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Education is necessary for human development, especially at a time when the conventional labor market is in decline, yet the challenges of child marriage remain unresolved. The study examined how Northern Ghana's rural folks handle calls for marriage and higher education. A case study design was implemented within the qualitative method to achieve the stated goal. Results revealed that factors influencing marriage and education choices include poor educational background, peer influence, teenage pregnancy, financial constraints, and parental pressure. There was a greater interest in marriage than in higher education. The institution of marriage is cheap compared to the cost of tertiary education, combined with economic and social advantages. This negatively affects education decisions. Results also showed that higher education helps build better homes and keeps marital households financially secure. However, females are less likely to marry and have children than their male counterparts. The results uncovered elements of incrementalism in the decisions of Senior High School graduates. This is reflected in limited expert advice, limited consideration of alternatives, and more focus on personal experience and feelings related to problem-solving and troubleshooting. However, when confronted with the consequences of their decisions, the study detected traces of rationality and incrementalism. [ABSTRACT FROM AUTHOR]

Dopamine (DA) and norepinephrine (NE) have been repeatedly implicated in neuropsychiatric vulnerability, in part via their roles in mediating the decision-making processes. Although two neuromodulators share a synthesis pathway and are coactivated under states of arousal, they engage in distinct circuits and modulatory roles. However, the specific role of each neuromodulator in decision-making, in particular the exploration–exploitation tradeoff, remains unclear. Revealing how each neuromodulator contributes to exploration– exploitation tradeoff is important in guiding mechanistic hypotheses emerging from computational psychiatric approaches. To under- stand the differences and overlaps of the roles of these two catecholamine systems in regulating exploration, a direct comparison using the same dynamic decision-making task is needed. Here, we ran male and female mice in a restless two-armed bandit task, which encourages both exploration and exploitation. We systemically administered a nonselective DA antagonist (flupenthixol), a nonselective DA agonist (apomorphine), a NE beta-receptor antagonist (propranolol), and a NE beta-receptor agonist (isoproterenol) and examined changes in exploration within subjects across sessions. We found a bidirectional modulatory effect of dopamine on exploration. Increasing dopamine activity decreased exploration and decreasing dopamine activity increased exploration. The modulatory effect of beta-noradrenergic receptor activity on exploration was mediated by sex. Reinforcement learning model parameters suggested that dopamine modulation affected exploration via decision noise and norepinephrine modulation affected exploration via sensitivity to outcome. Together, these findings suggested that the mechanisms that govern the exploration–exploitation transition are sensitive to changes in both catechol- amine functions and revealed differential roles for NE and DA in mediating exploration. [ABSTRACT FROM AUTHOR]

Background: Informal abortions, commonly known as unsafe abortions, refer to all induced abortions that occur outside of formal healthcare settings conducted without the assistance of a licensed, trained healthcare provider. Despite the legalization of safe induced abortion care services, informal abortions continue to be among the major causes of maternal mortality and morbidity among young women in Rwanda living in rural areas with limited or no access to safe abortion care services. The purpose of this qualitative study was to gain an in-depth understanding of the lived experience of seeking informal abortions from the perspective of young women in rural Rwanda and to identify the underlying factors for these women seeking abortion care services outside of the formal healthcare setting. Methods: This qualitative study was guided by a descriptive phenomenology in rural Rwanda, specifically in a selected district located in the Northern Province of Rwanda. Ten young women between 18 and 24 years of age, who had the experience of seeking informal abortion services from informal providers within the last eight years participated in audio-recorded, in-depth, face-to-face interviews. Collected data were analyzed using Colaizzi's (1978) seven steps of the phenomenological method. Results: The study found that young Rwandan women still seek unregulated abortions to end their unintended pregnancies due to limited access to or utilization of sexual reproductive health and rights services. Among the reasons for seeking abortion care services outside of the formal healthcare setting in Rwanda were sociocultural and economic factors and the stigma associated with terminating unintended pregnancies before marriage. Conclusion: In light of the findings of this study, the authors recommend the Ministry of Health and its stakeholders to expand access to comprehensive adolescent and youth-friendly reproductive health and reproductive rights while addressing the sociocultural stigma through public awareness and economic factors that play a big role in unregulated abortions rather than safe abortion care services. [ABSTRACT FROM AUTHOR]

The global construction industry is experiencing significant growth, driving the demand for building floor area. However, this expansion comes with substantial environmental consequences, including high‐energy consumption and greenhouse gas (GHG) emissions, together with economic and social impacts. To address these challenges, this research aims at providing designers and decisions‐makers with an approach that will aid the quantification of those impacts relevant for the sustainability performance of flooring systems. A holistic sustainability assessment was performed considering economic, environmental, and social aspects using the Integrated Value Model for Sustainability Evaluations. This study focused on various flooring typologies, including reinforced concrete (RC) and fiber‐RC (FRC) slabs with solid and waffle (for RC solution) configurations. The most representative criteria and indicators of sustainability for concrete column‐supported slabs were identified, measured, and weighted—aggregated in a decision‐making tree—in order to obtain a representative a sustainability index (SI) for each alternative. The results of the analysis evidence that the RC solid slab has a higher overall SI than the other alternatives, the FRC alternatives performing with similar SI of that quantified for the RC solid slab solution and the RC waffle slab being that with the lower sustainability performance among those flooring systems considered in this study. The results of a sensitivity analysis showed that those alternatives using FRC have potential for improving the overall sustainability performance. [ABSTRACT FROM AUTHOR]

