Food sharing is a prosocial behavior consisting of the unresisted transfer of monopolizable food from a possessor to another individual(Feistner and McGrew 1989;Stevens and Gilby 2004).Despite the cost for donors(i.e....Food sharing is a prosocial behavior consisting of the unresisted transfer of monopolizable food from a possessor to another individual(Feistner and McGrew 1989;Stevens and Gilby 2004).Despite the cost for donors(i.e.,loss of the food),intraspecifc food sharing occurs in various insects,fsh,birds,and aquatic,terrestrial,and arboreal mammals(Liévin‐Bazin et al.2019;Carter et al.2020).By far,most food sharing is intraspecifc,and takes place while possessors are in the process of eating.Here,we describe the remarkable case of a captive chimpanzee,Pan troglodytes,regularly dispensing food to another primate species(baboons,Papio hamadryas)in a neighboring enclosure.We discuss likely causes and functions of this interspecifc altruistic act.Observations were made in Xi’an Qinling Wildlife Park,Shaanxi Province,China(34°02ʹ56.22″N,108°51ʹ48.60″E),where two adult chimpanzees and a group of around 40-50 baboons lived in adjacent enclosures.The female chimpanzee(AiAi)was the elderly mother of the male(DuoDuo,or DD).At feeding times,AiAi usually ate near the door to the chimpanzees’indoor area,and she almost never interacted with the baboon group.The baboon group consisted of two one-male units.We recorded behaviors using focal-animal sampling(for information about subjects and methods,see Supplementary Materials).展开更多
In clustering algorithms,the selection of neighbors significantly affects the quality of the final clustering results.While various neighbor relationships exist,such as K-nearest neighbors,natural neighbors,and shared...In clustering algorithms,the selection of neighbors significantly affects the quality of the final clustering results.While various neighbor relationships exist,such as K-nearest neighbors,natural neighbors,and shared neighbors,most neighbor relationships can only handle single structural relationships,and the identification accuracy is low for datasets with multiple structures.In life,people’s first instinct for complex things is to divide them into multiple parts to complete.Partitioning the dataset into more sub-graphs is a good idea approach to identifying complex structures.Taking inspiration from this,we propose a novel neighbor method:Shared Natural Neighbors(SNaN).To demonstrate the superiority of this neighbor method,we propose a shared natural neighbors-based hierarchical clustering algorithm for discovering arbitrary-shaped clusters(HC-SNaN).Our algorithm excels in identifying both spherical clusters and manifold clusters.Tested on synthetic datasets and real-world datasets,HC-SNaN demonstrates significant advantages over existing clustering algorithms,particularly when dealing with datasets containing arbitrary shapes.展开更多
Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a quali...Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.展开更多
This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into t...This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into the economic benefits experienced by low-income households in the context of rural tourism development.Based on field research conducted from April 8,2023,to May 17,2023,including interviews and site visits,the study constructs an evaluation index system to assess the influencing factors.Through expert scoring and the application of a weighted set-valued mathematical statistical model,the importance and quantification of each factor are determined.The results indicate that the current stage of promoting shared prosperity through rural tourism in Yinan County is primarily influenced by the scale of tourist consumption of external visitors.This factor outweighs others such as the participation capacity and willingness of low-income households,the capacity of investment enterprises,and the policies and financial allocation of the local government.The findings emphasize the significance of external visitor spending and highlight the need to address the obstacles faced by low-income households in accessing economic benefits.The evaluation index system and measurement model presented in this study offer a scientific basis for assessing and improving the income situation of low-income households in rural tourism development initiatives.However,it is crucial to note that the importance of these influencing factors may evolve with the lifecycle of the tourism destination.Future research should include long-term tracking and consider a broader range of indicators to deepen our understanding of their mechanisms and significance.Furthermore,alternative approaches and theories may provide valuable perspectives for further exploration in this field.展开更多
Contemporary World Magazine,which is affiliated to the International Department of the CPC Central Committee(IDCPC),held an exchange act ivi ty themed on“Harmony for Shared Prosperity”in Beijing on May 7,2024.
