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Background: Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context of medical decisions of adults. Objective: The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods: A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results: 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual's relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers' dominant voice hampers the demonstration of relational autonomy. Conclusions: Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual's values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual's values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. [ABSTRACT FROM AUTHOR]

Background: Understanding the conceptual models that underpin interventions, and the linkage between mechanisms of action and their intended outcomes, makes replication possible. Aim: To identify and appraise conceptual models and mechanisms of action underpinning end-of-life care interventions to improve spiritual well-being. Design: A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis was conducted. Data sources: A comprehensive search was performed in eight databases from inception to January 12, 2021. Results: A logic model was developed and potential mechanisms of action were identified from the seven included studies. Conclusion: First, conceptual models that have relevance and appropriateness to cultural setting are required to underpin future intervention development and implementation. Second, careful intervention development should articulate the link between concept, mechanisms, and outcomes. Third, selection of valid outcome measured must have a strong justification of how the construct being measured relates to the intervention goals. [ABSTRACT FROM AUTHOR]

New paradigm shifts and 6G technological rev-olution in vehicular services have emerged toward unmanned driving, automated transportation, and self-driving vehicles. As the technology for autonomous cars becomes mature, real challeng-es come from reliable, safe, real-time connected transportation operations to achieve ubiquitous and prompt information exchanges with massive connected and autonomous vehicles. This article introduces novel wireless distributed architectures that embed the edge computing capability inside software-defined vehicular networking infrastructure. Such edge networks consist of open-loop grant-free communications and computing-based control frameworks, which enable dynamic eco-routing with ultra-low latency and mobile data-driven orchestration. Thus, this work advanc-es the frontiers of machine learning potential and next-generation mobile systems in vehicular net-working applications. [ABSTRACT FROM AUTHOR]

Achievable data rates in wireless systems rely heavily on the available channel state information (CSI) throughout the network. However, feedback links, which provide this information, are scarce, unreliable, and subject to security threats. In this work, we study the impact of having intermittent feedback links on the capacity region of the canonical two-user erasure broadcast channels. In our model, at any time instant, each receiver broadcasts its CSI, and at any other node, this information either becomes available with unit delay or gets erased. For this setting, we develop a new set of outer bounds to capture the intermittent nature of the feedback links. These outer bounds depend on the probability that the CSI from both receivers are erased at the transmitter. In particular, if at any time, the CSI from at least one of the two receivers is available at the other two nodes, then the outer-bounds match the capacity with global delayed CSI. We also provide capacity-achieving transmission strategies under certain scenarios, and we establish a connection between this problem and Blind Index Coding with feedback. [ABSTRACT FROM AUTHOR]

We characterize the capacity region of the two-user broadcast packet erasure channel (PEC) with single-user delayed channel state information (CSI). More precisely, we assume one receiver does not provide its channel state to the other two nodes (the other receiver and the transmitter), while the other receiver reveals its state globally with unit delay. This is a hybrid CSI at the transmitter (CSIT) setting where the transmitter has the delayed CSI of one user but not the other. Previous results developed opportunistic network coding schemes for this setting, which strictly enlarge the achievable rate region compared to the no-CSIT baseline. Characterization of the capacity region with single-user delayed CSI, however, remained open. In this work, we develop an improved achievability strategy and show that the capacity region, surprisingly, matches that of the broadcast PEC with global delayed CSI of both users. The key to such improvement over previous results is a new precoding strategy for the retransmission phase of the opportunistic network coding scheme. It harnesses the single-user delayed CSI in the retransmission phase, so that interference from the feedback receiver can be aligned at the other receiver. Besides the broadcast PEC with two private messages, an extension to a model with an additional common message is also provided and the corresponding capacity region with single-user CSI also matches that with global delayed CSI. Finally, further extensions to three-user cases are also provided. [ABSTRACT FROM AUTHOR]