In today's rapidly evolving technological landscape, this study investigates the impact of new technology on organizational work dynamics. By integrating the Job Demands-Resources theory and the Episodic Process Model, we examine the cognitive mechanisms that influence task performance during decision-making episodes. Our research focuses on episodic job demands and resources, emphasizing the mediating role of task absorption in the relationship between these factors and task performance. Our findings reveal that episodic job resources positively affect task absorption and performance, while job demands moderate the relationship between job resources and task absorption. Employing the Beer Distribution Game alongside neuroscience-based eye-tracking techniques, we analyze visual attention dynamics during decision-making episodes, providing novel insights into the interplay between task absorption and task performance. Theoretically, our study highlights the significance of task absorption in understanding how episodic job resources impact decision-making performance. Practically, our results advocate for the implementation of decision-making-focused skills development through physiological measures such as neurofeedback training programs. This research underscores the importance of individual time management in enhancing task performance, contributing to a nuanced understanding of job resources, job demands, and task absorption in the context of technological transformation. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusions Implications to Patient Care Reporting Method Patient or Public Contribution To capture older people's, informal caregivers' and health professionals' ideas on potential interventions for empowering older people and informal caregivers in transitional care decision‐making.A descriptive qualitative design was adopted.The study was conducted between February and May 2022 in the region of Flanders, Belgium, as part of the TRANS‐SENIOR consortium's collaborative research. Data were collected using focus groups, including older people, informal caregivers and healthcare professionals involved in any physical relocation of the older person across home, hospital or nursing home settings. Thematic data analysis was performed based on Braun and Clarke's six‐step method.A total of 40 people participated in the focus groups. Four main themes were identified, which describe ideas on how to empower older people and informal caregivers in transitional care: Providing clear and timely information, preparing people for what is to come, person‐centredness and providing professional and peer support for informal caregivers.Healthcare (professionals) should facilitate older people's and informal caregivers' empowerment in transitional care decision‐making by setting them at the core and inception of the decision‐making process. While informal caregivers support their loved ones in decision‐making processes, they should also be supported and monitored for burdensome issues.Multicomponent, well‐planned and personalised interventions are needed to empower older people and informal caregivers in transitional care decision‐making. The ideas raised by all stakeholders who participated in this study can inform these interventions.Adhered to consolidated criteria for reporting qualitative research checklist.Organisations advocating for the interests of older people and informal caregivers played a pivotal role in shaping the TRANS SENIOR project. Furthermore, the study benefitted from the collaborative input of AGE Platform Europe, which amplified the voices and representation of older people during the project design phase. [ABSTRACT FROM AUTHOR]

This study explores the relationship between humor, creativity, rationality, intuitiveness, and decision-making quality, all of which are vital in organizational management and success. Despite the importance attached to decision-making, prior research has not fully addressed how humor and creativity interact with rationality. Drawing from psychology, cognitive science, and management studies, we investigate how humor and creativity jointly influence cognitive reflection and decision quality. Using a sample of 998 participants and employing a mediating-moderation PROCESS model, our findings indicate that rational individuals tend to make higher-quality decisions, with affiliative humor mediating this relationship. Furthermore, we observed that employees' creativity levels moderated this relationship, especially among rational employees with high creativity, who made higher-quality decisions. These findings highlight the interconnectedness of humor, creativity, and rationality in decision-making processes, offering practical implications for organizational behavior and management practices. Understanding this interplay can provide a nuanced approach to enhancing decision-making processes in management, emphasizing the value of humor in organizational contexts. [ABSTRACT FROM AUTHOR]

This study utilized eye-tracking techniques to investigate decision-making behavior in intertemporal loss scenarios under both time pressure and no time pressure conditions. Results revealed shorter decision-making times and decreased large later (LL) option selection frequency under time pressure. Participants under time pressure exhibited reduced Mean Fixation Duration (MFD) and Search Measure (SM) values, indicating altered information processing. Mediation analyses confirmed that task choice outcomes were influenced by SM and MFD, suggesting a shift towards heuristic decision-making under time pressure. [ABSTRACT FROM AUTHOR]

