Multi-target Collaborative Combat Decision-Making by Improved Particle Swarm Optimizer

A decision-making problem of missile-target assignment with a novel particle swarm optimization algorithm is proposed when it comes to a multiple target collaborative combat situation.The threat function is established to describe air combat situation.Optimization function is used to find an optimal missile-target assignment.An improved particle swarm optimization algorithm is utilized to figure out the optimization function with less parameters,which is based on the adaptive random learning approach.According to the coordinated attack tactics,there are some adjustments to the assignment.Simulation example results show that it is an effective algorithm to handle with the decision-making problem of the missile-target assignment(MTA)in air combat.

Combinative Algorithms for the Multidisciplinary Collaborative Simulation of Complex Mechatronic Products Based on Major Step and Convergent Integration Step

Multidisciplinary collaborative simulation （MCS） is an important area of research in the domain of multidisciplinary design optimization （MDO）.Although previous research for MCS has to some extent addressed some issues like using of multiple tools,integration stability,control of step size,data synchronization,etc,further work is still necessary to study how to achieve improved precision.A theoretical model is formulated to describe and analyze the integration process of MCS.A basic algorithm with equal major steps is proposed based on the model,along with two methods of implementation for the model,namely the serial method and the parallel method.A further algorithm based on convergent integration step is proposed,which has a more flexible strategy for run-time integration.The influence of interpolation techniques on simulation performance is studied as well.Simulations of the performance of various algorithms with different interpolation techniques are performed for both a simple numerical example and a complex mechatronic product.The novel algorithm based on convergent integration step,when used with a high-order interpolation technique,has better performance in terms of precision and efficiency.The innovation of this paper is mainly on the validation of high precision of the proposed convergent integration step algorithm.

Benefits of multidisciplinary collaborative care team-based nursing services in treating pressure injury wounds in cerebral infarction patients

BACKGROUND Cerebral infarction patients need to be bedridden for long periods of time often resulting in pressure injuries,which may represent a serious threat to patients'life and health.An effective nursing program should be adopted for timely intervention in patients with pressure wounds.AIM To explore the value of nursing services based on a multidisciplinary collaborative treatment team in patients with pressure injury wounds following cerebral infarction.METHODS Patients with cerebral infarction pressure injury wounds in our hospital from December 2016 to January 2021 were selected and divided into one study group and one control group based on the simple random number table method.The control group was treated with conventional nursing care(CNC),and the study group was treated with care services based on multidisciplinary collaborative care(MDCC).The Pressure Ulcer Scale for Healing(PUSH),healing effect,Self-Perceived Burden Score(SPBS),and satisfaction with the intervention were calculated before and after 2 and 4 wk of intervention in both groups.RESULTS Sixty-two patients were enrolled,and 31 patients were assigned to each group.The results of the interventions were as follows:(1)There was no significant difference between the PUSH scores of the MDCC group(11.19±2.46)and CNC group(12.01±2.79)before the intervention(P>0.05),and the PUSH scores were lower after 2 and 4 wk of intervention in the MDCC group(6.63±1.97 and 3.11±1.04)than in the CNC group(8.78±2.13 and 4.96±1.35 points)(P<0.05);(2)The rate of wound healing in the MDCC group(96.77%)was higher than that in the CNC group(80.65%)(P<0.05);(3)There was no significant difference between the SPBS scores of emotional factors(21.15±3.11),economic factors(9.88±2.15),and physical factors(8.19±2.23)in the two groups before the intervention.The scores of emotional factors(13.51±1.88),economic factors(6.38±1.44),and physical factors(5.37±1.08)were lower in the MDCC group than in the CNC group(16.89±2.05,7.99±1.68 and 7.06±1.19)after 4 wk of intervention(P<0.05);and(4)Satisfaction with the intervention was higher in the MDCC group(93.55%)than in the CNC group(74.19%)(P<0.05).CONCLUSION Interventions for patients with cerebral infarction pressure wounds based on an MDCC treatment team can effectively reduce patients'self-perceived burden,improve pressure wound conditions,facilitate wound healing,and increase patient satisfaction with the intervention.

Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection

Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.

