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.

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 ...

Geological adaptability matching design of disc cutter using multicriteria decision making approaches

Geological adaptability matching design of a disc cutter is the prerequisite of cutter head design for tunnel boring machines(TBMs)and plays an important role in improving the tunneling efficiency of TBMs.The main purpose of the cutter matching design is to evaluate the cutter performance and select the appropriate cutter size.In this paper,a novel evaluation method based on multicriteria decision making(MCDM)techniques was developed to help TBM designers in the process of determining the cutter size.The analytic hierarchy process(AHP)and matter element analysis were applied to obtaining the weights of the cutter evaluation criteria,and the fuzzy comprehensive evaluation and technique for order performance by similarity to ideal solution(TOPSIS)approaches were employed to determine the ranking of the cutters.A case application was offered to illustrate and validate the proposed method.The results of the project case demonstrate that this method is reasonable and feasible for disc cutter size selection in cutter head design.

Research on an Intelligent Decision Support System for a Conceptual Innovation Design of Pumping Units Based on TRIZ

Attention is concentrated on how to perform the innovative design during the process of pumping unit conceptual design, and how to enhance design efficiency and inspire creativity. Aiming at the shortages of conceptual design, introducing the theory of inventive problem solving （TRIZ） into the mechanical product design for producing innovative ideas, and using the advanced computer-aided technique, the intelligent decision support system （IDSS） based on TRIZ （TRIZ-IDSS） has been constructed. The construction method, system structure, conceptual production, decisionmaking and evaluation of the problem solving subsystem are discussed. The innovative conceptual design of pumping units indicates that the system can help the engineers open up a new space of thinking, overcome the thinking inertia, and put forward innovative design concepts. This system also can offer the scientific instructions for the innovative design of mechanical products.

Constraints Based Decision Support for Site-Specific Preliminary Design of Wind Turbines

This study presents a decision-support tool for preliminary design of a horizontal wind turbine system. The function of this tool is to assist the various actors in making decisions about choices inherent to their activities in the field of wind energy. Wind turbine cost and site characteristics are taken into account in the used models which are mainly based on the engineering knowledge. The present tool uses a constraint-modelling technique in combination with a CSP solver (numerical CSPs which are based on an arithmetic interval). In this way, it generates solutions and automatically performs the concept selection and costing of a given wind turbine. The data generated by the tool and required for decision making are: the quality index of solution (wind turbine), the amount of energy produced, the total cost of the wind turbine and the design variables which define the architecture of the wind turbine system. When applied to redesign a standard wind turbine in adequacy with a given site, the present tool proved both its ability to implement constraint modelling and its usefulness in conducting an appraisal.

A Comparative Analysis of Visualization Methods in Architecture:Employing Virtual Reality to Support the Decision-Making Process in the Architecture,Engineering,and Construction Industry

The design process of the built environment relies on the collaborative effort of all parties involved in the project.During the design phase,owners,end users,and their representatives are expected to make the most critical design and budgetary decisions-shaping the essential traits of the project,hence emerge the need and necessity to create and integrate mechanisms to support the decision-making process.Design decisions should not be based on assumptions,past experiences,or imagination.An example of the numerous problems that are a result of uninformed design decisions is“change orders”,known as the deviation from the original scope of work,which leads to an increase of the overall cost,and changes to the construction schedule of the project.The long-term aim of this inquiry is to understand the user’s behavior,and establish evidence-based control measures,which are actions and processes that can be implemented in practice to decrease the volume and frequency of the occurrence of change orders.The current study developed a foundation for further examination by proposing potential control measures,and testing their efficiency,such as integrating Virtual Reality(VR).The specific aim was to examine the effect of different visualization methods(i.e.,VR vs.construction drawings)on,(1)how well the subjects understand the information presented about the future/planned environment;(2)the subjects’perceived confidence in what the future environment will look like;(3)the likelihood of changing the built environment;(4)design review time;and(5)accuracy in reviewing and understanding the design.

