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The importance of shared decision making (SDM) for informed consent has been emphasised in the updated regulatory guidelines. Errors of completion, legibility and omission have been associated with paper-based consent forms. We introduced a digital consent process and compared it against a paper-based process for quality and patient reported involvement in shared decision making. 223 patients were included in this multi-site, single centre study. Patient consent documentation was by either a paper consent form or the Concentric digital consent platform. Consent forms were assessed for errors of legibility, completion and accuracy of content. Core risks for 20 orthopaedic operations were pre-defined by a Delphi round of experts and forms analysed for omission of these risks. SDM was determined via the 'collaboRATE Top Score', a validated measure for gold-standard SDM. 72% (n = 78/109) of paper consent forms contained ≥1 error compared to 0% (n = 0/114) of digital forms (P < 0.0001). Core risks were unintentionally omitted in 63% (n = 68/109) of paper-forms compared to less than 2% (n = 2/114) of digital consent forms (P < 0.0001). 72% (n = 82/114) of patients giving consent digitally reported gold-standard SDM compared to 28% (n = 31/109) with paper consent (P < 0.001). Implementation of a digital consent process has been shown to reduce both error rate and the omission of core risks on consent forms whilst increasing the quality of SDM. This novel finding suggests that using digital consent can improve both the quality of informed consent and the patient experience of SDM. • The paper consent process is associated with errors and omissions of core risks. • A digital consent process improved error rate and omission rate of core risks. • Patients reported a higher level of shared decision making with a digital process. • Documentation of consent can be reliably standardised with an electronic record. [ABSTRACT FROM AUTHOR]

The objective of this paper is to show the added value of using tools such as eyetracking, galvanic skin response, facial coding and others in the field of market research and user experience research. We will present 3 case studies in which these tools have been used successfully. We will give an overview of the background, the objectives, methods and results and how the neuro-tools provided additional insights into consumer behaviour, which would otherwise not have been possible. In this paper we will specifically show cases from packaging design, advertising research and user experience research thus only covering a small part of possible application areas. [ABSTRACT FROM AUTHOR]

The incidence of differentiated thyroid cancer (DTC) has been increasing worldwide, mostly, as an increase in the incidental detection of micro papillary thyroid carcinomas (microPTCs), many of which are potentially overtreated, as suggested by the unchanged mortality. Several international guidelines have suggested a less aggressive approach. More recently, it has been shown that active surveillance or minimally invasive treatments (MIT) are good alternatives for the management of these patients. In this context, patient participation in the decision-making process is paramount. The Endocrine Task Force of the European Organisation for Research and Treatment of Cancer (EORTC) has undertaken the task to establish consensus and define its position based on the scientific evidence concerning, 1) the current state of diagnostic and management options in microPTCs, including the current opinion of physicians about shared decision making (SDM), 2) the available evidence concerning patients' needs and the available decision instruments, and 3) to provide practical suggestions for implementation of SDM in this context. To improve SDM and patients' participation, knowledge gaps and research directions were highlighted. • New management approaches for patients with low-risk microPTC have been introduced. • For all available options, scientific evidence is weak, resulting in clinical equipoise. • SDM to carefully discuss these treatment options with patients is paramount. [ABSTRACT FROM AUTHOR]

In recent years, the pulp and paper industry has changed a lot and products have been constructed in quite different methods using new technologies. It can be due to the emergence of challenges and constraints such as shortage of raw materials, energy consumption (fossil fuels, electric, etc.), management of the resulting pollutants, environmental issues, ongoing legal requirements and cleaner production strategies. In Iran, the pulp and paper industry's technological development is not keeping pace with global growth. Iran's pulp and paper mills supply a small fraction of domestic market. The reasons can be due to old technologies being used in factories, aging machinery, low productivity of production systems and lack of coordination with modern technologies. It leads to low-quality of paper products and willingness to buy local products. The aim of this study is to select the most appropriate technologies in the pulp section, due to high impact of pulp quality on the quality of final paper. Using a 2-filterd fuzzy decision-making, hierarchical structure of research is designed to assess technological alternatives according to the selected criteria. Findings show that after passing through two filters, Kraft method was chosen as the most appropriate method. The Kraft process has still many advantages like the high quality of the produced pulp and self-sufficiency in energy supply. This framework offers an appropriate procedure for identifying and selecting technologies that has not been used in past researches. Using this framework facilitates using a clear procedure for evaluating and selecting technology and prevents future losses for organizations. [ABSTRACT FROM AUTHOR]

This discussion paper highlights the importance of Australian nursing and midwifery students' lack of exposure to electronic medical records during their undergraduate programs. There is pressure on universities offering nursing and midwifery programs to provide students with opportunities to learn to use patient electronic medical records. This will provide authentic rehearsal with the digital technology prior to clinical placements and increase graduate work readiness. Informed by contemporary literature, we describe the benefits of implementing electronic medical records (eMR) in health organisations and identify the challenges and barriers to implementing and integrating the education of electronic records into undergraduate nursing and midwifery programs. Undergraduate students who had not experienced eMR as part of on-campus learning felt unprepared and lacked confidence when commencing clinical practice. Some international nursing and midwifery programs have found that student's skills improve in decision-making and documenting patient observations when eMR is integrated into their university education program. Successful integration of an eMR program should consider academic/teaching staff skills and confidence in technology use, initial and ongoing costs and technical support required to deliver the program. In conclusion, Australian universities need to embed eMR learning experiences into the nursing and midwifery undergraduate curricula to increase students work-readiness with a focus on patient safety. [ABSTRACT FROM AUTHOR]