Evaluation of Multidisciplinary Collaborative Care in Patients with Acute Coronary Syndrome and Depression and/or Anxiety Disorders

Objective:To evaluate the effect of multidisciplinary collaborative care(MCC)in patients with both acute coronary syndrome(ACS)and depression and/or anxiety disorders compared with usual physician care(UPC).Methods:Depression and/or anxiety were screened by using SDS and SAS,ACS patients with depression and/or anxiety disorders were randomized into MCC and UPC groups.The cardiac outcomes and the life quality were evaluated at1year follow-up.Results:Overall,30.19%(96/318)patients had positive screen results.At1year,Cardiac outcome measures for patients in MCC group were significantly better for composite events of cardiac death and non-fatal MI(6.12% vs23.40%,p=0.016),cardiac function(NYHA functional classifi cation III or IV,0% vs 25%,p=0.05),and angina pectoris(21.28% vs 85%,p<0.0005),than patients in UPC group;the life quality were improved in patients in MCC group.Conclusion:After ACS,30.19% of patients had depression and/or anxiety disorders,MCC had better effects on cardiac outcomes and quality of life in ACS patients with Psychiatric disorders.

Application of multidisciplinary collaborative nursing with family care for enhanced recovery after surgery in children with inguinal hernia

BACKGROUND Perioperative nursing can reduce the stress reaction and improve the prognosis of children.AIM To elucidate the influence of multidisciplinary collaborative nursing for enhanced recovery after surgery(ERAS)with family care in perioperative nursing children with an inguinal hernia and its impact on the prognosis.METHODS The data of 100 children with inguinal hernia were retrospectively analyzed.The participants were divided into three groups according to different nursing methods:Groups A(n=38),B(n=32),and C(n=30).Group A received multidisciplinary collaborative ERAS nursing combined with family care nursing;Group B received multidisciplinary collaborative nursing for ERAS;and Group C received routine nursing.The postoperative recovery results of the three groups were compared,including intraoperative blood loss and postoperative feeding time,time of getting out of bed,hospitalization time,and defecation time.Furthermore,the incidence of common complications was also compared between the three groups.RESULTS There was less intraoperative blood loss in Groups A and B than in Group C(P<0.05),and the time of getting out of bed and postoperative hospitalization and defecation times were also decreased in Group C(P<0.05).There was no significant difference in postoperative feeding time among the three groups(P>0.05).Each index had no statistical significance between Groups A and B(P>0.05).The incidence of urinary retention,infection,hematoma,and hernia recurrence in Group A was less than that in Group C(P<0.05).No significant difference was observed in the overall complication rate between Groups A and B and between Groups B and C(P>0.05).CONCLUSION The application of multidisciplinary collaborative nursing combined with family care in the perioperative care of children with an inguinal hernia for ERAS may promote postoperative rehabilitation for children and reduce the incidence of complications.

Perceptions of Collaboration and Satisfaction with Collaboration Regarding Care Decision-Making in Intensive Care Units in Japan: A National Survey

Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.

An extended HLA multilayer federation integration architecture for multidisciplinary collaborative simulation

The development of complex products is essentially concerned with multidisciplinary knowledge. Running on Internet, integration based on muhilayer federation architecture and dynamic reuse of simulation resources are the major difficulties for complex product collaborative design and simulation. Since the traditional Run-Time Infrastructure （RTI） is not good at supporting these new requirements, an extended high level architecture （HLA） multilayer federation integration architecture （MLFIA）, based on the resource management federation （RMF） and its supporting environment based Service-oriented architecture （SOA） and HLA （SOHLA） are proposed, The idea and realization of two key technologies, the dynamic creation of simulation federation based on RMF, TH RTI, an extensible HLA runtime infrastructure （RTI）, used at Internet are emphasized. Finally, an industry case about multiple unit （MU） is given.

Torpedo Overall Multidisciplinary Design Based on Collaborative Optimization

A torpedo multidisciplinary design optimization (MDO) based on the collaborative optimization is proposed. Through decomposition and coordination, some problems in torpedo design such as multidisciplinary coupling, large data volume and complex data relationships can be solved. Taking aim at some complex problems in the torpedo design, such as computation in multidisciplinary design, organization, modeling and information exchange, the collaborative optimization methods based on approximate technology are presented. An example to increase the torpedo range is also given. It demonstrates that the method can converge quickly, has higher reliability and smaller data throughput, and is a very effective MDO method.

