynamic parking demand of each site, the feasibility of shared parking scenarios and occupancy requirements during peak hours of each parking lot as restrictions. The simulation model in the lower level sets up rules to assign each parker in the random parking demand series to the proper parking lot. An iterative method is proposed to confirm the state of each parking lot at the start of formal simulations. Besides, two patterns linking initialization and formal simulation are presented to acquire multiple solutions. The results of the numerical examples indicate the effectiveness of the model and solution methods.
文摘Shared control schemes allow a human driver to work with an automated driving agent in driver-vehicle systems while retaining the driver’s abilities to control.The human driver,as an essential agent in the driver-vehicle shared control systems,should be precisely modeled regarding their cognitive processes,control strategies,and decision-making processes.The interactive strategy design between drivers and automated driving agents brings an excellent challenge for human-centric driver assistance systems due to the inherent characteristics of humans.Many open-ended questions arise,such as what proper role of human drivers should act in a shared control scheme?How to make an intelligent decision capable of balancing the benefits of agents in shared control systems?Due to the advent of these attentions and questions,it is desirable to present a survey on the decision making between human drivers and highly automated vehicles,to understand their architectures,human driver modeling,and interaction strategies under the driver-vehicle shared schemes.Finally,we give a further discussion on the key future challenges and opportunities.They are likely to shape new potential research directions.
基金This study was supported by the Science and Technology Innovation-Biomedical Supporting Program of Shanghai Science and Technology Committee(19441904400)Program for artificial intelligence innovation and development of Shanghai Municipal Commission of Economy and Informatization(2020-RGZN-02048).
文摘BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.
文摘For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.
文摘Shared decision-making has been described as allowing patients to gain more control over their life situation and feel less helpless. The aim of this systematic review was to describe the involvement of older patients in shared decision-making in community settings. In accordance with the systematic review method, a total of 2468 abstracts were read, after which nine quantitative studies were included. A qualitative thematic analysis was performed and two themes emerged;increased understanding of self-management and a desire to strengthen one’s position in relationship with professionals, both of which were essential for empowering older patients to participate in shared decision-making. Older patients’ shared decision-making was seen as a struggle to maintain their autonomy in different areas of everyday life. Emotional and psychological problems made their position more difficult. In order to empower them in relationships with healthcare professionals, older patients require more knowledge (self-efficacy) and information about their illness, which could strengthen their position in the decision-making process. They also need a greater awareness of decisional conflicts that may arise. Age, gender and health status influence older patients’ chance of being respected and taken seriously in relationship with professionals.
文摘BACKGROUND There is a lack of studies and educational programs focused on biosimilars and shared decision-making among patients diagnosed with various rheumatic diseases.AIM To improve knowledge and awareness of biosimilars and shared decision-making among patients attending rheumatology practices in Colorado as well as to assess a rheumatology patient’s interest in discussing biosimilars as well as shared decision-making with others(e.g.,medical professionals,family members,friends).METHODS Our goal was to work with 80 rheumatology teams in Colorado.We developed and distributed 2000 multi-page brochures to each participating office and later conducted an online anonymous survey.RESULTS There were a total of 49(2.5%)rheumatology patients who responded to our survey.After reading our educational booklet,many survey respondents identified the correct answer in most questions focused on biosimilars or shared decision-making.Our survey results suggest that patients attending rheumatology practices in Colorado are generally not involved in discussions with their providers regarding treatment plans or options.The improvement in scores after reading our educational materials was statistically significant for biosimilars and shared decision-making.CONCLUSION Overall,the level of knowledge and awareness of biosimilars and shared decisionmaking among patients attending rheumatology practices in Colorado was low.More educational programs as well as follow up trainings to measure changes in knowledge and awareness regarding biosimilars and shared decision-making among patients attending rheumatology practices are recommended.
基金the National Natural Science Foundation of China(No.51775331)。
文摘Contemporary autonomous-driving technology relies on good environmental-perception systems and high-precision maps.For unknown environments or scenarios where perception fails,a human-in-the-loop remote-driving system can effectively complement common solutions,although safety remains an issue for its application.A haptic shared-control algorithm based on non-cooperative game theory is presented in this paper.The algorithm generates collision-free reference paths with model predictive control and predicts the driver’s path using a two-point preview model.Man-machine torque interaction is modeled as a Nash game,and the assist system’s degree of intervention is regulated in real time,according to assessments of collision risk and the driver’s concentration.Simulations of several representative scenarios demonstrate how the proposed method improves driving safety,while respecting driver decisions.