Adolescents with brain stem dysfunction may undergo many invasive treatments, and parents are often faced with making the decision to withdraw treatment. However, in the face of their child's death, the spiritual practices of parents dealing with end-of-life decision-making remain under investigated. This study explores the spiritual practices in parents making end-of-life decisions for adolescents on life support with brain stem dysfunction. A descriptive phenomenological study was conducted through in-depth interviews with three parents of two adolescents in Taiwan. Data were analysed using Colaizzi's seven-step protocol. Three main themes emerged: (1) faith during decision-making, (2) struggles during decision-making, (3) transformation during decision-making. The findings indicate that "transforming the nature of hope" is the essence of the experience. Family-centred care, gaining insight into parental spiritual practices, and developing culturally-appropriate care are recommended. [ABSTRACT FROM AUTHOR]

In wireless networks, the link connectivity may be intermittent due to shadowing, burstiness of data arrival, or uncoordinated resource allocation. In this paper, we model the intermittence of links as Bernoulli distributed random channel states, termed intermittence channel states, and study the impact of the corresponding channel state information at the transmitter (CSIT) in a two-user Gaussian broadcast channel (BC). Moreover, due to the heterogeneous timeliness of intermittence channel states, the CSIT considered in this paper is hybrid. More specifically, the CSIT of each link can be perfectly (causally or non-causally) available, delayed, or not available. When the links are connected, we adopt a general setting that the received signal-to-noise ratios can be different. Our contribution is the characterization of the capacity regions of intermittent Gaussian BC to within bounded gaps for all combinations of hybrid CSIT, except for scenario DN (delayed CSIT of receiver 1, no CSIT of receiver 2). For scenario DN, we propose an opportunistic physical layer network coding scheme that achieves a strictly larger degree-of-freedom (DoF) region than the no-CSIT DoF region. As a corollary, single-user CSIT is able to increase the sum DoF for intermittent Gaussian BC (also the capacity region for the erasure BC, as a by-product). This result is in sharp contrast to the recent negative result by Davoodi and Jafar, where it is shown that for fast-fading multiple-input single-output BC with continuous channel states, single-user CSIT does not help at all in terms of sum DoF. [ABSTRACT FROM AUTHOR]

Aim: An inaccurate image of the nursing profession can negatively affect staff recruitment, resource allocation, and the perception of nursing professionalism. Previous research has investigated how nurses were portrayed in the traditional media but relatively little is known from the perspective of the Internet. Therefore, the present study aimed to explore how the nursing profession is portrayed on the Internet by using two popular sources of photographic images. Methods: The first 100 images that were obtained using the search term “nurse” on Google Images and Shutterstock were analyzed. The distribution of the image attributes between the two websites was compared with Fisher's exact test. The text description of the images that were obtained from Shutterstock also was analyzed. Results: In the 171 images with at least one nurse in them, the nurses were predominately female (91%). The facial expression of the nurses was mostly smiling (85%) and 68% of the nurses had a stethoscope. For those with their hands visible in the images, 39% were holding documents, writing boards, or tablet computers and 29% were shown touching patients. Only 7% were depicted as using medical devices. Conclusions: While most of the nursing images were relatively professional‐looking, the nurses were portrayed only as engaging in comforting patients and recording data. Nurses who were engaged in clinical tasks or scientific activities, such as research, were absent in the portrayals. A plan needs to be developed to accurately and comprehensively represent the nursing profession on the Internet. [ABSTRACT FROM AUTHOR]

This paper considers the resource allocation for an orthogonal-frequency-division-multiplexing (OFDM)-based cognitive decode-and-forward (DF) relay network. Our objective is to maximize the sum rate (over subcarriers) of the cognitive-radio user with the interference introduced to the primary users (PUs) being managed. The optimization is over subcarrier pairing and power allocation, which leads to a mixed-integer programming (MIP) problem. To resolve this complicated MIP problem at a reasonable cost, we adopt the heterogeneous genetic algorithm (HGA) framework. The main motivation for the HGA framework comes from the idea that it can reduce the impact of extra assumptions made in previous works to simplify the problem. In our HGA, the chromosome is divided into an integer string for subcarrier pairing and a real-number string for power allocation. Two new initialization methods of these chromosomes, which are motivated by the convex optimization theory, are proposed. New crossover and mutation schemes are also devised to accommodate these new chromosomes, as well as to manage the interference to the PUs. Furthermore, we also propose a two-stage low-complexity genetic algorithm, which separately determines the proper subcarrier pairs and power allocations. Our simulations show that our HGAs and the two-stage algorithm provide competing performance, compared with similar state-of-the-art works. [ABSTRACT FROM PUBLISHER]