The Effectiveness of a Multidisciplinary Collaborative Model for the Diagnosis and Treatment of Vertigo

Objective:To investigate the effectiveness of applying a multidisciplinary collaborative model for the diagnosis and treatment of patients with vertigo.Methods:The study was carried out in Xianyang Hospital of Yan’an University,in which 100 patients with vertigo were selected from April 2021 to April 2022 and were divided into two groups:the control group was under the single diagnosis and treatment model,whereas the experimental group was under the multidisciplinary collaborative diagnosis and treatment model,with 50 cases in each group.The diagnostic effects of the two groups were compared.Results:The diagnostic and therapeutic efficiency of the patients in the experimental group were 94%and 98%,respectively,while those of the patients in the control group were 78%and 82%,respectively,with a significant difference between the two groups(p<0.05).The balance scores of the patients in both groups were low before the treatment,in which the difference was not significant(p>0.05);after the treatment,the scores improved,with those of the patients in the experimental group being significantly higher than those in the control group(p<0.05).Moreover,the satisfaction rate of patients in the experimental group(98%)was significantly higher than that of the control group(80%)(p<0.05).Conclusion:The application of the multidisciplinary collaborative diagnosis and treatment model in the diagnosis of patients with vertigo is effective.The multidisciplinary model can improve clinical diagnosis,enhance the treatment effect,improve the clinical symptoms of patients,and increase the satisfaction of patient care.Hence,it is of high clinical application value.

Application of the optimal Latin hypercube design and radial basis function network to collaborative optimization

Improving the efficiency of ship optimization is crucial for modem ship design. Compared with traditional methods, multidisciplinary design optimization （MDO） is a more promising approach. For this reason, Collaborative Optimization （CO） is discussed and analyzed in this paper. As one of the most frequently applied MDO methods, CO promotes autonomy of disciplines while providing a coordinating mechanism guaranteeing progress toward an optimum and maintaining interdisciplinary compatibility. However, there are some difficulties in applying the conventional CO method, such as difficulties in choosing an initial point and tremendous computational requirements. For the purpose of overcoming these problems, optimal Latin hypercube design and Radial basis function network were applied to CO. Optimal Latin hypercube design is a modified Latin Hypercube design. Radial basis function network approximates the optimization model, and is updated during the optimization process to improve accuracy. It is shown by examples that the computing efficiency and robustness of this CO method are higher than with the conventional CO method.

Selecting suitable key supplier for core components during smart complex equipment central-private enterprises collaborative development process:from two different forms of evaluation information and matching perspective

With the development of central-private enterprises integration,selecting suitable key suppliers are able to provide core components for smart complex equipment.We consider selecting suitable key suppliers from matching perspective,for it not only satisfies natural development of smart complex equipment,it is also a good implementation of equipment project in central-private enterprises integration context.In in this paper,we carry out two parts of research,one is evaluation attributes based on comprehensive analysis,and the other is matching process between key suppliers and core components based on the matching attribute.In practical analysis process,we employ comprehensive evaluated analysis methods to acquire relevant attributes for the matching process that follows.In the analysis process,we adopt entropy-maximum deviation method(MDM)-decision-making trial and evaluation laboratory(DEMATEL)-technique for order preference by similarity to an ideal solution(TOPSIS)to obtain a comprehensive analysis.The entropy-MDM is applied to get weight value,DEMATEL is utilized to obtain internal relations,and TOPSIS is adopted to get ideal evaluated solution.We consider aggregating two types of evaluation information according to similarities of smart complex equipment based on the combination between geometric mean and arithmetic mean.Moreover,based on the aforementioned attributes and generalized power Heronian mean operator,we aggregate preference information to acquire relevant satisfaction degree,then combine the constructed matching model to get suitable key supplier.Through comprehensive analysis of selecting suitable suppliers,we know that two-sided matching and information aggregation can provide more research perspectives for smart complex equipment.Through analysis for relevant factors,we find that leading role and service level are also significant for the smart complex equipment development process.

多学科合作模式的综合干预对食管癌术后患者心理状态和营养状况的影响

目的:探讨多学科合作模式(MDT)的综合干预对食管癌术后患者心理状态和营养状况的影响。方法:选取2021年1月-2022年12月在某院进行治疗的120例食管癌术后患者,随机分为MDT组和常规组,各60例,常规组采用常规干预模式,MDT组给予多学科合作模式进行综合干预。对比两组患者干预前后心理状态、营养状态、生活质量和满意度。结果:与常规组比较,MDT组的心理状态指标SAS和SDS评分明显低于常规组(t=5.446,10.871;P<0.001),MDT组的营养状态指标转铁蛋白(TF)、白蛋白(ALB)、前白蛋白(PA)水平均高于常规组(t=8.492,3.358,2.231;P<0.05),MDT组的生活质量的躯体健康能力、心理健康、癌症造成的负担和社会能力4个维度的评分均高于常规组(t=7.746,10.867,14.674,32.460;P<0.05),且MDT组的满意高于常规组(χ^(2)=8.292;P=0.004)。结论:MDT的综合干预可较好改善食管癌术后患者的心理状态、营养状况和生活质量,且提高了患者满意度。