Research on Collaboration Decision Design of Complex C2 System

The design of collaboration decision of C2 system is one of the puzzles which dicision science studies in complex system. To solve the contravention between the theory of collaboration decision design and development requirement in distributed C2 system,three-stage design approach is proposed to research coherence and optimization by which decision-maker carries out decision regulations. First,getting information and decision process are described; decision indexes and regulation models of collaboration are established. And then,a test circumstance is designed and established for measuring various decision-maker’s capabilities of carrying out decision regulation by simulation and getting their load capability parameters. Finally,the obtained parameters from the experiment are disposed and substituted into the original models for proving the coherence of decision regulations. As a result,it is feasible for three-stage approach to design collaboration decision,and decision regulations can satisfy various decision-maker requirements.

Applying an Ordinal Priority Approach Based Neutrosophic Fuzzy Axiomatic Design Approach to Develop Sustainable Geothermal Energy Source

Geothermal energy is considered a renewable,environmentally friendly,especially carbon-free,sustainable energy source that can solve the problem of climate change.In general,countries with geothermal energy resources are the ones going through the ring of fire.Therefore,not every country is lucky enough to own this resource.As a country with 117 active volcanoes and within the world’s ring of fire,it is a country whose geothermal resources are estimated to be about 40%of the world’s geothermal energy potential.However,the percentage used compared to the geothermal potential is too small.Therefore,this is the main energy source that Indonesia is aiming to exploit and use.However,the deployment and development of this energy source are still facing many obstacles due to many aspects from budget sources due to high capital costs,factory construction location,quality of resources,and conflicts of the local community.In this context,determining the optimal locations for geothermal energy sites(GES)is one of the most important and necessary issues.To strengthen the selection methods,this study applies a two-layer fuzzy multi-criteria decision-making method.Through the layers,the Ordinal Priority Approach(OPA)is proposed to weight the sub-criteria,the main criterion,and the sustainability factors.In layer 2,the Neutrosophic Fuzzy Axiomatic Design(NFAD)is applied to rank and evaluate potential locations for geothermal plant construction.Choosing the right geothermal energy site can bring low-cost efficiency,no greenhouse gas emissions,and quickly become the main energy source providing electricity for Indonesia.The final ranking shows Papua,Kawah Cibuni,and Moluccas as the three most suitable cities to build geothermal energy systems.Kawah Cibuni was identified as the most potential GES in Indonesia,with a score of 0.46.Papua is the second most promising GES with a score of 0.45.Next is the Moluccas,with a score of 0.39.However,the three least potential sites among the 15 studied sites are Lumut Balai,Moluccas and Patuha,with scores of 0.08,0.11 and 0.17,respectively.The conclusion of this study also classifies positions into groups to aid in decision-making.

An Ethical Approach to Decision Design

This paper describes an approach to ethical decision design. It discusses the use of several mathematical tools applicable to the world of economics and business. It then demonstrates how the tools analogously extend themselves to making ethical decisions as supported by personal values. A review of the mathematics, including the design of a decision tree, the concept of mathematical expectation, and mathematical modeling are included.

Early Building Design:Informed decision-making by exploring multidimensional design space using sensitivity analysis

This paper describes a novel approach to explore a multidimensional design space and guide multi-actor decision making in the design of sustainable buildings.The aim is to provide proactive and holistic guidance of the design team.We propose to perform exhaustive Monte Carlo simulations in an iterative design approach that consists of tw o steps:1) preparation by the modeler,and 2) a multi-collaborator meeting.In the preparation phase,the simulation modeler performs Morris sensitivity analysis to fixate insignificant model inputs and to identify non-linearity and interaction effects.Next,a representation of the global design space is obtained from thousands of simulations using low-discrepancysequences(LPτ) for sampling.From these simulations,the modeler constructs fast metamodels and performs quantitative sensitivity analysis.During the meeting,the design team explores the global design space by filtering the thousands of simulations.Variable filter criteria are easily applied using an interactive parallel coordinate plot w hich provide immediate feedback on requirements and design choices.Sensitivity measures and metamodels show the combined effects of changing a single input and how to remedy unw anted output changes.The proposed methodology has been developed and tested through real building cases using a normative model to assess energy demand,thermal comfort,and daylight.