Abstract This conceptual paper provides a brief review of hospitality consumers' information search behavior and the factors that are likely to influence their information search behavior and their utilization and processing of online reviews. This study focuses on the factors such as information overload, confusion, information processing, information presentation format, trust and evaluation mode that has not received much attention from hospitality scholars in addition to discussing the impacts of perceived risk and familiarity on information search and information processing approaches utilized by hospitality consumers. This study also discusses opportunities for hospitality researchers to empirically examine the extent to which each of the factors discussed might influence hospitality consumers information search, information processing and especially their utilization of online reviews in their decision making process. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fibre transfer from unconstrained physical assaults involving human subjects. • More fibres transfer in person-person contact than previous data suggests. • Realistic fibre transfer quantities to inform better decision making. • Care must be taken in assigning 'roles' in physical assaults using fibre evidence. • Broad fibre distribution maps evident despite garments stored in paper bags. Knowledge of the number of fibres transferred during a particular activity is essential for the interpretation of findings in similar criminal cases. In this regard, violent contacts and physical assaults still present a challenge, due to a lack of robust published data. Hereby, we present the outcome of an empirical study where different assault activities were simulated by a Jiu Jitsu team and participants were asked to play either the role of an aggressive 'assailant' or a defensive 'victim', wearing cotton garments (i.e., Gi's). Four different scenarios were simulated in replicates (n = 5), each of them involving different intensity levels (low and high) and duration times (30 and 60 s). Results showed that approximately 1,000 to 44,000 fibres were cross-transferred between the participants' garments, with noticeable differences between the different scenarios. These values were significantly larger than those published in previous studies and, therefore, suggested the possibility of a current underestimation of the number of fibres transferred in physical assaults. Furthermore, statistical analysis by ANOVA indicated that the all the variables tested (i.e., intensity level, duration time, and participants role) had a significant effect on the number of transferred fibres (p < 0.001) and, consequently, that some knowledge of the case circumstances may be important to make more educated estimations. This is the first time that such a methodology has been applied for the quantitative assessment of fibre transfer between participants in assault activities. Data are expected to help practitioners with the interpretation of findings in real casework and lead to a more robust evidential assessment. [ABSTRACT FROM AUTHOR]

LCA studies on waste management have been promoted as they can help policy makers choose the best environmental options. However, the increasing globalization of raw materials and waste makes the optimization of waste management strategies and policies quite challenging. Therefore, new approaches are needed in order to identify the consequences of markets on the waste management systems. This paper concentrates on the quantification of greenhouse gas (GHG) emissions of recycling processes. The aim is to generate a comprehensive assessment of GHG emissions as a consequence of increasing the amount of material collected for recycling. Consequential life cycle assessment (CLCA) is an effective methodological framework for addressing GHG quantifications within market, but to properly perform and assess all of the market links between raw materials and waste, it is necessary to determine the cause-effect chains made up of physical flows. Thus, we propose integrating the methodologies of material flow analysis (MFA) and CLCA. We applied these methodologies to the paper and cardboard recycling system in Spain. The GHG results varied between −36 kg CO 2 eq. and −317 kg CO 2 eq. per ton of waste paper collected, depending on the quantity of waste paper exported and the source of marginal pulp considered. The cumulative energy demand (CED) was also calculated as complementary indicator. Similar trends as for GHG emissions were obtained. The future GHG quantifications should be based on the flows described by MFA analysis and should be quantified using CLCA because methodologies that accurately account for GHG are necessary for decision-making. [ABSTRACT FROM AUTHOR]

Numerous socio-legal factors make the process of surrogate decision-making for people living in dementia very complicated in Japan. In this discussion paper, we argue that the lack of early consultation between patients, surrogate decision-makers and healthcare providers and the overreliance of patients and their families on doctors to assume the decision-making role lead to healthcare practices that may not align with the patient's wishes. Further, we argue that lack of laws on surrogate decision-making, changing family structure and the liabilities associated with the care of people living with dementia contribute to the complexity of the decision-making process in Japan. Finally, given the rapidly changing social and healthcare norms in Japan, we call for greater involvement of nurses and care workers in the decision-making process to ensure patient-centric treatment and care are adopted. [ABSTRACT FROM AUTHOR]

Improvement In Shared Decision-Making SDM-Q-9 survey scores with concentric digital consent compared to paper-based consent. P149. [Extracted from the article]

Summary: The Anatomische Gesellschaft (anatomical society, AG) was founded in Germany in 1886 as an international society and remains the main organizing body of German anatomists to this day. A previous study of the history of the AG during National Socialism (NS) was based on the published proceedings of the AG and drew the preliminary conclusion that the “AG did not follow the path of preemptive obedience toward the new rulers” in contrast to some other professional societies. However, it was noted that archival sources were needed to support this conclusion and to illustrate the decision process within the society. Such sources are now available in the estate papers of Alfred Benninghoff, a leading anatomist at the time. His correspondence supports the previous finding that the AG was able to maintain its international character, thereby enabling it to avoid the active exclusion of “non-Aryan” members. The papers also confirm that the AG did not defend its vulnerable members as valiantly as the official narrative suggests, a fact illustrated in a controversy surrounding Martin Heidenhain. The interactions and conflicts between the leaders of the AG can now be reconstructed, i.e. between the secretary of the AG Heinrich von Eggeling, Benninghoff and Hermann Stieve. The Benninghoff documents also refer to a meeting of a subsection of the AG in November 1942, at which a disturbing radicalization of some anatomists developed. Finally, the papers reflect the political realities for German professionals trying to re-establish their science in a country divided into four occupation zones. [ABSTRACT FROM AUTHOR]