Application of Multidisciplinary Collaborative Interventions in the Early Rehabilitation of Patients with Hemorrhagic Stroke and Kinesiophobia

Objective:This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia.Methods:Using a convenience sampling method,100 patients with hemorrhagic stroke and kinesiophobia admitted to the Department of Neurology at Nantong First People’s Hospital between January 2022 and December 2023 were selected as subjects.Fifty patients admitted between January 2022 and January 2023 were assigned to the control group,while 50 patients admitted between February 2023 and December 2023 were assigned to the experimental group.The control group received conventional care,while the experimental group received multidisciplinary collaborative interventions provided by a team consisting of neurologists,rehabilitation therapists,psychological counselors,and nurses.The study evaluated the differences in emotional state(using the Hospital Anxiety and Depression Scale,HAD),kinesiophobia level(using the Tampa Scale for Kinesiophobia,TSK),functional recovery(using the modified Rankin Scale,mRS),and daily living abilities(using the Barthel Index,BI)before and after intervention.Results:After the intervention,the HAD scores in the experimental group were significantly lower than those in the control group(P<0.05).The TSK scores in the experimental group were also significantly lower than in the control group(P<0.05),while mRS and BI scores showed significant improvement compared to the control group(P<0.05).Conclusion:Multidisciplinary collaborative interventions have significant effects in reducing kinesiophobia,promoting functional recovery,and improving the quality of life in patients with hemorrhagic stroke.

依法依规加强医疗机构人体器官捐献与移植工作体系和人体器官移植伦理委员会建设

《人体器官捐献和移植条例》(以下简称新《条例》)和配套文件的实施,为依法依规完善人体器官捐献和移植工作体系奠定了坚实基础。为了更好地宣传、贯彻和落实新《条例》和配套文件,针对实际工作中遇到的问题和挑战,结合国家人体器官捐献和移植工作体系建设和国家脑死亡判定工作发展情况,本文对医疗机构人体器官捐献和移植工作体系与人体器官捐献系统性多学科协作机制建设,以及人体器官移植伦理委员会需要关注的若干问题进行分析和探讨,旨在为我国人体器官移植伦理委员会建设等提供参考,促进我国器官捐献和移植事业的持续健康发展。

“互联网+”多学科合作模式在肾移植术后患者中的效果评价

目的探讨构建“互联网+”多学科合作模式对肾移植术后患者的应用效果。方法选择2020年5月—2021年5月来医院肾移植门诊复诊的120例患者作为对照组,实施常规护理干预;选择2021年6月—2022年6月来医院肾移植门诊复诊患者120例作为观察组,在常规的护理基础上实施“互联网+”多学科合作模式。对比两组患者干预前后的自我效能、健康行为、服药依从性及生活质量变化。结果干预前,两组患者自我效能评分经过比较,差异无统计学意义(P>0.05);经过护理干预6个月后,观察组患者的自我效能各个维度的评分及其总分均高于对照组患者,经比较差异具有统计学意义(P<0.05)。干预前,两组患者的健康行为评分进行比较,差异无统计学意义(P>0.05);在干预6个月后,观察组患者健康行为的各项评分均高于对照组,经比较差异有统计学意义(P<0.05)。干预前,两组患者服药依从性评分比较差异无统计学意义(P>0.05);干预6个月后,观察组患者服药依从性评分高于对照组,经比较差异具有统计学意义(P<0.05)。干预前,两组患者生活质量评分比较差异无统计学意义(P>0.05);干预6个月后,观察组患者生活质量各个维度的评分均高于对照组,经比较差异有统计学意义(P<0.05)。结论将“互联网+”多学科合作模式应用于肾移植术后患者的护理过程中,可增强患者的自我效能,促进其健康行为,从而提升服药依从性,并最终提高患者的生活质量。