Background: Regularly measuring family satisfaction with intensive care unit (ICU) experience is crucial for ensuring high‐quality care and identifying areas for improvement. This study aimed to evaluate family satisfaction with the ICU in Saudi Arabia. Methods: A cross‐sectional survey was conducted among 248 family members of patients admitted to various ICUs. The survey assessed family satisfaction via a validated questionnaire, the Critical Care Family Satisfaction Survey (CCFSS), which includes five subscales: assurance, information, comfort, proximity, and support. Demographic data were also collected. Descriptive and inferential statistics were calculated. Results: The demographic distribution revealed that a majority of the participants were female (70.97%, n = 176), with the relationships with the patients predominantly being parents (41.94%, n = 104) or offspring (33.87%, n = 84). The overall satisfaction score was 3.79 ± 1.26, with 66.13% of the participants reporting high satisfaction, 20.97% reporting intermediate satisfaction, and 12.90% reporting low satisfaction. The mean subscale scores were as follows: assurance (3.82 ± 1.2), information (3.83 ± 1.25), comfort (3.81 ± 1.27), proximity (3.72 ± 1.28), and support (3.78 ± 1.28). The highest satisfaction scores were observed for sharing in decisions, noise levels, and staff honesty, whereas the lowest scores were for visiting hours flexibility, transfer preparation, and staff responsiveness. Males reported significantly greater satisfaction (4.24 ± 1.20) than females did (3.61 ± 1.11, p = 0.007). Conclusions: This study revealed moderate to high levels of family satisfaction with the ICU, with significant differences based on sex. The findings highlight the importance of effective communication, family involvement in decision‐making, and supportive ICU policies. ICUs should regularly assess family satisfaction and use the results to guide quality improvement efforts, with a focus on areas with lower satisfaction scores. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Prostate and breast cancer screening are prevalent among older adults, even among those unlikely to benefit. We aimed to evaluate why older adults stop cancer screening, including the role of physician recommendations.We used nationally representative data from the 2019 Medicare Current Beneficiary Survey (MCBS). We included women aged 76 and older without a history of breast cancer and men aged 71 and older without a history of prostate cancer. The primary outcome was reason for discontinuing screening, categorized as follows: (1) physician recommendation against screening; (2) absence of a recommendation to screen; and (3) patient‐driven reason, such as patient preferences or beliefs. We evaluated reasons for screening discontinuation by health status and educational attainment using age‐stratified multinomial logistic regression.The sample included 7350 participants representing a weighted population of 22,498,715. Overall, 53% of women underwent screening mammography in the past year or intended to continue screening. Among those who stopped screening, 5% reported a recommendation to stop screening from their doctor, 48% reported no recommendation, and 32% reported a patient‐driven reason for cessation. Findings did not differ by educational attainment or health status, including among the oldest patients. For men, 61% were screened with PSA in the past year or intended to continue. Among those who stopped, 3% reported a recommendation against screening, 54% reported no recommendation, and 27% reported a patient‐driven reason for cessation. Men with higher educational attainment were more likely to report that their physician recommended against screening (4% vs. 1%, p = 0.01) and that their doctor did not recommend screening (58% vs. 47%, p = 0.01). Reasons for screening cessation did not differ by health status, including among the oldest patients.Cancer screening remains common, even among those with limited potential for benefit, but discussions around screening cessation are rare. Improving communication between patients and physicians may improve screening decision quality. [ABSTRACT FROM AUTHOR]

As marine spatial planning becomes established, attention is turning to the influence of plans on coastal and marine decisions. A study of marine licencing in the East Marine Plan Areas in England, UK, revealed that little reference is being made to plans. A technical approach to licencing has persisted despite the broader perspectives that spatial planning can offer. Also, plans may not be sufficiently specific and tested to guide licencing. Reforms to integrate planning and decision-making are needed, including plans designed to help with setting conditions and spatially allocating marine uses. Increased dialogue between planners and decision-makers is also needed. [ABSTRACT FROM AUTHOR]

This study uses the newsvendor problemto investigate the correlations between thinking orientation, overconfidence, and economic outcome. We aim to shed light on possible interconnections between these variables and extend the existing conceptual models of thinking orientation and overconfidence. To test the conceptual model and the corresponding hypotheses empirically, we employed a laboratory experiment with 50 hypothetical decision periods in which 142 participants ordered a highly profitable product. We found compelling evidence that suggests overprecision as themediating variable between thinking orientation and the economic outcome. Furthermore, this research offers some practical implications. [ABSTRACT FROM AUTHOR]