Wherever people live together in or near homelands that harbour joint natural resources such as forest, water, minerals, oil etc., they must collaborate, co-exist and share these resources irrespective of their geneti...Wherever people live together in or near homelands that harbour joint natural resources such as forest, water, minerals, oil etc., they must collaborate, co-exist and share these resources irrespective of their genetic, social, cultural, and political peculiarities. This is not always the case when self-interest, ethnic divisions, elitist politics, economic interest and power tussle set in. The Nso and Oku people who reside in the Ngongbaa Forest area constitute an example of joint management of resources where at one period, their relationship over the management of the Oku Mountain Forest was cordial and at another, the relationship became conflictive. This study was designed to study the influence of the KIFP forest management policies on the Nso indigenous forest Management system in Ngongbaa Forest, and its implications. The data collected for the study was secured through the administration of a questionnaire to residents of 10 villages adjacent to the Ngongbaa Forest, and forest users who carried out livelihood activities there between 1963 and 2015. These forest user groups include beekeepers, rat trappers, grazers, mushroom gatherers, ground honey/tree honey harvesters, carvers, etc. The investigation also extended to the traditional leaders of Nso and Oku who are in charge of the land tenure systems. The findings show that the Oku Mountain Forest is jointly owned by the Nso and Oku people. The Nso own the eastern half of the forest known as Ngongbaa Forest while the Oku own the western half, known as the Kilum Forest. The cordial relationship that existed between these people ensured the conservation of the forest. But the conflicts that later set in, especially due to the creation of the Kilum Mountain Forest Project in 1987 later changed to the Kilum Ijim Forest Project (KIFP) in 1992 sidelined the local communities which was contrary to the dispositions of the new Cameroon forest law enacted in 1994. Thus, the indigenous conservation practices became ignored which the local population never digested well. This seriously jeopardized the wellbeing of the forest in general.展开更多
The idea of a human community with a shared future was proposed by the Communist Party of China(CPC)Central Committee with Comrade Xi Jinping at its core for the future development of human beings to face up to the mo...The idea of a human community with a shared future was proposed by the Communist Party of China(CPC)Central Committee with Comrade Xi Jinping at its core for the future development of human beings to face up to the most important question in today's world:“What is happening to the world and what should we do?”It profoundly answers the question of the world,history,and the times.The theory of a human community with a shared future is an innovative theory with a multidimensional formation logic that guides humanity toward continually seeking common interests and values.This paper dives into the profound motivations behind building a human community with a shared future from historical,cultural,and practical dimensions and analyzes its epochal value from both domestic and international perspectives.This not only helps exert China's role in the international community,contributing Chinese strength to the construction of a peaceful,stable,and prosperous human society,but also enhances the influence of the idea of a human community with a shared future in the international community,accelerating the building of a human community with a shared future that considers the legitimate concerns of all countries,and aiding in solving the crises facing the world.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
不幸消息告知(breaking bad news,BBN)是医务工作者必备且极具挑战的重要医患沟通技能,应用恰当的沟通模式进行BBN操作,可以有效提高癌症患者对病情的正确认知、治疗依从性和满意度,同时缓解不幸消息对患者情绪的不良影响等。国内外近...不幸消息告知(breaking bad news,BBN)是医务工作者必备且极具挑战的重要医患沟通技能,应用恰当的沟通模式进行BBN操作,可以有效提高癌症患者对病情的正确认知、治疗依从性和满意度,同时缓解不幸消息对患者情绪的不良影响等。国内外近年来开展了大量BBN相关研究及实践,并形成了多种沟通模式,其中SHARE模式被认为相对更适用于我国医疗环境繁忙及家属参与决策的文化背景。为了更好地适应当前我国知情权和决定权逐渐回归患者自身的趋势,提高我国医务工作者的医患沟通能力,本研究概述了SHARE模式在我国癌症患者BBN中的应用,重点阐述了其在我国的沟通对象,以及BBN对癌症患者心理状态等方面的影响。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