文摘This paper explores the decision-making mechanism of the consuming behavior hidden behind the sudden popularity of the Oriental Selection Company in terms of the mental accounting theory.Firstly,according to the“Non-alternative”characteristics of mental accounting,this paper expounds how the strategy of the bilingual live-streaming of Oriental Selection promoters stimulates consumers’desire to buy the advertised products and services whilst using the utility theory of mental accounting to analyze how Oriental Selection promoters improve consumers’acquisition utility and total utility.Secondly,we sum up the successful experiences of Oriental Selection:The live-streaming industry should apply the theory of mental accounting in effectively overcoming the shortcomings of the live-streamed marketing by stimulating consumers’desire and influencing their decision-making behavior through the streaming of content that triggers them to make purchases.This is achievable by abandoning the traditional ways of loudly urging consumers to buy goods.Finally,this paper puts forward some suggestions on how to use the mental accounting theory in promoting sustainable consumption and points out the prospects for Oriental Selection.
基金Supported by the National Natural Science Foundation of China (Grant No.12161074)the Talent Introduction Research Foundation of Suqian University (Grant No.106-CK00042/028)+1 种基金Suqian Sci&Tech Program (Grant No.M202206)Sponsored by Qing Lan Project of Jiangsu Province and Suqian Talent Xiongying Plan of Suqian。
文摘Throughout this work,we explore the uniqueness properties of meromorphic functions concerning their interactions with complex differential-difference polynomial.Under the condition of finite order,we establish three distinct uniqueness results for a meromorphic function f associated with the differential-difference polynomial L_(η)^(n)f=Σ_(k=0)^(n)a_(k)f (z+k_(η))+a_(-1)f′.These results lead to a refined characterization of f (z)≡L_(η)^(n)f (z).Several illustrative examples are provided to demonstrate the sharpness and precision of the results obtained in this study.
文摘Clinical decision-making and judgment is an essential skill that should be acquired by nursing interns.However,many studies reveal that a large proportion of nursing interns have difficulty in meeting the basic expectation of clinical decision-making.This article begins with a brief review of some theories related to clinical decision-making.Then it takes a case,for example,to show how the wrong decision is made.Furthermore,it makes a general analysis on the case drawing on the concept of bounded rationality,dual-process model,and skills acquisition theory.This article ends with some reflections from the case,to improve the consciousness and skills in decision-making for nursing interns.
文摘Using the dynamic optimization theory, we described a decision-making model for farmer choosing land use when there are several different kinds of uses for land. To obtain an empirical model that could be easily applied, decision rules for farmer with a single static expectation were given.
基金the National Natural Science Founda-tion of China(Nos.71971139 and 72201172)。
文摘Determining the travel intention of residents with shared electric vehicles(EVs)is significant for promoting the development of low-carbon transportation,considering that common problems such as high idle rate and lack of attractiveness still exist.To this end,a structural equation model(SEM)based on the theory of multiple motivations is proposed in this paper.First,the influencing motivations for EV sharing are divided into three categories:consumer-driven,program-driven,and enterprise-driven motivations.Then,the intentions of residents in Shanghai to travel with shared EVs are obtained through a survey questionnaire.Finally,an SEM is constructed to analyze quantitatively the impact of different motivations on the travel intention.The results show that consumer-driven motivations with impact weights from 0.14 to 0.63 have the overwhelming impact on travel intention,compared to program-driven motivations with impact weights from−0.14 to 0.15 and enterprise-driven motivations with impact weights from 0.02 to 0.06.In terms of consumer-driven motivations,the weight of green travel awareness is the highest.The implications of these results on the policy to enable large-scale implementation of shared EVs are discussed from the perspectives of the resident,enterprise,and government.
文摘If one uses a theoretic system to put into nutshell diplomatic thought of General-Secretary Xi Jinping since the 18th CPC National Congress,then he will use the theory of community of shared future of mankind,which can also be described as'to fly the banner of the doctrine of international winwin cooperation and to take the road of building a community of shared
文摘Autonomy, a key property associated with the agent, is an important topic in the current research of the agent theory. Although no definition of the agent autonomy is universally accepted, an important aspect of the agent autonomy is the decision-making capability of the agents. This paper investigates the autonomy of the agent, presents a framework for autonomous agent and discusses its decision-making process. Started with introducing a language for representing autonomous agent, a framework is proposed for modeling autonomous agent based on a BDI model and the situation calculus. Finally, a kind of decision-making process of the autonomous agent is presented.