Background: In Europe and elsewhere in the world, activities are taking place to improve the awareness of children and adolescents (hereinafter: adolescents) regarding their rights and obligations in autonomous decision-making about their own medical treatment and participation in clinical research. Methods: The cross-sectional survey of adolescents was carried out using an anonymous online questionnaire. We obtained consent from the Commission of the Republic of Slovenia for Medical Ethics. Participating young people were invited through the network of primary and secondary schools, the Society of Dystrophy of Slovenia and through the dissemination of electronic messages. The online questionnaire was open from April 25 to May 6, 2023. Young people aged 13 to 20 joined the survey. The association between several factors and awareness of the minimum age limit was tested by univariate logistic regression. All statistical testing was performed at a significance level of 0.05. Results: The responses of 458 respondents were analysed, of which 281 were male. Only 8.3% of participating adolescents knew the age limit set by law for autonomous decision-making about medical treatment at 15 years old. Most answered that a medical institution should inform them about their rights (62.4%). Only 5.02% responded that they do not need their parents' consent when making decisions; 2.6% of respondents answered that they autonomously decided to undergo treatment without their parents' knowledge. The majority obtained information about treatment from a doctor (more than 70%); 42.8% were in favour of new forms of treatment, especially chronic patients (more than 70%); 44.8% had already heard about clinical research, most of them through the media (55.4%); 70% of the respondents answered correctly about making an autonomous decision about participation in research at the age of 18. About three-quarters (75.6%) of respondents who had heard of clinical research believe that an individual should be paid for participating. Conclusions: Our research showed insufficient awareness of the age limit of adolescents regarding medical treatment decisions and clinical research. The prevailing view is that health professionals should inform young people more about their rights. Most adolescents believe they should be paid to participate in clinical research. [ABSTRACT FROM AUTHOR]

Background: In basketball training, self-evaluation plays a crucial role in the decision-making and execution of movements of players. The self-evaluation of players is influenced by their perception of own basketball ability and selfconfidence state. This study aimed to explore potential discrepancies between self-confidence levels of players and their decision-making performance, while also characterizing different types of players. Method: Data was collected from 20 youth basketball players who participated in a decision-making video task and a self-confidence assessment. Based on data from their self-confidence and decision-making awareness assessment, the K-means cluster analysis was used to categorize the players into different groups. Then, ANOVA and post hoc Scheffe test were conducted to compare these clusters. Results: The cluster analysis identified four distinct profiles of players and the results of the ANOVA and post hoc Scheffe tests revealed significant differences between the four clusters. The "High Self-confidence & Low Decision-making Awareness" players might display an overconfident mindset, while the "High Self-confidence & High Decision-making Awareness" players potentially demonstrated the better performance and maintained a consistent and confident attitude. The "Low Self-confidence & High Decision-making Awareness" players appeared to lack confidence and needed to foster greater faith in their abilities. Finally, the "Low Self-confidence & Low Decision-making Awareness" players required a long-term and comprehensive training program to improve their skills. Discussion: These preliminary findings informed the development of a selfevaluation matrix, designed to help coaches better understand player profiles and design tailored interventions. Moreover, this study contributes on sport calibration and enhances understanding of the behavioral and psychological states of players. [ABSTRACT FROM AUTHOR]

Objective: The incidence rates of dementia, mild cognitive impairment, and cancer increase with age, posing challenges to affected individuals and their families. However, there are currently no clear cancer screening guidelines for individuals with cognitive impairment. This study analyzed the impact of carer health literacy on screening behaviors in this population. Methods: We conducted a postal follow‐up survey, associated with the National Center for Geriatrics and Gerontology—Life STORIES of People with Dementia, that targeted primary carers to assess their reports regarding patient attendance at regular cancer screenings recommended by the Japanese Ministry of Health, Labor and Welfare, over the preceding 2 years. Screening rates were compared between the memory clinic cohort and the national average, and the influence of carer health literacy level on screening was analyzed. Results: Among the 826 total individuals analyzed, the memory clinic cohort exhibited lower breast cancer screening rates, at 11% among female patients aged 65–74 years versus the national average of 32%. Higher health literacy among carers was significantly associated with increased screening. For female patients, carers with high levels of communicative health literacy were more likely to ensure that patients attended screenings for gastric (adjusted odds ratio [AOR], 1.77; 95% confidence interval [CI], 1.03–3.04), colorectal (AOR, 1.70, 95% CI 1.08–2.70), and breast cancers (AOR, 3.08; 95% CI, 1.40–6.76). Among the male patients, high communicative health literacy was associated with increased lung cancer screening attendance (AOR, 1.82; 95% CI, 1.11–2.99). Conclusions: Our research highlights a notable gap in cancer screening attendance between individuals with cognitive impairment and the general population, potentially arising from the intricate nature of screening procedures and the extensive burden on carers. More informed decisions and increased screening rates can be achieved through patient‐centric communication strategies that accommodate the cognitive abilities of patients, ensuring the comprehensibility and accessibility of health‐related information. [ABSTRACT FROM AUTHOR]