This paper considers noisy Wyner–Ziv coding (WZC), in which a remote noisy source is compressed with side information at the decoder only. The decoder side information is not limited to being Gaussian, thus this noisy WZC problem cannot be transformed into the conventional one tailored for noiseless sources. A new coding structure, named the residual-quantization (RQ) based noisy WZC, is proposed to solve the problem. This scheme explicitly constructs the theoretical auxiliary random variable to facilitate optimal reconstruction of the noisy source. In this two-stage encoder, the noisy source is quantized twice and the quantization error (residue) of the first stage is the input of the second stage. By sending only the quantization index of the second stage to the decoder, the corresponding code rate can theoretically approach the noisy WZC bound. Moreover, the RQ-based noisy WZC is implemented using graph-based codes. The main challenge is that it is necessary to design a codebook that is simultaneously good for source and channel coding for the first stage quantization, since this quantization code also acts as a channel code at the decoder. This problem is solved by constructing a low-density parity check (LDPC) code with edge degrees optimized for channel coding, and enhancing its performance for source coding by using a modified reinforced belief-propagation quantization algorithm. Simulation results show that the noisy Wyner-Ziv bounds can be practically approached by our implementation. In addition, the proposed implementation offers more flexibility in the code rates compared with the existing practical designs, making it more suitable for emerging applications such as fronthaul compression. [ABSTRACT FROM AUTHOR]

• Four TADF materials with carbazole donor, and benzonitrile-substituted pyrimidine or triazine as acceptor core were developed. • OLEDs with m-CzPym, p-CzPym, m-CzTrz, and p-CzTrz as host and 4CzIPN were fabricated. • An impressive external quantum efficiency of 31.5% and a superior power efficiency of 116.5 lm W−1 were achieved. • Impressive efficiency roll-off performance (approximately 90% of EQE max at 5000 cd m−2). Four bipolar molecules, namely m-CzPym , p-CzPym , m-CzTrz , and p-CzTrz , with carbazole (Cz) donor and a benzonitrile-substituted pyrimidine (Pym) or triazine (Trz) acceptor core were synthesized and characterized. The electron deficiency of heteroaryl cores together with the substitution pattern of benzonitrile were employed to tune the energy levels as well as the thermally activated delayed fluorescence (TADF) characteristics. The four molecules exhibited TADF behavior with inferior photoluminescent quantum yields (PLQYs) that limit their applications as emitters. These bipolar molecules were employed as TADF host materials for the benchmark TADF emitter 4CzIPN to achieve high-performing green TADF organic light-emitting diodes (OLEDs). Among the molecules, m-CzPym -hosted TADF-OLEDs achieved a maximum external quantum efficiency (EQE max) of 31.5%, maximum power efficiency (PE max) of 95.6 lm/W, and maximum current efficiency (CE max) of 100.2 cd/A. Notably, p-CzPym -hosted TADF-OLEDs also achieved a PE max of 116.5 lm/W, turn-on voltage of 2.5 V, and impressive low efficiency roll-off performance (>89% of EQE max at 5000 cd/m2), representing one of the highest efficiencies ever reported in 4CzIPN-doped devices. The high device efficiency can be ascribed to the balanced ambipolar carrier-transporting character of the host materials and high PLQY as well as the outstanding light outcoupling efficiency of the emitting layer. [ABSTRACT FROM AUTHOR]

Streaming codes take a string of source symbols as input and output a string of coded symbols in real time, which eliminate the queueing delay of traditional block codes and are thus especially appealing for delay sensitive applications. Existing works on streaming code performance either focused on the asymptotic error-exponent analyses, or on the optimal code construction under deterministic adversarial channel models. In contrast, this work analyzes the exact error probability of random linear streaming codes (RLSCs) in the large field size regime over the stochastic i.i.d. symbol erasure channel model. A closed-form expression of the error probability of large-field-size RLSCs is derived under, simultaneously, the finite memory length and decoding deadline constraints. The result is then used to examine the intricate tradeoff between memory length (complexity), decoding deadline (delay), code rate (throughput), and error probability (reliability). Numerical evaluation shows that under the same code rate and error probability requirements, the end-to-end delay of RLSCs is 40–48% of that of the optimal block codes (i.e., MDS codes). This implies that switching from block codes to streaming codes not only eliminates the queueing delay completely (which accounts for the initial 50% of the delay reduction) but also improves the reliability (which accounts for the additional 2–10% delay reduction). [ABSTRACT FROM AUTHOR]