基金supported by Major Projects for Science and Technology Innovation 2030(Grant No.2018AA0100800)Equipment Pre-research Foundation of Laboratory(Grant No.61425040104)in part by Jiangsu Province“333”project under Grant BRA2019051.
文摘Game theory can be applied to the air combat decision-making problem of multiple unmanned combat air vehicles(UCAVs).However,it is difficult to have satisfactory decision-making results completely relying on air combat situation information,because there is a lot of time-sensitive information in a complex air combat environment.In this paper,a constraint strategy game approach is developed to generate intelligent decision-making for multiple UCAVs in complex air combat environment with air combat situation information and time-sensitive information.Initially,a constraint strategy game is employed to model attack-defense decision-making problem in complex air combat environment.Then,an algorithm is proposed for solving the constraint strategy game based on linear programming and linear inequality(CSG-LL).Finally,an example is given to illustrate the effectiveness of the proposed approach.
基金supported by the Aeronautical Science Foundation of China (No. 05D01002)
文摘Coordinated mission decision-making is one of the core steps to effectively exploit the capabilities of cooperative attack of multiple aircrafts. However, the situational assessment is an essential base to realize the mission decision-making. Therefore, in this paper, we develop a mission decision-making method of multi-aircraft cooperatively attacking multi-target based on situational assessment. We have studied the situational assessment mathematical model based on the Dempster-Shafer(D-S) evidence theory and the mission decision-making mathematical model based on the game theory. The proposed mission decision-making method of antagonized airfight is validated by some simulation examples of a swarm of unmanned combat aerial vehicles(UCAVs)that carry out the mission of the suppressing of enemy air defenses(SEAD).
基金supported by the China Medical BoardOpen Competition Program(20-378)Peking University Third Hospital Fund for Returned Scholars(BYSYLXHG2020004)+1 种基金JX was supported by the Peking Union Medical College Fund for Informatization of Postgraduate Courses(2021YXX001)YLZ was supported by the Sichuan University Graduate Education Reform Project(GSSCU2021046)。
文摘BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.
文摘Background Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement （TAVR）. Methods Qualitative study entailing semi-structured interviews of a purposive sample often older （range 73-89, median 83.5 years） adults after TAVR （median 23 days）. The study setting was a cardiac department at a university hospital performing TAVR since 2010. Analysis was by systematic text condensation. Results Even when choice seemed hard or absent, TAVR-patients deliberately took the chance offered them by processing risk assessment, ambivalence and fate. They regarded declining the treatment to be worse than accepting the risk related to the procedure. The experience of being thoroughly advised by their physician formed the basis of an autonomous trust. The trust they felt for the physicians＇ recommendations mitigated ambivalence about the procedure and risks. TAVR patients expressed feelings consistent with self-empowerment and claimed that it had to be their decision. Even so, choosing the intervention as an obligation to their family or passively accepting it was also reported. Conclusions Older TAVR patients＇ experience of an autonomous decision may encompass frank tradeoff; deliberate physician dependency as well as a resilient self-view. Physicians should be especially aware of how older adults＇ subtle cognitive declines and inclinations to preserve their identities which can influence their medical decision making when obtaining in- formed consent. Cardiologists and other providers may also use these insights to develop new strategies that better respond to such inherent complexities.
基金College Doctor Foundation (20060699026)Aviation Basic Scientific Foundation (05D53021).
文摘As to oppositional, multi-objective and hierarchical characteristic of air formation to ground attackdefends campaign, and using dynamic space state model of military campaign, this article establishes a principal and subordinate hierarchical interactive decision-making way, the Nash-Stackelberg-Nash model, to solve the problems in military operation, and find out the associated best strategy in hierarchical dynamic decision-making. The simulating result indicate that when applying the model to air formation to ground attack-defends decision-making system, it can solve the problems of two hierarchies, dynamic oppositional decision-making favorably, and reach preferable effect in battle. It proves that the model can provide an effective way for analyzing a battle,
