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.

医护-社会组织一体化模式对HIV/AIDS患者ART及自我管理能力的影响

探究接受高效抗反转录病毒治疗确诊HIV/AIDS患者接受医护-社会组织一体化模式干预价值。方法 从2022年1月至2022年12月南昌市某定点医院接受抗病毒治疗及随访管理的新确诊HIV/AIDS患者100例,50例接受传统医护合作模式对照组、50例接受医护-社会组织一体化模式观察组,两组各项临床指标差异进行分析对比(从HIV抗体初筛阳性到启动ART治疗时间、抗病毒治疗一年后HIV病毒载量的指标及病毒抑制率、抗病毒治疗一年后自我管理能力)。结果 干预后与对照组比较,观察组HIV抗体初筛阳性到启动ART治疗时间显著偏低,HIV病毒载量指标水平显著偏低,病毒抑制率显著偏高,一年后自我管理能力评分显著偏高,用药依从性显著偏高(P<0.05)。结论 接受抗病毒治疗及随访管理的确诊HIV/AIDS患者接受医护-社会组织一体化模式干预后,可显著提高患者自我管理能力。此外,还能保障高病毒抑制率,缩短患者治疗时间,提升患者用药依从性。

Design of Aided Decision-Making Program for Prioritizing Construction Projects in Urban Road Network Planning

The importance and complexity of prioritizing construction projects (PCP) in urban road network planning lead to the necessity to develop an aided decision making program (ADMP). Cost benefit ratio model and stage rolled method are chosen as the theoretical foundations of the program, and then benefit model is improved to accord with the actuality of urban traffic in China. Consequently, program flows, module functions and data structures are designed, and particularly an original data structure of road ...

Computer Aided Design Technology for Convex Faceted Gem Cuts Based on the Half-Edge Data Structure

Aiming to increase the efficiency of gem design and manufacturing, a new method in computer-aided-design (CAD) of convex faceted gem cuts (CFGC) based on Half-edge data structure (HDS), including the algorithms for the implementation is presented in this work. By using object-oriented methods, geometrical elements of CFGC are classified and responding geometrical feature classes are established. Each class is implemented and embedded based on the gem process. Matrix arithmetic and analytical geometry are used to derive the affine transformation and the cutting algorithm. Based on the demand for a diversity of gem cuts, CAD functions both for free-style faceted cuts and parametric designs of typical cuts and visualization and human-computer interactions of the CAD system including two-dimensional and three-dimensional interactions have been realized which enhances the flexibility and universality of the CAD system. Furthermore, data in this CAD system can also be used directly by the gem CAM module, which will promote the gem CAD/CAM integration.

Application of computer-aided engineering optimum design method in aluminum profile extrusion mould

The finite element analysis and the optimum design of aluminum profile extrusion mould were investigated using the ANSYS software and its parameterized modeling method. The optimum dimensions of the mould were obtained. It is found that the stress distribution is very uneven, and the stress convergence is rather severe in the bridge of the aluminum profile extrusion mould. The optimum height of the mould is 70.527 mm, and the optimum radius of dividing holes are 70.182 mm and 80.663 mm. Increasing the height of the mould in the range of 61.282 mm to 70.422 mm can prolong its longevity, but when the height is over 70.422 mm, its longevity reduces.

Computer Aided Composition Design of Prehardened-Mould Steel for Plastic

The improvement of machining behavior of prehardened-mould steel for plastic is realized by using computer-aided composition design in this work. The results showed that the matrix composition of large sectional prehardened mould steel for plastic markedly influences the precipitation of non-metallic inclusion and the control of composition aided by Thermo-Calc software package minimizes the amount of detrimental oxide inclusion. In addition the modification of calcium is optimized in the light of composition design.

Computer-aided Design and Custom-made Guide in Corrective Osteotomy for Complex Femoral Deformity

Summary： Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral de- formities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography （CT） scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional （3D） photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were de- signed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the op- eration as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpreta- tion three-dimensional visualization introduces an advantage in preoperative planning for corrective os- teotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a de- liberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

Computer-aided designing and manufacturing of advanced steels

Suitable optimization and simulation were performed using a powerful software package with a mature database as well as modem measurement facilities, which led to the successful designing and manufacturing of advanced steels. In the course of designing, the composition of a large section of prehardened mold steel for plastics was estimated so as to lower the quantities of oxide inclusions to change the type of carbides and to raise the machinability. The composition and process were adjusted to obtain satisfactory surface quality for the prevailing galvanization in transformation-induced plasticity （TRIP） steel. The refuting process of low-carbon steel was simulated in the light of both Thermo-Calc and Factsage. Thermodynamic and kinetic analyses were always conducted during the test and the procedure.