Introduction: Clinical decision‐making in oncology is a complex process, with the primary goal of identifying the most effective treatment tailored to individual cancer patients. Many factors influence the treatment decision: disease‐ and patient‐specific criteria, the increasingly complex treatment landscape, market authorization and drug availability, financial aspects, and personal treatment expertise. In the domain of genitourinary cancers, particularly prostate cancer, decision‐making is challenging. Despite the prevalence of this malignancy, there are few in‐depth explorations of these factors within real‐world scenarios. Understanding and refining this intricate decision‐making process is essential for future successful clinical decisions and the integration of computerized decision support into clinicians' workflows. Aim: The objective of this study is to improve the current knowledge base and evidence of the factors that influence treatment decision‐making for patients with genitourinary cancers. Methods: Assessment of how routine treatment decisions are made for genitourinary cancers was performed by a mixed‐methods study, encompassing field observations and focus group discussions. Results: In total, we identified 59 factors that influence clinical decision‐making in oncology, specifically for genitourinary and prostate cancer. Of these, 23 criteria can be classified as decision‐maker‐related criteria encompassing personal, cognitive, and emotional attributes and factors of both, healthcare professionals and patients. Moreover, 20 decision‐specific criteria have been identified that refer to clinical and disease‐related factors, followed by 16 contextual decision factors that describe the relevant criteria introduced by the specific circumstances and environment in which the treatment decision is made. Conclusion: By presenting an exhaustive set of decision factors and providing specific examples for genitourinary cancers, this observational study establishes a possible framework for a better understanding of decision‐making. Moreover, we specify and expand the set of decision factors, while emphasizing the importance of cognitive, emotional, and human factors, as well as the quality and accessibility of decision‐relevant information. [ABSTRACT FROM AUTHOR]

Autonomous navigation systems often struggle in dynamic, complex environments due to challenges in safety, intent prediction, and strategic planning. Traditional methods are limited by rigid architectures and inadequate safety mechanisms, reducing adaptability to unpredictable scenarios. We propose SafeMod, a novel framework enhancing safety in autonomous driving by improving decision-making and scenario management. SafeMod features a bidirectional planning structure with two components: forward planning and backward planning. Forward planning predicts surrounding agents' behavior using text-based environment descriptions and reasoning via large language models, generating action predictions. These are embedded into a transformer-based planner that integrates text and image data to produce feasible driving trajectories. Backward planning refines these trajectories using policy and value functions learned through Actor–Critic-based reinforcement learning, selecting optimal actions based on probability distributions. Experiments on CARLA and nuScenes benchmarks demonstrate that SafeMod outperforms recent planning systems in both real-world and simulation testing, significantly improving safety and decision-making. This underscores SafeMod's potential to effectively integrate safety considerations and decision-making in autonomous driving. [ABSTRACT FROM AUTHOR]

The ability and rapid access to execution data and information in manufacturing workshops have been greatly improved with the wide spread of the Internet of Things and artificial intelligence technologies, enabling real-time unmanned integrated control of facilities and production. However, the widespread issue of data quality in the field raises concerns among users about the robustness of automatic decision-making models before their application. This paper addresses three main challenges relative to field data quality issues during automated real-time decision-making: parameter identification under measurement uncertainty, sensor accuracy selection, and sensor fault-tolerant control. To address these problems, this paper proposes a risk assessment framework in the case of continuous production workshops. The framework aims to determine a method for systematically assessing data quality issues in specific scenarios. It specifies the preparation requirements, as well as assumptions such as the preparation of datasets on typical working conditions, and the risk assessment model. Within the framework, the data quality issues in real-time decision-making are transformed into data deviation problems. By employing the Monte Carlo simulation method to measure the impact of these issues on the decision risk, a direct link between sensor quality and risks is established. This framework defines specific steps to address the three challenges. A case study in the steel industry confirms the effectiveness of the framework. This proposed method offers a new approach to assessing safety and reducing the risk of real-time unmanned automatic decision-making in industrial settings. [ABSTRACT FROM AUTHOR]

The ability to coordinate actions is of vital importance for group-living animals, particularly in relation to travel. Groups can only remain cohesive if members possess a cooperative mechanism to overcome differences in individual priorities and social power when coordinating departures. To better understand how hominids achieve spatio-temporally coordinated group movements, we investigated vocally initiated group departures in three habituated groups of western gorillas (Gorilla gorilla) in the Central African Republic. The large sexual dimorphism of gorillas has led to the untested assumption that the silverback males are the sole decision-makers in gorilla groups, although there are also observations that suggest otherwise. To address this, we analysed the direction and timing of group departures and found that high-ranking individuals (silverbacks and high-ranking females) were more successful in indicating the direction of future travel than others, but that the timing of departure was the apparent result of a cumulative vocal voting process among all adult group members. Our findings illustrate that even in species with a large sexual size dimorphism, travel decisions can be taken collectively via a consensus-building process. [ABSTRACT FROM AUTHOR]