Objective The aims of this quasi-experimental before-and-after study were to first determine whether the use of eye tracking technology combined with video debriefing techniques has the potential to improve the quality of feedback and enhance situation awareness (SA) in simulated settings and second to determine students' satisfaction towards simulated learning. Methods Nursing and paramedicine students from three universities participated in three 8-minute simulation scenarios of acutely deteriorating patients. Eye tracking glasses video recorded the scenarios and tracked right eye movement. On completion, participants were questioned using the Situation Awareness Global Assessment Technique, completed the Satisfaction with Simulation Experience Scale (SSES), and provided textual feedback and received video-based verbal feedback. Results Participants lacked awareness of presenting medical conditions and patient environments and had poor recall of patient vital signs. Significant improvements in SA scores were demonstrated between the first and third scenarios ( P  = 0.04). Participants reported greater insight into their performance and were satisfied with simulated learning. Conclusions Use of visual field review techniques appears to enhance the use of realistic simulated practice as a means of addressing significant performance deficits. Eye tracking and point of view recording techniques are feasible and with applicable debriefing techniques could enhance clinical and situated performance. [ABSTRACT FROM AUTHOR]

Abstract: We propose an intelligent sensor system based on a new sensing methodology, relying also on 3D map reconstruction techniques, for computing with high precision, in real-time and without human intervention the parameters needed for stream-flow computa- tion: water levels, morphology of the streams of all potentially flooded areas by each controlled stream. The collected data will be continuously transmitted, through a communication infrastructure, to software agents designed to compute the stream-flow and to quantify the spatial distribution of flood risk for each controlled watershed. The computed risks, together with other data coming from other sources (barometric sensors, camera operators of public organizations, emergency agencies, private citizens), will be analyzed by a diagnostic decision system implementing a risk-alert scheduling strategy. This system will be able to diagnose the health state of the controlled environment and to define specialized alarm levels for each potentially interested area that will be used to alert all citizens (ubiquity) locally present (alerting locality). [Copyright &y& Elsevier]

Abstract: Bibliometric studies at the micro level are increasingly requested by science managers and policy makers to support research decisions. Different measures and indices have been developed at this level of analysis. One type of indices, such as the h-index and g-index, describe the most productive core of the output of a researcher and inform about the number of papers in the core. Other indices, such as the a-index and m-index, depict the impact of the papers in the core. In this paper, we present a new index which relates two different dimensions in a researcher’s productive core: a quantitative one (number of papers) and a qualitative one (impact of papers). In such a way, we could obtain a more balanced and global view of the scientific production of researchers. This new index, called -index, is based on the geometric mean of h-index and the median number of citations received by papers in the h-core, i.e., the m-index, which allows us to combine the advantages of both kind of indices. [Copyright &y& Elsevier]

The design of a high-volume printer for professional use is rather complex. The design of the paper path and the timing of sheets is frequently reengineered as the design of the printer components progresses. This paper presents an optimization model for the combined paper path and timing design problem. The paper path is an optimal physical dimensioning problem, while the timing is an open-loop optimal control problem. The coupled optimization problem is formulated as a simultaneous analysis and design (SAND) problem using a direct transcription of the optimal control problem. Benefits of the chosen formulation for industrial application are the ease of setting up the optimization model for arbitrary printer configurations, and the short computation times. Results of an industrial case are presented. [ABSTRACT FROM AUTHOR]

Evidence-based published data is the prime source used for clinical decision making, the issuance of guidelines and the drafting new policies. A number of different study designs are used to perform and publish research studies, corresponding to the research question being investigated. Over the decades, a hierarchical system of evidence has been established. This provides an indication of the level of evidence each study design contributes to the research community. Policies and clinical guidelines should naturally be based on the highest level of evidence data available. However, the highest level of evidence study designs may not always provide an adequate answer to a research question. Thus, when utilising published evidence-based data, one should first understand the clinical question that needs to be answered, and then critically appraise the published data accordingly. [ABSTRACT FROM AUTHOR]

Modern day societies and economies are becoming increasingly vulnerable to the continued erosion of the stocks and flows of essential ecosystem services. Thus, the management of complex socio-economic systems to effectively provide these essential services has become a global priority policy and academic research area. Understanding how underlying processes and functions contribute towards the provision of final ecosystem services can facilitate improved dissemination of credible, legitimate and salient information to decision-makers. This paper presents an ecosystem service value chain analysis framework that applies basic system dynamics modelling in the form of causal loop diagrams to facilitate an alternative analysis of ecosystem service value chains. A scoping application of the framework is applied to a case study for flood attenuation services in the Baviaanskloof catchment in South Africa. The framework enables the identification of forward linkages and ripple effects in individual value chains of final ecosystem services as well as the identification and assessment of challenges and opportunities within individual causal pathways. Ultimately, providing the potential to advance strategies for improving the efficiency and effectiveness of final ecosystem service provision. [ABSTRACT FROM AUTHOR]

