Investigation of Student Nurses’Attitudes towards End-of-Life Care and Their Influencing Factors

Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey student nurses enrolled in one of four nursing colleges in China from January 2023 to December 2023. Student nurses’ general demographic and prior related information, attitudes towards death and attitudes towards end-of-life care were determined using a general information questionnaire, the Death Attitude Profile—Revised scale and the Professional End-of-Life Attitude Scale (PEAS), respectively. Results: The total PEAS score was 122.91 ± 16.123. Significant differences were noted in the attitude towards end-of-life care scores according to sources of end-of-life care knowledge (P Conclusions: Student nurses lacked an optimistic attitude towards end-of-life care, which was influenced by differences in the sources of end-of-life care knowledge.

Research on the Innovative Decisions of Supermarket Private Brands and Designated Manufacturers

One of the core competencies of a supermarket lies in its branding.With the continuous development of the market economy and the ongoing evolution of consumer demand,private brands have progressively emerged as significant contributors to supermarket growth.However,a pivotal developmental challenge for supermarkets is navigating the innovative decision-making process between private brands and designated manufacturers.This paper aims to investigate the innovative decisions between private brands and designated manufacturers,along with the relevant promotional strategies employed during entry into the United States market.

A Building Information Modeling-Life Cycle Cost Analysis Integrated Model to Enhance Decisions Related to the Selection of Construction Methods at the Conceptual Design Stage of Buildings

Life Cycle Cost Analysis (LCCA) provides a systematic approach to assess the total cost associated with owning, operating, and maintaining assets throughout their entire life. BIM empowers architects and designers to perform real-time evaluations to explore various design options. However, when integrated with LCCA, BIM provides a comprehensive economic perspective that helps stakeholders understand the long-term financial implications of design decisions. This study presents a methodology for developing a model that seamlessly integrates BIM and LCCA during the conceptual design stage of buildings. This integration allows for a comprehensive evaluation and analysis of the design process, ensuring that the development aligns with the principles of low carbon emissions by employing modular construction, 3D concrete printing methods, and different building design alternatives. The model considers the initial construction costs in addition to all the long-term operational, maintenance, and salvage values. It combines various tools and data through different modules, including energy analysis, Life Cycle Assessment (LCA), and Life Cycle Cost Analysis (LCCA) to execute a comprehensive assessment of the financial implications of a specific design option throughout the lifecycle of building projects. The development of the said model and its implementation involves the creation of a new plug-in for the BIM tool (i.e., Autodesk Revit) to enhance its functionalities and capabilities in forecasting the life-cycle costs of buildings in addition to generating associated cash flows, creating scenarios, and sensitivity analyses in an automatic manner. This model empowers designers to evaluate and justify their initial investments while designing and selecting potential construction methods for buildings, and enabling stakeholders to make informed decisions by assessing different design alternatives based on long-term financial considerations during the early stages of design.

Relationships between Features of EmergingAdulthood, Situated Decisions toward PhysicalActivity, and Physical Activity among CollegeStudents: The Moderating Role of ExerciseIntensity Tolerance

A significant portion of emerging adults do not achieve recommended levels of physical activity (PA). Previous studies observedassociations between features of emerging adulthood and PA levels, while the potential psychological mechanisms that mightexplain this phenomenon are not fully understood. In this context, there is some evidence that situated decisions towardphysical activity (SDPA) and exercise-intensity tolerance might influence PA level. To provide empirical support for thisassumption, the current study investigated whether (i) features of emerging adulthood are linked to SDPA, which, in turn,might affect PA engagement;(ii) exercise-intensity tolerance moderate the relationship between SDPA and PA level;and (iii)SDPA is a mediator of the relationship between features of emerging adulthood and PA levels under the prerequisite thatexercise-intensity tolerance moderates the link between SDPA and PA engagement. In this study a group of 1,706 Chinesecollege students was recruited and asked to complete a set of questionnaires assessing their SDPA, PA levels, exercise-intensitytolerance, and features associated with emerging adulthood, namely Self-exploration, Instability, and Possibility. Our resultsindicated that SDPA positively predicted PA levels and this relationship became stronger when exercise-intensity tolerance wasused as a moderator. Furthermore, it was observed that individuals with a higher level of Instability and a lower level ofPossibility during emerging adulthood exhibited a lower level of SDPA. Taken together, the results of our study providefurther insights on a potential psychological mechanism linking features of emerging adulthood and physical activity.