Sharing of personal health records(PHR)in cloud computing is an essential functionality in the healthcare system.However,how to securely,efficiently and flexibly share PHRs data of the patient in a multi-receiver sett...Sharing of personal health records(PHR)in cloud computing is an essential functionality in the healthcare system.However,how to securely,efficiently and flexibly share PHRs data of the patient in a multi-receiver setting has not been well addressed.For instance,since the trust domain of the cloud server is not identical to the data owner or data user,the semi-trust cloud service provider may intentionally destroy or tamper shared PHRs data of user or only transform partial ciphertext of the shared PHRs or even return wrong computation results to save its storage and computation resource,to pursue maximum economic interest or other malicious purposes.Thus,the PHRs data storing or sharing via the cloud server should be performed with consistency and integrity verification.Fortunately,the emergence of blockchain technology provides new ideas and prospects for ensuring the consistency and integrity of shared PHRs data.To this end,in this work,we leverage the consortiumblockchain technology to enhance the trustworthiness of each participant and propose a blockchain-based patient-centric data sharing scheme for PHRs in cloud computing(BC-PC-Share).Different from the state-of-art schemes,our proposal can achieve the following desired properties:(1)Realizing patient-centric PHRs sharing with a public verification function,i.e.,which can ensure that the returned shared data is consistent with the requested shared data and the integrity of the shared data is not compromised.(2)Supporting scalable and fine-grained access control and sharing of PHRs data with multiple domain users,such as hospitals,medical research institutes,and medical insurance companies.(3)Achieving efficient user decryption by leveraging the transformation key technique and efficient user revocation by introducing time-controlled access.The security analysis and simulation experiment demonstrate that the proposed BC-PC-Share scheme is a feasible and promising solution for PHRs data sharing via consortium blockchain.展开更多
Given the challenges of manufacturing resource sharing and competition in the modern manufacturing industry,the coordinated scheduling problem of parallel machine production and transportation is investigated.The prob...Given the challenges of manufacturing resource sharing and competition in the modern manufacturing industry,the coordinated scheduling problem of parallel machine production and transportation is investigated.The problem takes into account the coordination of production and transportation before production as well as the disparities in machine spatial position and performance.A non-cooperative game model is established,considering the competition and self-interest behavior of jobs from different customers for machine resources.The job from different customers is mapped to the players in the game model,the corresponding optional processing machine and location are mapped to the strategy set,and the makespan of the job is mapped to the payoff.Then the solution of the scheduling model is transformed into the Nash equilibrium of the non-cooperative game model.A Nash equilibrium solution algorithm based on the genetic algorithm(NEGA)is designed,and the effective solution of approximate Nash equilibrium for the game model is realized.The fitness function,single-point crossover operator,and mutation operator are derived from the non-cooperative game model’s characteristics and the definition of Nash equilibrium.Rules are also designed to avoid the generation of invalid offspring chromosomes.The effectiveness of the proposed algorithm is demonstrated through numerical experiments of various sizes.Compared with other algorithms such as heuristic algorithms(FCFS,SPT,and LPT),the simulated annealing algorithm(SA),and the particle swarm optimization algorithm(PSO),experimental results show that the proposed NE-GA algorithm has obvious performance advantages.展开更多
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB31020302)the Natural Science Foundation of China(32271564,31730104)“Western Young Scholars”Project of the Chinese Academy of Sciences(XAB2020YW02).
文摘Food sharing is a prosocial behavior consisting of the unresisted transfer of monopolizable food from a possessor to another individual(Feistner and McGrew 1989;Stevens and Gilby 2004).Despite the cost for donors(i.e.,loss of the food),intraspecifc food sharing occurs in various insects,fsh,birds,and aquatic,terrestrial,and arboreal mammals(Liévin‐Bazin et al.2019;Carter et al.2020).By far,most food sharing is intraspecifc,and takes place while possessors are in the process of eating.Here,we describe the remarkable case of a captive chimpanzee,Pan troglodytes,regularly dispensing food to another primate species(baboons,Papio hamadryas)in a neighboring enclosure.We discuss likely causes and functions of this interspecifc altruistic act.Observations were made in Xi’an Qinling Wildlife Park,Shaanxi Province,China(34°02ʹ56.22″N,108°51ʹ48.60″E),where two adult chimpanzees and a group of around 40-50 baboons lived in adjacent enclosures.The female chimpanzee(AiAi)was the elderly mother of the male(DuoDuo,or DD).At feeding times,AiAi usually ate near the door to the chimpanzees’indoor area,and she almost never interacted with the baboon group.The baboon group consisted of two one-male units.We recorded behaviors using focal-animal sampling(for information about subjects and methods,see Supplementary Materials).
基金This work was supported by Science and Technology Research Program of Chongqing Municipal Education Commission(KJZD-M202300502,KJQN201800539).