The Byzantine distributed quickest change detection (BDQCD) is studied, where a fusion center monitors the occurrence of an abrupt event through a bunch of distributed sensors that may be compromised. We first consider the binary hypothesis case where there is only one post-change hypothesis and prove a novel converse to the first-order asymptotic detection delay in the large mean time to a false alarm regime. This converse is tight in that it coincides with the currently best achievability shown by Fellouris et al.; hence, the optimal asymptotic performance of binary BDQCD is characterized. An important implication of this result is that, even with compromised sensors, a 1-bit link between each sensor and the fusion center suffices to achieve asymptotic optimality. To accommodate multiple post-change hypotheses, we then formulate the multi-hypothesis BDQCD problem and again investigate the optimal first-order performance under different bandwidth constraints. A converse is first obtained by extending our converse from binary to multi-hypothesis BDQCD. Two families of stopping rules, namely the simultaneous d-th alarm and the multi-shot d-th alarm, are then proposed. Under sufficient link bandwidth, the simultaneous d-th alarm, with d being set to the number of honest sensors, can achieve the asymptotic performance that coincides with the derived converse bound; hence, the asymptotically optimal performance of multi-hypothesis BDQCD is again characterized. Moreover, although being shown to be asymptotically optimal only for some special cases, the multi-shot d-th alarm is much more bandwidth-efficient and energy-efficient than the simultaneous d-th alarm. Built upon the above success in characterizing the asymptotic optimality of the BDQCD, a corresponding leader-follower Stackelberg game is formulated and its solution is found. [ABSTRACT FROM AUTHOR]

Careful hematologic management is required in surgical patients with traumatic acute subdural hematoma (aSDH) taking antithrombotic medications. We sought to compare outcomes between patients with aSDH taking antithrombotic medications at admission who received antithrombotic reversal with patients with aSDH not taking antithrombotics. Retrospective review identified patients with traumatic aSDH requiring surgical evacuation. The cohort was divided based on antithrombotic use and whether pharmacologic reversal agents or platelet transfusions were administered. A 3-way comparison of outcomes was performed between patients taking anticoagulants who received pharmacologic reversal, patients taking antiplatelets who received platelet transfusion, and patients not taking antithrombotics. Multivariable regressions, adjusted for injury severity, further investigated associations with outcomes. Of 138 patients who met inclusion criteria, 13.0% (n = 18) reported taking anticoagulants, 16.7% (n = 23) reported taking antiplatelets, and 3.6% (n = 5) reported taking both. Patients taking antiplatelets who received platelet transfusion had longer intraoperative times (P = 0.040) and higher rates of palliative care consultations (P = 0.046) compared with patients taking anticoagulants who received pharmacologic reversal and patients not taking antithrombotics. Across groups, no significant differences were found in frequency of in-hospital intracranial hemorrhage and venous thromboembolism, length of hospital stay, rate of inpatient mortality, or follow-up health status. In multivariable analysis, intraoperative time remained longest for the antiplatelets with platelet transfusion group. Other outcomes were not associated with patient group. Among surgical patients with traumatic aSDH, those taking antiplatelet medications who receive platelet transfusions experience longer intraoperative procedure times and higher rates of palliative care consultation. Comparable outcomes were observed between patients receiving antithrombotic reversal and patients not taking antithrombotics. [ABSTRACT FROM AUTHOR]