Stress-assisted corrosion mechanism of 3Ni steel by using gradient boosting decision tree machining learning method

Traditional 3Ni weathering steel cannot completely meet the requirements for offshore engineering development,resulting in the design of novel 3Ni steel with the addition of microalloy elements such as Mn or Nb for strength enhancement becoming a trend.The stress-assisted corrosion behavior of a novel designed high-strength 3Ni steel was investigated in the current study using the corrosion big data method.The information on the corrosion process was recorded using the galvanic corrosion current monitoring method.The gradi-ent boosting decision tree(GBDT)machine learning method was used to mine the corrosion mechanism,and the importance of the struc-ture factor was investigated.Field exposure tests were conducted to verify the calculated results using the GBDT method.Results indic-ated that the GBDT method can be effectively used to study the influence of structural factors on the corrosion process of 3Ni steel.Dif-ferent mechanisms for the addition of Mn and Cu to the stress-assisted corrosion of 3Ni steel suggested that Mn and Cu have no obvious effect on the corrosion rate of non-stressed 3Ni steel during the early stage of corrosion.When the corrosion reached a stable state,the in-crease in Mn element content increased the corrosion rate of 3Ni steel,while Cu reduced this rate.In the presence of stress,the increase in Mn element content and Cu addition can inhibit the corrosion process.The corrosion law of outdoor-exposed 3Ni steel is consistent with the law based on corrosion big data technology,verifying the reliability of the big data evaluation method and data prediction model selection.

Cognitive interference decision method for air defense missile fuze based on reinforcement learning

To solve the problem of the low interference success rate of air defense missile radio fuzes due to the unified interference form of the traditional fuze interference system,an interference decision method based Q-learning algorithm is proposed.First,dividing the distance between the missile and the target into multiple states to increase the quantity of state spaces.Second,a multidimensional motion space is utilized,and the search range of which changes with the distance of the projectile,to select parameters and minimize the amount of ineffective interference parameters.The interference effect is determined by detecting whether the fuze signal disappears.Finally,a weighted reward function is used to determine the reward value based on the range state,output power,and parameter quantity information of the interference form.The effectiveness of the proposed method in selecting the range of motion space parameters and designing the discrimination degree of the reward function has been verified through offline experiments involving full-range missile rendezvous.The optimal interference form for each distance state has been obtained.Compared with the single-interference decision method,the proposed decision method can effectively improve the success rate of interference.

Multicriteria game approach to air-to-air combat tactical decisions for multiple UAVs

Air-to-air combat tactical decisions for multiple unmanned aerial vehicles(ACTDMU)are a key decision-making step in beyond visual range combat.Complex influencing factors,strong antagonism and real-time requirements need to be considered in the ACTDMU problem.In this paper,we propose a multicriteria game approach to ACTDMU.This approach consists of a multicriteria game model and a Pareto Nash equilibrium algorithm.In this model,we form the strategy profiles for the integration of air-to-air combat tactics and weapon target assignment strategies by considering the correlation between them,and we design the vector payoff functions based on predominance factors.We propose a algorithm of Pareto Nash equilibrium based on preference relations using threshold constraints(PNE-PRTC),and we prove that the solutions obtained by this algorithm are refinements of Pareto Nash equilibrium solutions.The numerical experiments indicate that PNE-PRTC algorithm is considerably faster than the baseline algorithms and the performance is better.Especially on large-scale instances,the Pareto Nash equilibrium solutions can be calculated by PNEPRTC algorithm at the second level.The simulation experiments show that the multicriteria game approach is more effective than one-side decision approaches such as multiple-attribute decision-making and randomly chosen decisions.