Abstract: Recycling activities have demonstrated a remarkable increase over the last decade due to the economic and environmental dimensions of sustainability. In particular, capacity planning in production facilities has become a strategic issue of key importance affecting the profitability of the recycling industry. By integrating the simulation discipline and the feedback control theory into a dynamic consideration of recycling networks, this paper proposes a System Dynamics (SD) model for strategic capacity planning in the recycling industry. The decision-making process is based on a balanced tradeoff between profit and capacity utilization for a single producer with closed-loop recycling activities. The SD model captures physical stocks and flows apparent in real-world recycling networks and includes the feedback mechanisms which regulate these flows. When used as an “experimental tool”, the model tests alternative capacity planning policies and demonstrates policy suggestions for the forward and reverse channels, which maximize profitability over a strategic planning horizon. This experimentation is illustrated by using data from a paper producer with recycling activities, as a real-world test case. Extensive simulation runs, investigate the efficiency of a wide range capacity acquisition decisions, using total company profit as the measure of performance. Although such an analysis may differ from one recycling network to another, it has been kept as generic as possible to facilitate its applicability to a wide-spectrum of real-world local, regional or global networks. [Copyright &y& Elsevier]

Digital twins have emerged as novel technology in the wind energy sector that enables the design, monitoring and prediction of wind turbine performance. Despite growing attention on their potential, little is known about how digital twins are designed, by whom and how their design choices affect multiple aspects of decision making in the development of wind energy. Using a framework of co-production, this paper examines digital twins as boundary objects and the role of twinning as boundary work that involves an active process of design and affects multiple aspects of decision making in the development of wind energy. Our results demonstrate how the design of digital twins evolves throughout the twinning process, affected by regulation, choices of expert twinners on data and models, and what constitutes a matter of concern. We shed light on the role of these twinners in influencing which actors and their matters of concern are included and excluded during the twinning process. Our understanding of twinning as an active process of governance by design more clearly reveals how digital twins are not objective representations of reality, but a function of boundary work. We conclude that more transparency is needed over how digital twins are designed to enhance their role as technologies that foster a transition towards more sustainable energy systems and decision-making over wind energy technologies and their integration in landscapes. • There is limited understanding of how digital twins are designed • We focus on wind energy and 'twinning' as an act of governance • We unpack twinning as boundary work and digital twins as boundary objects • Twinning involves choices about data, models, concerns and regulation • Priorities and focus in twinning may steer wind energy transitions [ABSTRACT FROM AUTHOR]

Cumulative risk assessments (CRAs) examine potential risks posed by exposure to multiple and sometimes disparate environmental stressors. CRAs are more resource intensive than single chemical assessments, and pose additional challenges and sources of uncertainty. CRAs may examine the impact of several factors on risk, including exposure magnitude and timing, chemical mixture composition, as well as physical, biological, or psychosocial stressors. CRAs are meant to increase the relevance of risk assessments, providing decision makers with information based on real world exposure scenarios that improve the characterization of actual risks and hazards. The U.S. Environmental Protection Agency has evaluated a number of CRAs, performed by or commissioned for the Agency, to seek insight into CRA concepts, methods, and lessons learned. In this article, ten case studies and five issue papers on key CRA topics are examined and a set of lessons learned are identified for CRA implementation. The lessons address the iterative nature of CRAs, importance of considering vulnerability, need for stakeholder engagement, value of a tiered approach, new methods to assess multiroute exposures to chemical mixtures, and the impact of geographical scale on approach and purpose. [ABSTRACT FROM AUTHOR]

The vision of a sustainable and safe use of chemicals to protect human health, preserve the environment and maintain the ecosystem requires innovative and more holistic approaches to risk assessment (RA) in order to better inform decision making. Integrated risk assessment (IRA) has been proposed as a solution to current scientific, societal and policy needs. It is defined as the mutual exploitation of environmental risk assessment (ERA) for human health risk assessment (HHRA) and vice versa in order to coherently and more efficiently characterize an overall risk to humans and the environment for better informing the risk analysis process. Extrapolating between species which are relevant for HHRA and ERA requires a detailed understanding of pathways of toxicity/modes of action (MoA) for the various toxicological endpoints. Significant scientific advances, changes in chemical legislation, and increasing environmental consciousness have created a favourable scientific and regulatory environment to develop and promote the concept and vision of IRA. An initial proof of concept is needed to foster the incorporation of IRA approaches into different chemical sectorial regulations and demonstrate their reliability for regulatory purposes. More familiarity and confidence with IRA will ultimately contribute to an overall reduction in in vivo toxicity testing requirements. However, significant progress will only be made if long-term support for MoA-related research is secured. In the short term, further exchange and harmonization of RA terminology, models and methodologies across chemical categories and regulatory agencies will support these efforts. Since societal values, public perceptions and cultural factors are of increasing importance for the acceptance of risk analysis and successful implementation of risk mitigation measures, the integration of socio-economic analysis and socio-behavioural considerations into the risk analysis process may help to produce a more effective risk evaluation and consideration of the risks and benefits associated with the use of chemicals. [ABSTRACT FROM AUTHOR]

This paper concerns problem formulation and solution procedure for inventory planning with Markov decision process models. Using data collected from a large paper manufacturer, we develop inventory policies for the finished products. To incorporate both variability and regularity of the system into mathematical formulation, we analyze probabilistic distribution of the demand, explore its connection with the corresponding Markov chains, and integrate these into our decision making. In particular, we formulate the Markov decision model by identifying the chain''s state space and the transition probabilities, specify the cost structure and evaluate its individual component; and then use the policy-improvement algorithm to obtain the optimal policy. Application examples are provided for illustration. [Copyright &y& Elsevier]