AbstractThis study explores the often-overlooked phenomenon of immobility within migration studies, focusing on the Governador Valadares Region of Brazil. Despite the region’s history of significant outmigration to the United States, there needs to be more investigation into why some young people remain in their communities instead of pursuing the American Dream. Using ethnographic methods, the study search surpasses simplistic dichotomies of mobility-immobility, recognizing that decisions to leave or stay are complex and influenced by various interconnected factors. By employing the perspectives of ‘linked lives’ and ‘life-course situatedness’, the study provides nuanced insights into how individual choices are affected by familial, social, and economic contexts over time. The findings shed light on the diverse experiences of young people while revealing the carry of involuntary immobility. Furthermore, it contests assumptions that remaining in a particular location signifies immobility or a lack of ambition. It contributes to a more nuanced comprehension of migration agency and well-being, underscoring the multifaceted nature of aspirations and capabilities. The results illuminate the intricate interplay between personal aspirations and the environment in shaping migration decisions, emphasizing the significance of viewing (im)mobility as a relational and temporally situated phenomenon. [ABSTRACT FROM AUTHOR]

The visual world is richly adorned with texture, which can serve to delineate important elements of natural scenes. In anesthetized macaque monkeys, selectivity for the statistical features of natural texture is weak in V1, but substantial in V2, suggesting that neuronal activity in V2 might directly support texture perception. To test this, we investigated the relation between single cell activity in macaqueV1 and V2 and simultaneouslymeasured behavioral judgments of texture. We generated stimuli along a continuumbetween naturalistic texture and phase-randomized noise and trained two macaque monkeys to judge whether a sample texture more closely resembled one or the other extreme. Analysis of responses revealed that individual V1 and V2 neurons carried much less information about texture naturalness than behavioral reports. However, the sensitivity of V2 neurons, especially those preferring naturalistic textures, was significantly closer to that of behavior comparedwith V1. The firing of both V1 andV2 neurons predicted perceptual choices in response to repeated presentations of the same ambiguous stimulus in one monkey, despite low individual neural sensitivity. However, neither population predicted choice in the secondmonkey. We conclude that neural responses supporting texture perception likely continue to develop downstreamof V2. Further, combined with neural data recordedwhile the same twomonkeys performed an orientation discrimination task, our results demonstrate that choice-correlated neural activity in early sensory cortex is unstable across observers and tasks, untethered from neuronal sensitivity, and therefore unlikely to directly reflect the formation of perceptual decisions. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsTo explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the subacute phase of stroke rehabilitation.An explorative qualitative design was used. Individual interviews were conducted with 10 stroke survivors (4 women and 6 men, mean age 68 years) 4 weeks after their stroke, and follow-up interviews were conducted with 6 of them after 10 weeks. The interview settings were the patient’s home during their home rehabilitation, an inpatient and an outpatient rehabilitation unit. A reflexive thematic analysis was performed.Four themes were identified: discharge as a critical point for participation, describing a stressful time with varying involvement; supportive actions and context as crucial for participation, describing collaboration with the stroke team, the team’s consideration of the stroke survivor’s resources and needs, and a supportive home environment; the importance of goals and follow-up, describing goals as motivational and an unstructured use of goals; and difficulties in participation, describing a lack of dialogue with the stroke team and undetected resources and needs.The stroke survivors experienced changes in their participation in the clinical reasoning process as their rehabilitation progressed. They moved from perceiving themselves as passengers at the time of their hospital discharge to gradually seeing themselves as the driver of their rehabilitation process. Some person-centered attributes, such as respectful relationships and a health focus, were incorporated into the clinical reasoning, while others, such as a holistic view and shared goal-setting, required further emphasis for improved person-centeredness in stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Strategic supply chain management (SCM) is essential for organizations striving to optimize performance and attain their goals. Prediction of supply chain management distribution cost (SCMDC) is one branch of SCM and it’s essential for organizations striving to optimize performance and attain their goals. For this purpose, four machine learning algorithms, including random forest (RF), support vector machine (SVM), multilayer perceptron (MLP) and decision tree (DT), along with deep learning using convolutional neural network (CNN), was used to predict and analyze SCMDC. A comprehensive dataset consisting of 180,519 open-source data points was used for analyze and make the structure of each algorithm. Evaluation based on Root Mean Square Error (RMSE) and Correlation coefficient (R2) show the CNN model has high accuracy in SCMDC prediction than other models. The CNN algorithm demonstrated exceptional accuracy on the test dataset, with an RMSE of RMSE of 0.528 and an R2 value of 0.953. Notable advantages of CNNs include automatic learning of hierarchical features, proficiency in capturing spatial and temporal patterns, computational efficiency, robustness to data variations, minimal preprocessing requirements, end-to-end training capability, scalability, and widespread adoption supported by extensive research. These attributes position the CNN algorithm as the preferred choice for precise and reliable SCMDC predictions, especially in scenarios requiring rapid responses and limited computational resources. [ABSTRACT FROM AUTHOR]