Naturally Nitrogen-Doped Biochar Made from End-of-Life Wood Panels for SO_(2) Gas Depollution

Reconstituted wood panels have several advantages in terms of ease of manufacturing,but their shorter life span results in a huge amount of reconstituted wood panels being discarded in sorting centers yearly.Currently,the most common approach for dealing with this waste is incineration.In this study,reconstituted wood panels were converted into activated biochar through a two-step thermochemical process:(i)biochar production using pilot scale fast pyrolysis at 250 kg/h and 450℃;and(ii)a physical activation at three temperatures(750℃,850℃ and 950℃)using an in-house activation furnace(1 kg/h).Results showed that the first stage removed about 66% of the nitrogen from the wood panels in the form of NO,NH3,and trimethylamine,which were detected in small amounts compared to emitted CO_(2).Compared to other types of thermochemical conversion methods(e.g.,slow pyrolysis),isocyanic acid and hydrogen cyanide were not detected in this study.The second stage produced activated biochar with a specific surface area of up to 865 m^(2)/g at 950℃.The volatile gases generated during activation were predominantly composed of toluene and benzene.This two-step process resulted in nitrogen-rich carbon in the form of pyrrolic and pyridinic nitrogen.Activated biochars were then evaluated for their SO_(2) retention performance and showed an excellent adsorption capacity of up to 2140 mg/g compared to 65 mg/g for a commercial activated carbon(889 m^(2)/g).End-of-life reconstituted wood panels and SO_(2) gas are problematic issues in Canada where the economy largely revolves around forestry and mining industries.

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Attribute Reduction Method Based on Sequential Three-Branch Decision Model

Attribute reduction is a research hotspot in rough set theory. Traditional heuristic attribute reduction methods add the most important attribute to the decision attribute set each time, resulting in multiple redundant attribute calculations, high time consumption, and low reduction efficiency. In this paper, based on the idea of sequential three-branch decision classification domain, attributes are treated as objects of three-branch division, and attributes are divided into core attributes, relatively necessary attributes, and unnecessary attributes using attribute importance and thresholds. Core attributes are added to the decision attribute set, unnecessary attributes are rejected from being added, and relatively necessary attributes are repeatedly divided until the reduction result is obtained. Experiments were conducted on 8 groups of UCI datasets, and the results show that, compared to traditional reduction methods, the method proposed in this paper can effectively reduce time consumption while ensuring classification performance.

Method for triangular fuzzy multiple attribute decision making based on two-dimensional density operator method

Aiming at the triangular fuzzy(TF)multi-attribute decision making(MADM)problem with a preference for the distribution density of attribute(DDA),a decision making method with TF number two-dimensional density(TFTD)operator is proposed based on the density operator theory for the decision maker(DM).Firstly,a simple TF vector clustering method is proposed,which considers the feature of TF number and the geometric distance of vectors.Secondly,the least deviation sum of squares method is used in the program model to obtain the density weight vector.Then,two TFTD operators are defined,and the MADM method based on the TFTD operator is proposed.Finally,a numerical example is given to illustrate the superiority of this method,which can not only solve the TF MADM problem with a preference for the DDA but also help the DM make an overall comparison.

Multi-UAV cooperative maneuver decision-making for pursuitevasion using improved MADRL

Aiming at the problem of multi-UAV pursuit-evasion confrontation, a UAV cooperative maneuver method based on an improved multi-agent deep reinforcement learning(MADRL) is proposed. In this method, an improved Comm Net network based on a communication mechanism is introduced into a deep reinforcement learning algorithm to solve the multi-agent problem. A layer of gated recurrent unit(GRU) is added to the actor-network structure to remember historical environmental states. Subsequently,another GRU is designed as a communication channel in the Comm Net core network layer to refine communication information between UAVs. Finally, the simulation results of the algorithm in two sets of scenarios are given, and the results show that the method has good effectiveness and applicability.