Abstract: Computer-based interventions are being used more in the classroom. Student responses to these interventions often contribute to decisions making regarding important outcomes. It is important to understand the effect of these interventions within the context of the intervention as well as across related context. The current study examined the generalization of math fact fluency gains resulting from a computer-based intervention to paper-and-pencil performance. A total of 31 second grade students completed fluency drills on the computer or with paper and pencil. Pretest–posttest performance on both computer and paper and pencil for all students was evaluated using a doubly multivariate repeated measure ANOVA. Results indicated that gains achieved on the computer did not generalize to paper-and-pencil performance. [Copyright &y& Elsevier]

Abstract: Study results are often presented as abstracts at scientific conferences before publication as full articles in peer-reviewed journals. Given the current emphasis on evidence-based decision-making, it is vital that the peer-reviewed literature represents as broad and un-biased a selection of studies as possible. While the proportion of abstracts published as full papers in the peer-reviewed literature has been extensively studied in human healthcare, no such studies have been published in the field of food safety. The goal of this study was to estimate the proportion published and average time to publication for conference abstracts involving studies of pre-harvest or abattoir interventions to reduce foodborne pathogens. Abstracts were obtained by hand-searching available proceedings between 1995 and 2004 from 10 conferences. Included abstracts were limited to those detailing non-observational, controlled in vivo trials where outcome(s) were measured in livestock, carcasses or eggs. Data on abstract type (≤500 words, >500 words), species, intervention, study type, sample size, number housed together and outcomes were recorded. Four databases (Agricola, CAB, Web of Science, Scholar''s Portal) were searched for published papers corresponding to the conference abstracts using author and intervention/pathogen terms. Time to publication and overall median time to publication were estimated. Chi-squared, logistic regression and survival analyses were used to test for significant differences in proportion published and time to publication between variable levels. Of the 149 abstracts identified, 68 (45.6%) were published in peer-reviewed journals within 4 years. The median time to publication was 13.5 months (range: 0, 72). Abstracts shorter than 1 page were significantly more likely to be published (OR=2.2, 95% CI=1.0, 4.8), and abstracts involving pork or pigs were significantly less likely to be published that those involving poultry (OR=0.4: 0.2, 0.8). Abstracts reporting at least one positive outcome were more likely to be published (OR=2.608: 1.097, 6.196) and were published faster (HR=2.3: 1.1, 4.7). Time to publication decreased with the number of positive outcomes reported (HR=1.1: 1.0, 1.3). Sample size could only be determined for 46% of abstracts, with a median sample size of 9 (range 1–378), and housing was sufficiently described to determine sample size in 35% of pre-slaughter studies. The potential effects of this bias on systematic reviews and uses of interventions could be significant, and thus improvements may be warranted in the proportion of conference abstracts resulting in papers in the peer-reviewed literature. [Copyright &y& Elsevier]

Highlights: [•] Theoretically placing strategic communication management within the DRR paradigm. [•] Defining DR4 in the South African environment. [•] Indicating the need for DR4 communication in the South African environment. [ABSTRACT FROM AUTHOR]

Abstract: Game theory provides a solution to the problem of finding a set of optimal decision-making strategies in a group. However, people seldom play such optimal strategies and adjust their strategies based on their experience. Accordingly, many theories postulate a set of variables related to the probabilities of choosing various strategies and describe how such variables are dynamically updated. In reinforcement learning, these value functions are updated based on the outcome of the player''s choice, whereas belief learning allows the value functions of all available choices to be updated according to the choices of other players. We investigated the nature of learning process in monkeys playing a competitive game with ternary choices, using a rock–paper–scissors game. During the baseline condition in which the computer selected its targets randomly, each animal displayed biases towards some targets. When the computer exploited the pattern of animal''s choice sequence but not its reward history, the animal''s choice was still systematically biased by the previous choice of the computer. This bias was reduced when the computer exploited both the choice and reward histories of the animal. Compared to simple models of reinforcement learning or belief learning, these adaptive processes were better described by a model that incorporated the features of both models. These results suggest that stochastic decision-making strategies in primates during social interactions might be adjusted according to both actual and hypothetical payoffs. [Copyright &y& Elsevier]

In this position paper, we shall undertake a critical scrutiny of the decision analysis (DA) paradigm on the basis of experience we gained from working on the bullwhip effect. We had some success with sorting out the complexities of the bullwhip by using fuzzy numbers in the bullwhip models, and we found out that this points the way to a more viable approach to sort out complex decision problems. As a positive criticism of the DA paradigm we have collected the insights we have gained in an agenda for soft decision analysis (SDA), which we hasten to add is not complete but—hopefully—an opening for focused research and continuing development. [Copyright &y& Elsevier]

Highlights: [•] Consistency in the identification, assessment and management of ED substances is needed. [•] Scientifically robust weight-of-evidence approaches for regulatory decision making are needed. [•] More debates on socioeconomic benefits in the context of decision making are needed. [ABSTRACT FROM AUTHOR]

Background: Electronic data collection is increasingly being used for discrete choice experiments (DCEs).Objectives: To study whether paper or electronic administration results in measurement effects.Methods: Respondents were drawn from the same sample frame (an Internet panel) and completed a nearly identical DCE survey either online or on paper during the same period. A DCE on preferences for basic health insurance served as a case study. We used panel mixed logit models for the analysis.Results: In total, 898 respondents completed the survey: 533 respondents completed the survey online, whereas 365 respondents returned the paper survey. There were no significant differences with respect to sociodemographic characteristics between the respondents in both samples. The median response time was shorter for the online sample than for the paper sample, and a smaller proportion of respondents from the online sample were satisfied with the number of choice sets. Although some willingness- to-pay estimates were higher for the online sample, the elicited preferences for basic health insurance characteristics were similar between both modes of administration.Conclusions: We find no indication that online surveys yield inferior results compared with paper-based surveys, whereas the price per respondent is lower for online surveys. Researchers might want to include fewer choice sets per respondent when collecting DCE data online. Because our findings are based on a nonrandomized DCE that covers one health domain only, research in other domains is needed to support our findings. [ABSTRACT FROM AUTHOR]