文摘In clustering algorithms,the selection of neighbors significantly affects the quality of the final clustering results.While various neighbor relationships exist,such as K-nearest neighbors,natural neighbors,and shared neighbors,most neighbor relationships can only handle single structural relationships,and the identification accuracy is low for datasets with multiple structures.In life,people’s first instinct for complex things is to divide them into multiple parts to complete.Partitioning the dataset into more sub-graphs is a good idea approach to identifying complex structures.Taking inspiration from this,we propose a novel neighbor method:Shared Natural Neighbors(SNaN).To demonstrate the superiority of this neighbor method,we propose a shared natural neighbors-based hierarchical clustering algorithm for discovering arbitrary-shaped clusters(HC-SNaN).Our algorithm excels in identifying both spherical clusters and manifold clusters.Tested on synthetic datasets and real-world datasets,HC-SNaN demonstrates significant advantages over existing clustering algorithms,particularly when dealing with datasets containing arbitrary shapes.
基金financed by the Flinders University College of Business,Government and Law Large Project Grant(Grant number:100031.21).
文摘Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.
基金This research is supported by the National Social Science Fund of China(Grant No.21BGL150).
文摘This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into the economic benefits experienced by low-income households in the context of rural tourism development.Based on field research conducted from April 8,2023,to May 17,2023,including interviews and site visits,the study constructs an evaluation index system to assess the influencing factors.Through expert scoring and the application of a weighted set-valued mathematical statistical model,the importance and quantification of each factor are determined.The results indicate that the current stage of promoting shared prosperity through rural tourism in Yinan County is primarily influenced by the scale of tourist consumption of external visitors.This factor outweighs others such as the participation capacity and willingness of low-income households,the capacity of investment enterprises,and the policies and financial allocation of the local government.The findings emphasize the significance of external visitor spending and highlight the need to address the obstacles faced by low-income households in accessing economic benefits.The evaluation index system and measurement model presented in this study offer a scientific basis for assessing and improving the income situation of low-income households in rural tourism development initiatives.However,it is crucial to note that the importance of these influencing factors may evolve with the lifecycle of the tourism destination.Future research should include long-term tracking and consider a broader range of indicators to deepen our understanding of their mechanisms and significance.Furthermore,alternative approaches and theories may provide valuable perspectives for further exploration in this field.
文摘Contemporary World Magazine,which is affiliated to the International Department of the CPC Central Committee(IDCPC),held an exchange act ivi ty themed on“Harmony for Shared Prosperity”in Beijing on May 7,2024.
文摘Wherever people live together in or near homelands that harbour joint natural resources such as forest, water, minerals, oil etc., they must collaborate, co-exist and share these resources irrespective of their genetic, social, cultural, and political peculiarities. This is not always the case when self-interest, ethnic divisions, elitist politics, economic interest and power tussle set in. The Nso and Oku people who reside in the Ngongbaa Forest area constitute an example of joint management of resources where at one period, their relationship over the management of the Oku Mountain Forest was cordial and at another, the relationship became conflictive. This study was designed to study the influence of the KIFP forest management policies on the Nso indigenous forest Management system in Ngongbaa Forest, and its implications. The data collected for the study was secured through the administration of a questionnaire to residents of 10 villages adjacent to the Ngongbaa Forest, and forest users who carried out livelihood activities there between 1963 and 2015. These forest user groups include beekeepers, rat trappers, grazers, mushroom gatherers, ground honey/tree honey harvesters, carvers, etc. The investigation also extended to the traditional leaders of Nso and Oku who are in charge of the land tenure systems. The findings show that the Oku Mountain Forest is jointly owned by the Nso and Oku people. The Nso own the eastern half of the forest known as Ngongbaa Forest while the Oku own the western half, known as the Kilum Forest. The cordial relationship that existed between these people ensured the conservation of the forest. But the conflicts that later set in, especially due to the creation of the Kilum Mountain Forest Project in 1987 later changed to the Kilum Ijim Forest Project (KIFP) in 1992 sidelined the local communities which was contrary to the dispositions of the new Cameroon forest law enacted in 1994. Thus, the indigenous conservation practices became ignored which the local population never digested well. This seriously jeopardized the wellbeing of the forest in general.
文摘The idea of a human community with a shared future was proposed by the Communist Party of China(CPC)Central Committee with Comrade Xi Jinping at its core for the future development of human beings to face up to the most important question in today's world:“What is happening to the world and what should we do?”It profoundly answers the question of the world,history,and the times.The theory of a human community with a shared future is an innovative theory with a multidimensional formation logic that guides humanity toward continually seeking common interests and values.This paper dives into the profound motivations behind building a human community with a shared future from historical,cultural,and practical dimensions and analyzes its epochal value from both domestic and international perspectives.This not only helps exert China's role in the international community,contributing Chinese strength to the construction of a peaceful,stable,and prosperous human society,but also enhances the influence of the idea of a human community with a shared future in the international community,accelerating the building of a human community with a shared future that considers the legitimate concerns of all countries,and aiding in solving the crises facing the world.