A Practical Decision Making on Design of Fixed Offshore Wind Turbine Support Structure Considering Socio-economic Impact

Wind energy is considered one of the most promising alternative energy sources against the conventional fossil fuels.However,the deployment of these structures in deep-water for better power production is considered as a complex task.This also has raised the issue regarding selection of appropriate support structures for various sea conditions by considering environmental impact and carbon footprint.This paper considers a jacket like support structure as a case study for an intermediate water depth(50m).The jacket is considered to be located in North of Dutch Sea,and 100-extreme wave is applied as load condition.Here,the presented methodology provides an insight towards environmental/social impact made by the optimized designs in comparison with reference design.

Research on Top-layer Planning and Overall Design Project Decision of Weapon System Based on Analytic Hierarchy Process

Based on analytic hierarchy process(AHP) theory,a vital important problem for top-layer planning and overall design of modern self-propelled gun-howitzer system,namely overall project decision-making,was analyzed.A hierarchy model was built to solve the complex and uncertain problem,and a decision-making index system was established.Then,the weights in all layers of the model were determined by simulating experts.Finally,according to the calculated results of the elements in each layer,the weights of the alternatives to the overall goal were calculated to conduct the hierarchy total decision.A decision example shows that the overall project of a self-propelled gun-howitzer A is much better than that of another self-propelled gun-howitzer B,digitalized in comprehensive efficiency,operability,system accuracy and economy,but inferior to it in the information capability,and there exists relatively larger gap between them in the information sharing index.

Efficient sampling for decision making in materials discovery

Accelerating materials discovery crucially relies on strategies that efficiently sample the search space to label a pool of unlabeled data.This is important if the available labeled data sets are relatively small compared to the unlabeled data pool.Active learning with efficient sampling methods provides the means to guide the decision making to minimize the number of experiments or iterations required to find targeted properties.We review here different sampling strategies and show how they are utilized within an active learning loop in materials science.

Weighted Parameterized Correlation Coefficients of Indeterminacy Fuzzy Multisets and Their Multicriteria Group Decision Making Method with Different Decision Risks

Real-life data introduce noise,uncertainty,and imprecision to statistical projects;it is advantageous to consider strategies to overcome these information expressions and processing problems.Neutrosophic(indeterminate)numbers can flexibly and conveniently represent the hybrid information of the partial determinacy and partial indeterminacy in an indeterminate setting,while a fuzzy multiset is a vital mathematical tool in the expression and processing of multi-valued fuzzy information with different and/or same fuzzy values.If neutrosophic numbers are introduced into fuzzy sequences in a fuzzy multiset,the introduced neutrosophic number sequences can be constructed as the neutrosophic number multiset or indeterminate fuzzy multiset.Motivated based on the idea,this study first proposes an indeterminate fuzzy multiset,where each element in a universe set can be repeated more than once with the different and/or identical indeterminate membership values.Then,we propose the parameterized correlation coefficients of indeterminate fuzzy multisets based on the de-neutrosophication of transforming indeterminate fuzzy multisets into the parameterized fuzzy multisets by a parameter(the parameterized de-neutrosophication method).Since indeterminate decision-making issues need to be handled by an indeterminate decision-making method,a group decision-making method using the weighted parameterized correlation coefficients of indeterminate fuzzy multisets is developed along with decision makers’different decision risks(small,moderate,and large risks)so as to handle multicriteria group decision-making problems in indeterminate fuzzy multiset setting.Finally,the developed group decision-making approach is used in an example on a selection problem of slope design schemes for an open-pit mine to demonstrate its usability and flexibility in the indeterminate group decision-making problem with indeterminate fuzzy multisets.