Abstract: Land-use change (LUC) estimated by economic models has sparked intense international debate. Models estimate how much LUC might be induced under prescribed scenarios and rely on assumptions to generate LUC values. It is critical to test and validate underlying assumptions with empirical evidence. Furthermore, this modeling approach cannot answer if any specific indirect effects are actually caused by biofuel policy. The best way to resolve questions of causation is via scientific methods. Kim and Dale attempt to address the question of if, rather than how much, market-induced land-use change is currently detectable based on the analysis of historic evidence, and in doing so, explore some modeling assumptions behind the drivers of change. Given that there is no accepted approach to estimate the global effects of biofuel policy on land-use change, it is critical to assess the actual effects of policies through careful analysis and interpretation of empirical data. Decision makers need a valid scientific basis for policy decisions on energy choices. [Copyright &y& Elsevier]

Abstract: Objective: This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality''s Effective Health Care (EHC) program. Study Design and Setting: The EHC program seeks to align its research topic selection with the overall goals of the program, impartially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. Results: A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are “appropriate”) to determine how “important” topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the “potential value and impact” of a comparative effectiveness systematic review. Conclusion: As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthesized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness. [Copyright &y& Elsevier]

Abstract: Several authors have highlighted the role of intuition in expertise. In particular, a large amount of data has been collected about intuition in expert nursing, and intuition plays an important role in the influential theory of nursing expertise developed by Benner [1984. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Addison–Wesley, Menlo Park, CA]. We discuss this theory, and highlight both data that support it and data that challenge it. Based on this assessment, we propose a new theory of nursing expertise and intuition, which emphasizes how perception and conscious problem solving are intimately related. In the discussion, we propose that this theory opens new avenues of enquiry for research into nursing expertise. [Copyright &y& Elsevier]

Abstract: Although children partition by repeatedly halving easily and spontaneously as early as the age of 4, multiplicative thinking is difficult and develops over a long period in school. Given the apparently multiplicative character of repeated halving and doubling, it is natural to ask what role they might play in the development of multiplicative thinking. We investigated this question by examining children''s solutions to folding tasks, which involved predicting the number of equal parts created by a succession of given folds and determining a sequence of folds to create a given number of equal parts. Analyzing a combination of cross-sectional data and case studies from standardized clinical interviews, we found that children were most successful at coordinating folding sequences with multiplicative thinking when they used a conceptualization of doubling based upon recursion. This conceptualization tended to generate more sophisticated solutions. [Copyright &y& Elsevier]

Abstract: The paper of Huang, Keisler and Linkov (HKL) () has motivated us to this note about the relation between ranking procedures and Multi-Criteria Decision Analysis (MCDA) tools. The key concept in the HKL-paper is in our eyes the ‘trade-off’. A ‘trade-off’ seems necessary, when conflicting indicator values are present. HKL stress that the general application of MCDA is hampered by different terminology. We do not claim to have a solution for that problem. Nevertheless, we think that the discussion is worthwhile and this note presents some of our ideas, which basically imply the need of a broadening of the definition of MCDA. [Copyright &y& Elsevier]

Doctors in Star Trek are vital and central characters, often crucial in helping their captains to reach command decisions. They are also interdisciplinarians, performing not only medical tasks but also any form of work related to all fields of biology. Furthermore, these doctors also carry out any required research that pertains to the biological sciences. It is perhaps this unique blend of skills, combined with a fundamental orientation towards humanism and compassion, that leads to their default position, de facto, if not de jure, as the crew's ethics officers, a role that they embrace with as much dedication and zeal as the former Soviet communist political officers/commissars (the Zampolit) did theirs. This paper will show that from the very inception of Star Trek, doctors strictly adhered to deontological tenets which lead them to actively influence command decisions that pertain not only to health, but also to any ethical decisions that may have to be taken by Starfleet officers. This portrayal of future doctors signals the wishes of contemporary audiences: that future doctors remain humane, compassionate and ethical guardian angels, and not only superb medics. [ABSTRACT FROM AUTHOR]

The CPR school has successfully rebutted Hardin''s pessimistic Tragedy of the Commons model. However, in recent years, critics have focussed on the inward orientation and lack of contextual analysis characterising the writings of the CPR school.Oakerson [A Model for the analysis of common property problems. Working Paper R86-13. Workshop in Political Theory and Policy Analysis, Indiana University, 1986] and Ostrom [Governing the Commons. Cambridge, Cambridge University Press, 1990] have detailed the list of variables that have to be studied to understand the mechanics of collective action. However, these factors are internal to the community. Recent critics'' point out that the actions of individual agents are also influenced by the alternatives embedded outside the system. These variables are collectively labelled contextual factors.In our paper, we have analysed the case of a fishermen''s cooperative in the Calcutta Metropolitan District to show how the historic and economic context shapes targets of resource users and affects the feasibility of alternative courses to achieve the target by determining opportunity and transaction costs of actions. This indicates the importance of contextual factors in explaining the formation and evolution of the resource regime. [Copyright &y& Elsevier]