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.
文摘不幸消息告知(breaking bad news,BBN)是医务工作者必备且极具挑战的重要医患沟通技能,应用恰当的沟通模式进行BBN操作,可以有效提高癌症患者对病情的正确认知、治疗依从性和满意度,同时缓解不幸消息对患者情绪的不良影响等。国内外近年来开展了大量BBN相关研究及实践,并形成了多种沟通模式,其中SHARE模式被认为相对更适用于我国医疗环境繁忙及家属参与决策的文化背景。为了更好地适应当前我国知情权和决定权逐渐回归患者自身的趋势,提高我国医务工作者的医患沟通能力,本研究概述了SHARE模式在我国癌症患者BBN中的应用,重点阐述了其在我国的沟通对象,以及BBN对癌症患者心理状态等方面的影响。
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.
基金supported by the Youth Doctoral Foundation of Gansu Education Committee under Grant No.2022QB-176.
文摘Sharing of personal health records(PHR)in cloud computing is an essential functionality in the healthcare system.However,how to securely,efficiently and flexibly share PHRs data of the patient in a multi-receiver setting has not been well addressed.For instance,since the trust domain of the cloud server is not identical to the data owner or data user,the semi-trust cloud service provider may intentionally destroy or tamper shared PHRs data of user or only transform partial ciphertext of the shared PHRs or even return wrong computation results to save its storage and computation resource,to pursue maximum economic interest or other malicious purposes.Thus,the PHRs data storing or sharing via the cloud server should be performed with consistency and integrity verification.Fortunately,the emergence of blockchain technology provides new ideas and prospects for ensuring the consistency and integrity of shared PHRs data.To this end,in this work,we leverage the consortiumblockchain technology to enhance the trustworthiness of each participant and propose a blockchain-based patient-centric data sharing scheme for PHRs in cloud computing(BC-PC-Share).Different from the state-of-art schemes,our proposal can achieve the following desired properties:(1)Realizing patient-centric PHRs sharing with a public verification function,i.e.,which can ensure that the returned shared data is consistent with the requested shared data and the integrity of the shared data is not compromised.(2)Supporting scalable and fine-grained access control and sharing of PHRs data with multiple domain users,such as hospitals,medical research institutes,and medical insurance companies.(3)Achieving efficient user decryption by leveraging the transformation key technique and efficient user revocation by introducing time-controlled access.The security analysis and simulation experiment demonstrate that the proposed BC-PC-Share scheme is a feasible and promising solution for PHRs data sharing via consortium blockchain.
基金supported in part by the Project of Liaoning BaiQianWan Talents ProgramunderGrand No.2021921089the Science Research Foundation of EducationalDepartment of Liaoning Province under Grand No.LJKQZ2021057 and WJGD2020001the Key Program of Social Science Planning Foundation of Liaoning Province under Grant L21AGL017.
文摘Given the challenges of manufacturing resource sharing and competition in the modern manufacturing industry,the coordinated scheduling problem of parallel machine production and transportation is investigated.The problem takes into account the coordination of production and transportation before production as well as the disparities in machine spatial position and performance.A non-cooperative game model is established,considering the competition and self-interest behavior of jobs from different customers for machine resources.The job from different customers is mapped to the players in the game model,the corresponding optional processing machine and location are mapped to the strategy set,and the makespan of the job is mapped to the payoff.Then the solution of the scheduling model is transformed into the Nash equilibrium of the non-cooperative game model.A Nash equilibrium solution algorithm based on the genetic algorithm(NEGA)is designed,and the effective solution of approximate Nash equilibrium for the game model is realized.The fitness function,single-point crossover operator,and mutation operator are derived from the non-cooperative game model’s characteristics and the definition of Nash equilibrium.Rules are also designed to avoid the generation of invalid offspring chromosomes.The effectiveness of the proposed algorithm is demonstrated through numerical experiments of various sizes.Compared with other algorithms such as heuristic algorithms(FCFS,SPT,and LPT),the simulated annealing algorithm(SA),and the particle swarm optimization algorithm(PSO),experimental results show that the proposed NE-GA algorithm has obvious performance advantages.