In this paper, we consider a multiuser wireless system with one full duplex (FD) base station (BS) serving a set of half duplex (HD) mobile users. To cope with the in-band self-interference (SI) and co-channel interference, we formulate a quality-of-service (QoS) based linear transceiver design problem. The problem jointly optimizes the downlink (DL) and uplink (UL) beamforming vectors of the BS and the transmission powers of UL users so as to provide both the DL and UL users with guaranteed signal-to-interference-plus-noise ratio performance, using a minimum UL and DL transmission sum power. The considered system model not only takes into account noise caused by nonideal RF circuits, analog/digital SI cancellation but also constrains the average signal power at the input of the analog-to-digital converter (ADC) for avoiding signal distortion due to finite ADC precision. The formulated design problem is not convex and challenging to solve in general. We first show that for a special case with a worst case SI channel estimation error, the QoS-based linear transceiver design problem is globally solvable by a polynomial time bisection algorithm. For the general case, we propose a suboptimal algorithm based on alternating optimization (AO). The AO algorithm is guaranteed to converge to a Karush–Kuhn–Tucker solution. To improve the computational efficiency of the AO algorithm, we further develop a fixed-point method by extending the classical uplink–downlink duality in HD systems to the FD system. Simulation results are presented to demonstrate the performance of the proposed algorithms and the comparison with HD systems. [ABSTRACT FROM AUTHOR]

Background: The Internet is an increasingly important source of health information for the general population. Both preventive health behavior and Internet use are known to be different between men and women. However, few studies have compared predictors of Internet use for health information between the sexes.Objectives: To investigate the prevalence and predictors of Internet use for health information among male and female adult Internet users using data from a population-based survey in Taiwan.Methods: Respondents between the ages of 20-65 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome variable of the study, the utilization of the Internet for health information, was ascertained by asking whether the respondent had ever used the Internet to search for health information or obtain health services. Univariate and multivariate logistic regression analyses were conducted separately for men and women to evaluate factors associated with the use of Internet for health information.Results: Of the 2741 adults aged 20-65 years who had ever used the Internet, 1766 (64.4%) of them had used it for health information or services. Multivariate logistic regression analyses showed that a higher educational level (adjusted odds ratio [AOR]=3.60, P<0.001), living alone (AOR=1.77, P=0.019), had exercised in the past two weeks (AOR=2.41, P<0.001), residing in city or urban district (AOR=1.28, P=0.049), with a perceived health status of extremely good, very good, or good (AOR=1.34, P=0.022), and had used Western medicine services in the past month (AOR=1.51, P=0.005) were significantly associated with health information use in male Internet users. On the other hand, age between 20-44.9 years (AOR=1.87, P<0.001), a higher educational level (AOR=3.57, P<0.001), being married (AOR=1.68, P=0.001), had exercised in the past two weeks (AOR=1.56, P<0.001), and had a mean monthly personal income of NT$ 20,000 and above were significant factors in female Internet users.Conclusions: This secondary data analysis of a representative sample of Taiwan population revealed that a similar but not identical set of independent factors was associated with the use of Internet for health information between male and female Internet users. [ABSTRACT FROM AUTHOR]

Physical layer secrecy has attracted much attention in recent years due to its ability to ensure communication secrecy with the use of channel coding and signal processing techniques (and without the explicit use of secret keys) in the physical layer. It serves as a promising technique for highly dynamic or ad hoc systems such as device-to-device and machine-type communication systems. However, the achievable secrecy performance depends highly on the level of CSI at the transmitter, the receiver, and the eavesdropper. In this article, we discuss how different levels of CSI resulting from conventional and unconventional ways of performing training and channel feedback may affect the confidentiality in terms of the information-theoretic (perfect) secrecy rate. The conventional approach refers to the emission of pilot signals from the transmitter and explicit channel feedback from the receiver. This approach is backward compatible with existing systems and allows the receiver to obtain accurate knowledge of the CSI, but may suffer from CSI leakage toward the eavesdropper. Unconventional approaches capitalize on reverse training to prevent CSI leakage and are shown to achieve significant improvements over conventional schemes in certain cases. For example, in a system with four transmit antennas and a single antenna at both the receiver and the eavesdropper, a secrecy rate gain of approximately 0.8 b/channel use at transmit SNR of 16 dB is observed over the full CSI case by providing CSI only to the transmitter (but not the receiver and the eavesdropper). [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey.Methods: Women aged 50.0-65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms.Results: The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P < 0.001), and somatic climacteric symptoms (AOR = 2.32, P = 0.012) were independent and significant factors of depressive symptoms in late middle-aged Taiwanese women.Conclusions: Findings from this secondary analysis of a population-based survey suggested independent associations of somatic climacteric symptoms, and a number of socio-demographic and health-related factors with depressive symptoms in late middle-aged Taiwanese women. [ABSTRACT FROM AUTHOR]