Tjong:A transformer‐based Mahjong AI via hierarchical decision‐making and fan backward

Mahjong,a complex game with hidden information and sparse rewards,poses significant challenges.Existing Mahjong AIs require substantial hardware resources and extensive datasets to enhance AI capabilities.The authors propose a transformer‐based Mahjong AI(Tjong)via hierarchical decision‐making.By utilising self‐attention mechanisms,Tjong effectively captures tile patterns and game dynamics,and it decouples the decision pro-cess into two distinct stages:action decision and tile decision.This design reduces de-cision complexity considerably.Additionally,a fan backward technique is proposed to address the sparse rewards by allocating reversed rewards for actions based on winning hands.Tjong consists of 15M parameters and is trained using approximately 0.5 M data over 7 days of supervised learning on a single server with 2 GPUs.The action decision achieved an accuracy of 94.63%,while the claim decision attained 98.55%and the discard decision reached 81.51%.In a tournament format,Tjong outperformed AIs(CNN,MLP,RNN,ResNet,VIT),achieving scores up to 230%higher than its opponents.Further-more,after 3 days of reinforcement learning training,it ranked within the top 1%on the leaderboard on the Botzone platform.

Novelty of Different Distance Approach for Multi-Criteria Decision-Making Challenges Using q-Rung Vague Sets

In this article,multiple attribute decision-making problems are solved using the vague normal set(VNS).It is possible to generalize the vague set(VS)and q-rung fuzzy set(FS)into the q-rung vague set(VS).A log q-rung normal vague weighted averaging(log q-rung NVWA),a log q-rung normal vague weighted geometric(log q-rung NVWG),a log generalized q-rung normal vague weighted averaging(log Gq-rung NVWA),and a log generalized q-rungnormal vagueweightedgeometric(logGq-rungNVWG)operator are discussed in this article.Adescription is provided of the scoring function,accuracy function and operational laws of the log q-rung VS.The algorithms underlying these functions are also described.A numerical example is provided to extend the Euclidean distance and the Humming distance.Additionally,idempotency,boundedness,commutativity,and monotonicity of the log q-rung VS are examined as they facilitate recognizing the optimal alternative more quickly and help clarify conceptualization.We chose five anemia patients with four types of symptoms including seizures,emotional shock or hysteria,brain cause,and high fever,who had either retrograde amnesia,anterograde amnesia,transient global amnesia,post-traumatic amnesia,or infantile amnesia.Natural numbers q are used to express the results of the models.To demonstrate the effectiveness and accuracy of the models we are investigating,we compare several existing models with those that have been developed.

Multi-Objective Optimization Algorithm for Grouping Decision Variables Based on Extreme Point Pareto Frontier

The existing algorithms for solving multi-objective optimization problems fall into three main categories:Decomposition-based,dominance-based,and indicator-based.Traditional multi-objective optimization problemsmainly focus on objectives,treating decision variables as a total variable to solve the problem without consideringthe critical role of decision variables in objective optimization.As seen,a variety of decision variable groupingalgorithms have been proposed.However,these algorithms are relatively broad for the changes of most decisionvariables in the evolution process and are time-consuming in the process of finding the Pareto frontier.To solvethese problems,a multi-objective optimization algorithm for grouping decision variables based on extreme pointPareto frontier(MOEA-DV/EPF)is proposed.This algorithm adopts a preprocessing rule to solve the Paretooptimal solution set of extreme points generated by simultaneous evolution in various target directions,obtainsthe basic Pareto front surface to determine the convergence effect,and analyzes the convergence and distributioneffects of decision variables.In the later stages of algorithm optimization,different mutation strategies are adoptedaccording to the nature of the decision variables to speed up the rate of evolution to obtain excellent individuals,thusenhancing the performance of the algorithm.Evaluation validation of the test functions shows that this algorithmcan solve the multi-objective optimization problem more efficiently.