A Curriculum Report on Teachers as Decision-maker

Curriculum design is an aspect of education profession which focuses on developing curricula for students.Educators will take many factors in consideration when design a curriculum.In practical teaching,teacher as decision makers to design an appropriate curricu lum and teaching activities play an important part in the whole teaching and learning.Many classroom teachers are working with students of different levels of ability,and they need to be able to adjust the curriculum to keep all of the students engaged and learning.It may also be necessary to change the pace of a curriculum to deal with problems as they arise.The essay analyse five parts in designing the curriculum as a teacher decision maker and get a conclusion according to the whole analysis course.

Kind of Fuzzy Method Determining Index Weight on Multi-Objctive Decision Making

Based on fuzzy characteristic of dicision-making thought, matrix of priority relation has been introduced and blurrized. A kind of fuzzy method, which is to determine the index weight on multi-objective decision making, has been put forward by means of the sequence root method for analysis of hierarchical process (AHP). Using this method an example which is to define the index weigbt on multi-objective decision making in thc scheme optimization of mine design has been given.

Feed back Mechanism in Decision Support Systems

Feedback mechanism is a specific feature of control systems, however, the similarity has been found in decision support systems. Just because of this, the DSS can provide a flexible learning and thinking environment, and help decision maker to solve semistructured and unstructured problems actively and creatively. In this paper, the role and type of the feedback in decision making are discussed from different point of view. This is also true in DSS because it supports decision making. The feedback design, especially the feedback interface design, is described through a case of practice DSS. Based on these points, the feedback mechanism is an important feature of DSS, and it is one of the differences between DSS and MIS.

Bayesian Networks as a Support to Decision-Making When Evaluating Maintenance Scenarios

Contemporary architecture is characterized by an ever-greater morphological,functional and technological complexity.This requires new skills to effectively implement a process capable of ensuring an uninterrupted link between the concept of a building and its construction.The research described here focuses on implementing a tool for evaluating levels of maintenance quality applied at various stages in a project.In methodological terms,the research was conducted with the intention of constructing a system capable of managing the large number of variables involved in the design of a work of architecture from the earliest phases.The proposed digital model was defined through the construction and implementation of a Bayesian Network.The duration and maintainability of building components-generally expressed in statistical forecasts as expected duration in relation to operating conditions and as estimated costs and times of maintenance-were jointly evaluated using a synthetic index to generate a true overall rating of the various aspects that play a part in defining the quality of maintenance.The effectiveness of this decision-making support was tested in evaluations of complex architectural projects.Specifically,this text presents the results of an analysis of different maintenance scenarios for the ING Group Headquarters.

基于案例推理的隧道洞门智能设计方法研究

为将以往隧道案例的经验应用到新建隧道设计中,以解决传统设计方法工作量大且效率低下的问题,提出基于案例推理的隧道洞门智能设计方法。结合隧道洞门工程特点,选取影响洞门设计的主要因素,将影响因素划分为12个属性单元来表征工程案例,运用三角模糊数的层次赋权计算方法对各属性单元权重进行赋值,借助相似度理论建立隧道洞门设计方案相似决策模型。基于GIS技术开发了隧道洞门工程案例库,实现对既有工程的存储管理,同时利用SQL查询语言及Python计算脚本实现案例的属性特征值计算与最相似匹配,进一步修正后可实现隧道洞门修建方案的设计决策。以某山区隧道为例对智能设计方法进行验证,结果表明:根据属性单元特征值计算结果,在案例库中比选得出与拟建隧道相似度最高的既有工程为凤凰山隧道,且相似度为0.707。因此,设定阈值为0.7时能加快案例库的检索速率与匹配准确率,该方法吸取了既有工程案例的经验,能应用于隧道洞门施工方案的决策设计,可供今后隧道洞门方案的智能化设计参考。