多学科协作下肺炎患儿康复护理质量评价体系的构建与验证研究

目的:通过文献分析、德尔菲法构建多学科协作下的肺炎患儿康复护理质量评价体系,并探究其临床应用效果。方法:通过文献检索分析筛选多学科协作下的肺炎患儿康复护理质量评价指标,遴选专家、组织函询,综合专家评价及意见对指标进行修订,形成多学科协作下的肺炎患儿康复护理质量评价体系。2022年12月起应用多学科协作下的肺炎患儿康复护理质量评价体系,此前均实施常规护理管理,选取江苏省盐城市建湖县人民医院2022年1月—11月、2022年12月—2023年10月收治的肺炎患儿各65例为研究对象,设为对照组、观察组,比较两组患儿康复效果及家属护理满意度。结果:两轮函询问卷回收率分别为95.00%、100.00%,专家权威系数分别为0.847,0.864,函询意见协调度肯德尔和谐系数W分别为0.427(χ^(2)=28.042,P<0.001)、0.514(χ^(2)=31.728,P<0.001),最终形成的多学科协作下的肺炎患儿康复护理质量评价体系包含一级指标3个,二级指标9个,三级指标39个,变异系数范围0.075~0.145。应用结果显示,观察组患儿康复效果评价指标表现优于对照组(P<0.05);观察组患儿家属护理满意度评价高于对照组(P<0.05)。结论:多学科协作下的肺炎患儿康复护理质量评价体系内容全面,且科学性、可靠性较强,其在肺炎患儿康复护理管理中的应用,能实现对护理质量的持续、有效评价与改进,有助于改善患儿康复效果、提升护理满意度。

多学科协作下生活方式管理模式在精神分裂症合并代谢综合征患者中的应用

目的 采用多学科协作下生活方式管理模式对精神分裂症合并代谢综合征患者进行生活方式干预,观察其对患者精神症状、代谢指标及生活质量的影响,为精神分裂症合并代谢综合征患者制定生活方式管理方案提供理论依据。方法 采用随机数字表法将2023年1月—2024年6月绍兴市第七人民医院收治的152例精神分裂症合并代谢综合征患者分为对照组(76例)和观察组(76例)。对照组应用常规生活方式干预方法,观察组采用多学科协作下生活方式管理模式。比较2组患者干预前后精神症状、代谢指标及生活质量情况。结果 干预3个月后,观察组阳性和阴性症状量表(PANSS)总分为(37.96±4.27)分,低于对照组的(49.64±5.04)分,差异有统计学意义(P<0.05);观察组主要代谢指标[BMI、腰围、空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)]均优于对照组(P<0.05);观察组精神分裂症生活质量量表(SQLS)总分为(68.13±6.00)分,低于对照组的(85.15±8.27)分,差异有统计学意义(F=12.886,P<0.001)。结论 多学科协作下生活方式管理模式可促进精神分裂症合并代谢综合征患者病情恢复,改善代谢指标,提高患者生活质量。

基于多学科协作的晚期癌症患者安宁疗护评价体系的建立及临床实践

目的建立基于多学科协作的晚期癌症患者安宁疗护评价体系并在临床护理管理中应用,以验证其效果。方法通过文献分析法提取晚期癌症患者安宁疗护质量评价指标,按“结构-过程-结果”三维质量模式对指标进行整理,综合德尔菲法专家函询意见对指标进行修订,进而形成晚期癌症患者安宁疗护评价体系。选择深圳市龙岗区第七人民医院2021年1月—2022年5月和2022年6月—2023年5月两阶段收治的晚期癌症患者各55例,将2022年6月—2023年5月应用晚期癌症患者安宁疗护评价体系的患者作为观察组,将2021年1月—2022年5月采取常规护理模式护理的患者作为对照组,比较两组生活质量改善效果及护理满意度。结果第1、2轮函询有效问卷回收率均为100%,专家权威度系数分别为0.859、0.897,专家意见协调度Kendall’s W系数分别为0.374、0.428,最终形成的基于多学科协作的晚期癌症患者安宁疗护评价体系包含一级指标3个,二级指标10个,三级指标38个,指标变异系数为0.07~0.12。指标体系应用结果显示,观察组患者生活质量改善效果大于对照组,差异有统计学意义(P<0.05);观察组患者安宁疗护满意度问卷基础服务、日常服务、安宁疗护服务评分均高于对照组,差异有统计学意义(P<0.05)。结论基于多学科协作的晚期癌症患者安宁疗护评价体系在临床护理管理中应用,能实现对安宁疗护质量的持续、全面评价,可为护理质量改进提供可靠依据。

基于互联网+的多学科协作模式在母婴延续性护理中的应用进展

本文从基于互联网+的多学科协作模式母婴延续性护理的需求现状、组成及要点、临床研究现状、优势与不足等方面进行了综述,分析了其在母婴延续性护理中的应用进展,发现该护理模式有利于改善产妇护理质量并提升母婴护理服务的效率,从而促进母婴健康,是值得临床推广的一种护理方式。相信通过进一步的临床实践与探索,会使基于互联网+的多学科协作模式母婴延续性护理方式更加符合临床需求,助力提升我国整体母婴护理水平。