Background: Black patients with cancer are less likely to receive precision cancer treatments than White patients and are underrepresented in clinical trials. To address these disparities, the study aimed to develop and pilot‐test a digital intervention to improve Black patients' knowledge about precision oncology and clinical trials, empower patients to increase relevant discussion, and promote informed decision‐making. Methods: A community‐engaged approach, including a Community Advisory Board and two rounds of key informant interviews with Black patients with cancer, their relatives, and providers (n = 48) was used to develop and refine the multimedia digital intervention. Thematic analysis was conducted for qualitative data. The intervention was then pilot‐tested with 30 Black patients with cancer to assess feasibility, acceptability, appropriateness, knowledge, decision self‐efficacy, and patient empowerment; Wilcoxon matched pairs signed‐rank test was used to analyze quantitative data. Results: The digital tool was found to be feasible, acceptable, and culturally appropriate. Key informants shared their preferences and recommendations for the digital intervention and helped improve cultural appropriateness through user and usability testing. In the pilot test, appreciable improvement was found in participants' knowledge about precision oncology (z = –2.04, p =.052), knowledge about clinical trials (z = –3.14, p =.001), and decisional self‐efficacy for targeted/immune therapy (z = –1.96, p =.0495). Conclusions: The digital intervention could be a promising interactive decision‐support tool for increasing Black patients' participation in clinical trials and receipt of precision treatments, including immunotherapy. Its use in clinical practice may reduce disparities in oncology care and research. Plain Language Summary: We developed a digital interactive decision support tool for Black patients with cancer by convening a Community Advisory Board and conducting interviews with Black patients with cancer, their relatives, and providers.We then pilot‐tested the intervention with newly diagnosed Black patients with cancer and found appreciable improvement in participants' knowledge about precision oncology, knowledge about clinical trials, and confidence in making decisions for targeted/immune therapy.Our digital tool has great potential to be an affordable and scalable solution for empowering and educating Black patients with cancer to help them make informed decisions about precision oncology and clinical trials and ultimately reducing racial disparities. We developed and pilot‐tested a digital intervention to promote informed decision‐making regarding precision oncology and clinical trial participation among Black patients with cancer. Key informant interviews and pilot‐testing suggest that the intervention could be a promising interactive decision‐support tool. [ABSTRACT FROM AUTHOR]

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. The aim of this study was to explore family medicine physicians' perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using social exchange theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians (six focus groups) with clinical experience ranging from 3 to 20 years. The data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and Conclusions: This study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance. [ABSTRACT FROM AUTHOR]

Background: Diabetes insipidus (DI) is a common complication following pituitary surgery, causing significant health issues if left untreated. As part of the diagnostic process, accurate urinary output monitoring via indwelling urinary catheters (IDUCs) is essential, despite risks such as urinary tract infections and hindered recovery. Research on IDUC removal after pituitary surgery remains scarce. Aim: To explore health professionals' perspectives on IDUC management following pituitary surgery. Methods: Employing a qualitative design, semistructured interviews were conducted with 15 professionals in the neurosurgical ward of a Dutch academic hospital. Findings: Four themes emerged: Concerns about missing identifying DI, patient–nurse dynamics, workload management, and lack of shared decision making. Conclusion: The findings underscore the need to balance clinical needs with patient care efficiency. There is a need for evidence-based guidelines and a multidisciplinary approach to optimise IDUC management, given the importance of patient-centred care and shared decision-making. [ABSTRACT FROM AUTHOR]