Objectives: To synthesize the findings of cognitive interview and usability studies performed to assess the measurement equivalence of patient-reported outcome (PRO) instruments migrated from paper to electronic formats (ePRO), and make recommendations regarding future migration validation requirements and ePRO design best practice.Methods: We synthesized findings from all cognitive interview and usability studies performed by a contract research organization between 2012 and 2015: 53 studies comprising 68 unique instruments and 101 instrument evaluations. We summarized study findings to make recommendations for best practice and future validation requirements.Results: Five studies (9%) identified minor findings during cognitive interview that may possibly affect instrument measurement properties. All findings could be addressed by application of ePRO best practice, such as eliminating scrolling, ensuring appropriate font size, ensuring suitable thickness of visual analogue scale lines, and providing suitable instructions. Similarly, regarding solution usability, 49 of the 53 studies (92%) recommended no changes in display clarity, navigation, operation, and completion without help. Reported usability findings could be eliminated by following good product design such as the size, location, and responsiveness of navigation buttons.Conclusions: With the benefit of accumulating evidence, it is possible to relax the need to routinely conduct cognitive interview and usability studies when implementing minor changes during instrument migration. Application of design best practice and selecting vendor solutions with good user interface and user experience properties that have been assessed in a representative group may enable many instrument migrations to be accepted without formal validation studies by instead conducting a structured expert screen review. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Biobased chemistry has gained interest and has the potential to tackle some of the sustainability challenges the chemical industry must endure. Sustainability impacts need to be evaluated and monitored to highlight the advantages and pitfalls of different biobased routes over the entire product life cycle. This study aims for expert consensus concerning indicators needed and preferred for sustainability analysis of biobased chemicals in Europe. Experts are consulted by means of a Delphi method with stakeholders selected from three core groups: the private, public and academic sector. Best-Worst Scaling (BWS) is performed to gather data on the prioritization of the sustainability indicators per respondent. Afterwards, Multi-Criteria Decision Analysis (MCDA) is used to develop a consensus ranking among the experts. The results show that GHG emissions , market potential and acceptance of biobased materials are deemed the most crucial indicators for respectively environmental, economic and social sustainability. Expert consensus is positive in all three sustainability domains, with the strongest consensus measured for environmental sustainability showing a median Kendall's τ of 0.63 (τ ranging from -1 to 1) and the weakest consensus found within social sustainability showing a median Kendall's τ of 0.50. Further research can apply the ranked indicators on specific case studies to evaluate the practicability of the defined indicator set. [ABSTRACT FROM AUTHOR]

Industrial technologies have evolved towards circular-oriented manufacturing. New approaches in the management of production systems are needed to guarantee the success of such a circular approach. This paper identifies three research questions related to the complexities of decision-making within CEs and defines the concept of Green Gateways in the circular economy. A Green Gateway is a type of decision that supports to realizing the full potential of products and materials. Indeed, the potential value of products and materials must be assessed and leveraged and the concept of Green Gateway will be useful to identify common decisions and to define a common framework in the future. The integration of digital information and digital twins of products, processes, and circular value and supply chains emerges as a key factor in guiding decision-makers effectively, especially for Green Gateways where adequate information, tools and methods must be used to manage value retention options, product flows, production and pricing decisions jointly with the multiple objectives of profitability and sustainability. Additionally, this paper explores specific examples of circular economy use cases, drawing attention to their similarities and highlighting key insights. [ABSTRACT FROM AUTHOR]

Fetuses at low gestational age limit of viability, neonates with life threatening or life limiting congenital anomalies and deteriorating acutely ill newborn babies in intensive care, pose taxing ethical questions on whether to forego or stop treatment and allow them to die naturally. Although there is essentially no ethical difference between end of life decision between neonates and other children and adults, in the former, the fact that we are dealing with a new life, may pose greater problems to staff and parents. Good communication skills and involvement of all the team and the parents should start from the beginning to see which treatment can be foregone or stopped in the best interests of the child. This article deals with the importance of clinical ethics to avoid legal and moral showdowns and discusses accepted moral practice in this difficult area. [ABSTRACT FROM AUTHOR]

Introduction : In pursuit of sustainability goals, many cities are introducing measures to increase the usage of bicycles as a means of transportation. City planners aim to ensure that this increase does not lead to an increase in crashes, but must make corresponding infrastructure decisions with limited information. Sufficient data to perform a statistical analysis of location-specific crash frequencies is rarely available. For example, only approximately 10% of all bicycle crashes are reported to the police (Shinar et al., 2018). Therefore, urban planners often rely on expert opinion, which may lead to suboptimal prioritization and realization of infrastructure improvements. Method: This paper demonstrates how surveys on bicycle crashes can be used to aid urban planners in making infrastructure decisions. In addition to confirming the location and characteristics of reported crashes, surveys can uncover characteristics of crashes that are not reported to the police, situations in which a crash almost occurred, and locations perceived by cyclists to be dangerous. Surveys also allow urban planners to investigate non-infrastructure related causes of crashes, such as the frequency with which individual cyclists use other modes of transportation. Practical Applications: The usefulness of surveys in the determination of urban cycling safety is demonstrated in this paper through analysis of survey results from the city of Zurich in 2018. [ABSTRACT FROM AUTHOR]