3-D MODELLING OF COMPUTER AIDED GARMENT DESIGN

This paper describes a method of the computer aided garment design,and discusses 3-D humanbody,wire frame modelling,approaches of expressing and a shading model of the 3-D garment.

Case-based intelligent computer aided design system of welding machinery

The procedure during complex system plan design of welding position-locating machine is studied in this paper. The main difficulties in designing welding position-locating machine utilizing computer are discussed as well. A method of case-based intelligent CAD system for welding position-locating machine ( WMICAD) is put forward through wide research on design methodology. Object-oriented programming method is also applied to Ms system. The basic idea and realizing method are described.

ON CURVED SURFACE APPROXIMATION AND HIDDEN SURFACE ELIMINATION IN 3-D COMPUTER AIDED GARMENT DESIGN

An approximation method for curved surface mannequin and hidden surface eliminationin 3-D computer aided garment design system is described. The mannequin is the basis of the3-D modeling for clothes. In terms of the requirements of computer aided garment design,the authors put forward a method for curved surface approximation in the meaning of leastsquares. Using. this method the computation of geometric modeling is simple andefficient. It is also convenient for curved surface modification and shading.

COMPUTER-AIDED DESIGN OF ADAPTIVE PULSED ARC WELDING OF ROOT WELDS BY MELTING ELECTRODE

The purpose of computer-aided design of new adaptive pulsed arc technologies of welding is: to de- sign optimum algorithms of pulsed control over main energy parameters of welding.It permits:to in- crease welding productivity, to stabilize the welding regime, to control weld formation,taking into ac- count its spatial position, to proveal specie strength of the welded and coatings. Computer- aided design reduces the time of development of new pulsed arc technology:provides the optimization of technological referes according to the operating conditions of welded joints,the prediction of the ser- vice life of the welds.The developed methodology of computer-aided design of advanced technologies, models, original software, adaptive algorithms of pulsed control, and spend equipment permits to regulate penetration,the weld shape, the sizes of heat - affected zone; to predict sired properties and quality of welded joints.

Computer-aided Pattern Design of Multi-bar Warp Knitted Fabrics

To meet the development trend of multi-bar warp knit-ting machine towards high-speed,advanced technologyand computer control and the requirements of variousproducts with small quantity,there are many researcheson the computer-aided pattern design of multi-barwarp knitted fabrics.In terms of the special propertiesof the computer-aided pattern design of multi-barwarp knitted fabrics,the Object Oriented Program(OOP)programming-Object Windows class Library(OWL)programming is selected.According to thecharacters of the OWL programming,various functionsare defined.Pattern design and technical parameters canbe output,which offers a great convenience for the fac-tory.

A Computer-aided Design System for Framed-mould in Autoclave Processing

The general computer-aided design （CAD） software cannot meet the mould design requirement of the autoclave process for composites, because many parameters such as temperature and pressure should be considered in the mould design process, in addition to the material and geometry of the part. A framed-mould computer-aided design system （FMCAD） used in the autoclave moulding process is proposed in this paper. A function model of the software is presented, in which influence factors such as part structure, mould structure, and process parameters are considered; a design model of the software is established using object oriented （O-O） technology to integrate the stiffness calculation, temperature field calculation, and deformation field calculation of mould in the design, and in the design model, a hybrid model of mould based on calculation feature and form feature is presented to support those calculations. A prototype system is developed, in which a mould design process wizard is built to integrate the input information, calculation, analysis, data storage, display, and design results of mould design. Finally, three design examples are used to verify the prototype.

Computer-Aided Design of Some Advanced Steels and Cemented Carbides

Thermodynamic and kinetic study on TRIP （transformation induced plasticity） steels, cemented carbides and mold steel for plastics were carried out in order to design modern advanced materials. With the sublattice model, equilibrium compositions of ferrite and austenite phases in TRIP steels, as well as volume fraction of austenite at inter-critical temperatures for different time were calculated. Concentration profiles of carbon, manganese, aluminum and silicon in the steels were also estimated in the lattice fixed frame of reference. The effect of Si and Mn on TRIP was discussed according to thermodynamic and kinetic analyses. In order to understand and produce the graded nanophase structure of cemented carbides, miscellaneous phases in the M-Co-C （M= Ti, Ta, Nh） systems and Co-V-C system were modeled. Solution parameters and thermodynamic： properties were listed in detail. The improvement of machining behavior of prehardened mould steel for plastics was obtained by computer-aided composition design. The results showed that the matrix composition of large-section prehardened mould steel for plastic markedly influences the precipitation of non-metallic inclusion and the composition control by the aid of Thermo-Calc software package minimizes the amount of detrimental oxide inclusion. In addition, the modification of calcium was optimized in composition design.