Two-Stage IoT Computational Task Offloading Decision-Making in MEC with Request Holding and Dynamic Eviction

The rapid development of Internet of Things(IoT)technology has led to a significant increase in the computational task load of Terminal Devices(TDs).TDs reduce response latency and energy consumption with the support of task-offloading in Multi-access Edge Computing(MEC).However,existing task-offloading optimization methods typically assume that MEC’s computing resources are unlimited,and there is a lack of research on the optimization of task-offloading when MEC resources are exhausted.In addition,existing solutions only decide whether to accept the offloaded task request based on the single decision result of the current time slot,but lack support for multiple retry in subsequent time slots.It is resulting in TD missing potential offloading opportunities in the future.To fill this gap,we propose a Two-Stage Offloading Decision-making Framework(TSODF)with request holding and dynamic eviction.Long Short-Term Memory(LSTM)-based task-offloading request prediction and MEC resource release estimation are integrated to infer the probability of a request being accepted in the subsequent time slot.The framework learns optimized decision-making experiences continuously to increase the success rate of task offloading based on deep learning technology.Simulation results show that TSODF reduces total TD’s energy consumption and delay for task execution and improves task offloading rate and system resource utilization compared to the benchmark method.

Online Learning-Based Offloading Decision and Resource Allocation in Mobile Edge Computing-Enabled Satellite-Terrestrial Networks

Mobile edge computing(MEC)-enabled satellite-terrestrial networks(STNs)can provide Internet of Things(IoT)devices with global computing services.Sometimes,the network state information is uncertain or unknown.To deal with this situation,we investigate online learning-based offloading decision and resource allocation in MEC-enabled STNs in this paper.The problem of minimizing the average sum task completion delay of all IoT devices over all time periods is formulated.We decompose this optimization problem into a task offloading decision problem and a computing resource allocation problem.A joint optimization scheme of offloading decision and resource allocation is then proposed,which consists of a task offloading decision algorithm based on the devices cooperation aided upper confidence bound(UCB)algorithm and a computing resource allocation algorithm based on the Lagrange multiplier method.Simulation results validate that the proposed scheme performs better than other baseline schemes.

A Large-Scale Group Decision Making Model Based on Trust Relationship and Social Network Updating

With the development of big data and social computing,large-scale group decisionmaking(LGDM)is nowmerging with social networks.Using social network analysis(SNA),this study proposes an LGDM consensus model that considers the trust relationship among decisionmakers(DMs).In the process of consensusmeasurement:the social network is constructed according to the social relationship among DMs,and the Louvain method is introduced to classify social networks to form subgroups.In this study,the weights of each decision maker and each subgroup are computed by comprehensive network weights and trust weights.In the process of consensus improvement:A feedback mechanism with four identification and two direction rules is designed to guide the consensus of the improvement process.Based on the trust relationship among DMs,the preferences are modified,and the corresponding social network is updated to accelerate the consensus.Compared with the previous research,the proposedmodel not only allows the subgroups to be reconstructed and updated during the adjustment process,but also improves the accuracy of the adjustment by the feedbackmechanism.Finally,an example analysis is conducted to verify the effectiveness and flexibility of the proposed method.Moreover,compared with previous studies,the superiority of the proposed method in solving the LGDM problem is highlighted.

Large-Scale Multi-Objective Optimization Algorithm Based on Weighted Overlapping Grouping of Decision Variables

The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the interaction among decision variables is intricate,leading to large group sizes and suboptimal optimization effects;hence a large-scale multi-objective optimization algorithm based on weighted overlapping grouping of decision variables(MOEAWOD)is proposed in this paper.Initially,the decision variables are perturbed and categorized into convergence and diversity variables;subsequently,the convergence variables are subdivided into groups based on the interactions among different decision variables.If the size of a group surpasses the set threshold,that group undergoes a process of weighting and overlapping grouping.Specifically,the interaction strength is evaluated based on the interaction frequency and number of objectives among various decision variables.The decision variable with the highest interaction in the group is identified and disregarded,and the remaining variables are then reclassified into subgroups.Finally,the decision variable with the strongest interaction is added to each subgroup.MOEAWOD minimizes the interactivity between different groups and maximizes the interactivity of decision variables within groups,which contributed to the optimized direction of convergence and diversity exploration with different groups.MOEAWOD was subjected to testing on 18 benchmark large-scale optimization problems,and the experimental results demonstrate the effectiveness of our methods.Compared with the other algorithms,our method is still at an advantage.

Development of a Decision Aid for Family Surrogate Decision Makers of Critically Ill Patients Requiring Renal Replacement Therapy in ICU:A User-Centered Design for Rapid Prototyping

Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.