• Healthcare demand change is investigated from the view of the economic and societal dynamics. • The differentiated risk attitudes of individuals and groups are considered. • An extended PageRank algorithm are applied to determine the weights of experts. • An improved GLDS method is developed to prioritize healthcare risk. • A conflict analysis is established to show PIR between failure modes. Faced with backward and uneven economic conditions and an irrational and increasingly inequitable social structure, healthcare disparities are widening and the healthcare inequalities are expanding. This can lead to an increasing public demand for healthcare services, posing unprecedented risk, such as resource shortages, quality deterioration and rising healthcare costs. By identifying, managing, and optimizing the aforementioned risks within the healthcare system, it helps the healthcare system better address the challenges of expanding healthcare demands under evolving economic and social structure. To achieve this, this paper employs failure mode and effects analysis (FMEA) to identify severe failure modes in healthcare services. However, traditional FMEA methods possess limitations in assessing the dynamics of trust relationships and interaction effects among experts within social networks. Therefore, this paper proposes an improved gained and lost dominance score (GLDS) based social network decision-making method considering risk attitudes for FMEA to prioritize failure modes in healthcare services. First, transform linguistic risk assessment information from an interdisciplinary team of experts based on probabilistic linguistic term sets handle uncertain efficiently. Meanwhile, experts' influence is reflected by an extended PageRank algorithm with trust degrees based on social networks analysis. Next, an improved GLDS method considering the differentiated risk attitudes of individuals and groups is developed to prioritize failure modes. Especially, to solve the problems of soft preference and incomparability relation among failure modes, which are ignored by the traditional GLDS method, a conflict analysis is established to determine the preference, indifference, and incomparability relations. Finally, the practicality of the proposed method is illustrated by the healthcare service risk case in the emergency department and the effectiveness of the developed method is validated by comparison and sensitivity experiments. The results suggest that failure to update labels showing patient severity promptly is the most dangerous. In addition, it would be more economically efficient to analyze the non-comparable failure modes facing different risk factors. [ABSTRACT FROM AUTHOR]

In the rapidly evolving field of Artificial Intelligence (AI), its application in industrial settings, particularly for anomaly detection in time series data, poses unique challenges. Current methods often lack a comprehensive understanding of the trade-offs involved in achieving optimal model performance, data preparation effort, and prediction quality. To bridge this gap, this paper presents an adaptive approach to address these challenges, focusing on making conscious decisions about mentioned trade-offs. Inspired by the principles of the Iron Triangle from product engineering, our methodology introduces a novel "AI triangle" with dimensions of Speed, Effort, and Quality. We applied this methodology to a real-world case study involving anomaly detection in a constrained hardware environment in the context of a forming production process. The results highlight the effectiveness of our approach in achieving a practical balance between speed, effort, and quality constraints for implementing AI in an industrial setting. This paper provides valuable insights into the considerations and trade-offs necessary for the successful deployment of AI in manufacturing and other similar industrial applications. [ABSTRACT FROM AUTHOR]

To investigate the rate of registered protocols published as research papers as a measure of publication bias, and the concordance rates of the primary outcomes between research protocol and published papers as a measure of selective outcome reporting bias in randomized controlled trials (RCTs) related to rehabilitation. Protocols related to RCTs were extracted from electronic databases, the University Hospital Medical Information Network (UMIN), International Standard Research Clinical Trial Number (ISRCTN), ClinicalTrials.gov, and MEDLINE. Published papers were retrieved from MEDLINE. The inclusion criteria were as follows: (1) initial registration (UMIN, ISRCTN, ClinicalTrials.gov) within the designated period; (2) published as a paper from a research protocol in MEDLINE (PubMed); and (3) written in English or Japanese. The search period was from January 1, 2013, to December 31, 2020. The outcome of this study was set as the rate of published papers that were consistent with the extracted research protocol and the concordance rate between the primary outcomes in published papers and in protocols. The concordance rate of the primary outcomes was evaluated by checking whether the description in the research protocol matched that in the paper's abstract and main text. Out of the 5597 research protocols registered, only 727 were published (13.0%). The concordance rates of the primary outcomes were 48.7% and 72.6% in the abstract and main text, respectively. This study revealed major discrepancies between the number of research protocols and published papers, and difference of description regarding the primary outcomes in published papers which were already defined in the research protocols. [ABSTRACT FROM AUTHOR]

Abstract: The Nutrition Care Process and Model (NCPM) provides registered dietitian nutritionists (RDNs) and dietetic technicians, registered (DTRs) a framework to recognize, diagnose, and intervene upon nutrition-related health concerns. Within the NCPM, nutrition assessment is essential to develop a comprehensive evaluation of the client’s nutrition history. The application of critical thinking skills to nutrition assessment is imperative to ensure appropriate acquisition and interpretation of data. The Academy of Nutrition and Dietetics’ Career Development Guide, adapted from the Dreyfus Model of Skill Acquisition, illustrates the progression of critical thinking skills as RDNs and DTRs gain knowledge and experience with practice. The Career Development Guide is characterized by the transition through the following stages: novice, beginner, competent, proficient, and advance practice/expert. The foundation of dietetics knowledge is obtained during the novice and beginner stages. Throughout, the primary objective is introduction of the NCPM and nutrition assessment theory via dietetics education and the application of nutrition assessment in supervised practice. Next, RDNs and DTRs transition to the competent stage of practice. During this phase, entry-level knowledge and skill are applied to patient care settings, and critical thinking skills develop as RDNs and DTRs gain experience. Subsequently, RDNs and DTRs move to the proficient stage as the ability to prioritize attention, generalize, apply problem-solving skills to new scenarios, and identify innovative solutions develops. Some RDNs and DTRs may transition to the advance practice/expert stage, during which critical thinking becomes intuitive. Critical thinking skills are essential to ensure diagnostic accuracy; however, more research is needed to further describe progression of critical thinking skills among RDNs and DTRs. [Copyright &y& Elsevier]