Computer-Aided Design and Fabrication of Finger Prosthesis

Custom-made esthetic finger prostheses, which are used for rehabilitation of patients with missing or impaired fingers, have been fabricated manually. However, such fabrication is time-consuming and requires manual skill. Here we propose a computer-aided method for fabricating finger pros-theses to save time and allow fabrications that do not require considerable manual skill. In this method, the dimensions of a patient’s healthy finger on the contralateral hand are first measured using a caliper. Using these dimensions, a three-dimensional model is constructed for fabricating a prosthesis for the patient’s impaired finger. Using the 3D model, a mold is designed using 3D modeling tools and a computer-aided design system. The resulting mold is then fabricated using a 3D printer. A finger prosthesis is fabricated by pouring silicone resin into the mold. A finger prosthesis for a volunteer was experimentally fabricated according to the proposed method. To evaluate the size and shape of the finger prosthesis, the difference between the finger prosthesis and the original finger of the volunteer was analyzed. Because the average difference between them was 0.25 mm, it was concluded that the proposed method could be used to fabricate a finger prosthesis of adequate size and shape.

DESIGN AND IMPLEMENTATION OF A 3-DIMENSIONAL COMPUTER AIDED GARMENT DESIGN SYSTEM

A 3-Dimensional computer aided garment design (CAGD) system has been developed andimplemented on a high-performance workstation. We studied various approaches to the func-tional modelling of garment designs for the system. According to the characteristic data of a hu-man body, the models of human body and the garment are displayed on the screen, then we canmodify the garment with various styles and different sizes. The system can transform the 3-Dgarment to the 2-D pieces. The system has improved design efficiency. Various potential alterna-tives and improvement of the system have also been studied and explored.

Computer-Aided Design of X-Ray Microtomographic Scanners

The article is to study the development of computer-aided design of X-ray microtomography—the device for investigating the structure and construction of three-dimensional images of organic and inorganic objects on the basis of shadow projections. This article provides basic information regarding CAD of X-ray microtomography and a scheme consisting of three levels. The article also shows basic relations of X-ray computed tomography, the generalized scheme of an X-ray microtomographic scanner. The methods of X-ray imaging of the spatial microstructure and morphometry of materials are described. The main characteristics of an X-ray microtomographic scanner, the X-ray source, X-ray optical elements and mechanical components of the positioning system are shown. The block scheme and software functional scheme for intelligent neural network system of analysis of the internal microstructure of objects are presented. The method of choice of design parameters of CAD of X-ray microtomography aims at improving the quality of design and reducing costs of it. It is supposed to reduce the design time and eliminate the growing number of engineers involved in development and construction of X-ray microtomographic scanners.

The Implementation Methods for Computer Aided Design and Analysis on Color-Woven Fabrics

Methods for computer aided design and analysis on color-woven fabrics are presented. The relation of color pattern, colored warp, colored weft and the model for regular weave texture are given based on their formative principle. Some efficient algorithms are developed to determine the color order of warp and weft threads which yields a given color pattern and regular weave texture. Finally, the design system structure and data process flowing are introduced.

一类具有Dirichlet边界条件的年龄-空间结构HIV/AIDS传染病模型的动力学分析

为了探讨个体扩散、感染年龄和Dirichlet边界环境对HIV/AIDS时空传播动力学的影响,该文构建了一类具有齐次Dirichlet边界条件的年龄空间结构HIV/AIDS传染病动力学模型.首先,应用特征线方法,作者将模型转化为一个积分反应扩散方程模型.其次,作者给出模型基本再生数R_(0)的泛函表达式,并研究了以R_(0)为阈值的模型解的动力学行为.具体地,当R_(0)<1时,HIV/AIDS在人群中可以被消除;而当R_(0)>1时,HIV感染在人群中会持续存在.最后,在二维空间区域中作者通过数值模拟验证了文中理论结果.