Background: Network meta-analysis is developed to compare all available treatments; therefore it enriches evidence for clinical decision-making, offering insights into treatment effectiveness and safety when faced with multiple options. However, the complexity and numerous treatment comparisons in network meta-analysis can challenge healthcare providers and patients. The purpose of this study aimed to introduce a graphic design to present complex rankings of multiple interventions comprehensively. Methods: Our team members developed a "beading plot" to summary probability of achieving the best treatment (P-best) and global metrics including surface under the cumulative ranking curve (SUCRA) and P-score. Implemented via the "rankinma" R package, this tool summarizes rankings across diverse outcomes in network meta-analyses, and the package received an official release on the Comprehensive R Archive Network (CRAN). It includes the 'PlotBead()' function for generating beading plots, which represent treatment rankings among various outcomes. Results: Beading plot has been designed based on number line plot, which effectively displays collective metrics for each treatment across various outcomes. Order on the -axis is derived from ranking metrics like P-best, SUCRA, and P-score. Continuous lines represent outcomes, and color-coded beads signify treatments. Conclusion: The beading plot is a valuable graphic that intuitively displays treatment rankings across diverse outcomes, enhancing reader-friendliness and aiding decision-making in complex network evidence scenarios. While empowering clinicians and patients to identify optimal treatments, it should be used cautiously, alongside an assessment of the overall evidence certainty. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions To determine how the treatment decision‐making process and posttreatment health‐related quality of life (HRQOL) are related to regret about treatment choice for prostate cancer patients in Japan.We invited a total of 614 patients who were treated with radiation therapy (RT), radical prostatectomy (RP), or active surveillance/watchful waiting (AS/WW) from April 2007 to March 2021. Posttreatment regret was evaluated by the Decision Regret Scale. HRQOL was evaluated by the Expanded Prostate Cancer Index Composite and the 12‐item Short Form Survey. The decision‐making process was assessed by patient evaluation of the decision‐making process. We compared the decision regret scale scores across treatment types, HRQOL, and decision‐making processes.Data from 371 patients were analyzed (RT: 202, RP: 149, AS/WW: 20). The median length of time since treatment was 64 (IQR: 43–93) months. The decision regret scale scores were not significantly different among the treatment groups but were significantly greater (strong regret) in patients with poor urinary summary scores, bowel summary scores, and hormonal summary scores. The decision regret scale scores were significantly lower (less regret) for patients who reported being adequately informed at the time of the treatment decision and who had adequately communicated their questions and concerns to physicians than for patients who reported less adequate communication. This result was also observed among patients who reported low HRQOL scores.These findings underline the important influence of posttreatment HRQOL and decision‐making as an interactive process between physicians and their patients on posttreatment regret in prostate cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: In the early days of the COVID-19 pandemic, individuals were asked to perform costly actions to reduce harm to strangers, even while the general population, including authorities and experts, grappled with the uncertainty surrounding thenovel virus. Many studies have examined health decision-making by experts, but the study of lay, non-expert, individual decisionmaking on a stranger's health has been left to the wayside, as ordinary citizens are usually not tasked with such decisions. Methods: We sought to capture a snapshot of this specific choice behavior by administering two surveys to the general population in the spring of 2020, when much of the global community was subject to COVID-19-related restrictions, as well as uncertainty surrounding the virus. We presented study participants with fictitious diseases varying in severity that threatened oneself, a loved one or a stranger. Participants were asked to choose between treatment options that could either provide a sure, but mild improvement (sure option) or cure the affected person at a given probability of success (risky option). Results: Respondents preferred gambles overall, but risk-seeking decreased progressively with higher expected severity of disease. This pattern was observed regardless of the recipient's identity. Distinctions between targets emerged however whendecisions were conditioned on a treatment's monetary cost, with participants preferring cheaper options for strangers. Discussion: Overall, these findings provide a descriptive model of individual decision-making under risk for others; and inform on the limits of what can be asked of an individual in service to a stranger. [ABSTRACT FROM AUTHOR]

Emerging adults' relationship development is an increasingly multi-faceted process characterized by ambiguity. Just talking has emerged as a phrase to characterize early relationship formation in popular culture, yet it remains understudied in the empirical literature. Constructivist grounded theory was used to explore this phenomenon in modern romantic relationship formation employing nine focus groups (N = 52) of emerging adult men and women from two large Midwestern universities. Eleven unique themes were generated to identify how emerging adult men and women conceptualize just talking (pre-dating, ambiguity about commitment, unofficial romantic label), reasons for just talking (pressure to keep options open, protection from rejection, testing the waters, avoiding defining the relationship), and how technology may facilitate the just talking process (increases the pool of potential partners, comfortable frequent contact, image crafting, less effort required). The findings have substantial implications for educators, clinicians, and other professionals who work with emerging adults. [ABSTRACT FROM AUTHOR]

The investigation of cognitive processes that form the basis of decision-making in paradigms involving continuous outcomes has gained the interest of modeling researchers who aim to develop a dynamic decision theory that accounts for both speed and accuracy. One of the most important of these continuous models is the circular diffusion model (CDM, Smith. Psychological Review, 123(4), 425. 2016), which posits a noisy accumulation process mathematically described as a stochastic two-dimensional Wiener process inside a disk. Despite the considerable benefits of this model, its mathematical intricacy has limited its utilization among scholars. Here, we propose a straightforward and user-friendly method for estimating the CDM parameters and fitting the model to continuous-scale data using simple formulas that can be readily computed and do not require theoretical knowledge of model fitting or extensive programming. Notwithstanding its simplicity, we demonstrate that the aforementioned method performs with a level of accuracy that is comparable to that of the maximum likelihood estimation method. Furthermore, a robust version of the method is presented, which maintains its simplicity while exhibiting a high degree of resistance to contaminant responses. Additionally, we show that the approach is capable of reliably measuring the key parameters of the CDM, even when these values are subject to across-trial variability. Finally, we demonstrate the practical application of the method on experimental data. Specifically, an illustrative example is presented wherein the method is employed along with estimating the probability of guessing. It is hoped that the straightforward methodology presented here will, on the one hand, help narrow the divide between theoretical constructs and empirical observations on continuous response tasks and, on the other hand, inspire cognitive psychology researchers to shift their laboratory investigations towards continuous response paradigms. [ABSTRACT FROM AUTHOR]

This study addresses building performance profiles of building-integrated photovoltaic/thermal double-skin façades (BIPV/T-DSF) integrated with the decision-making for the opening control algorithm in the mixed-mode building ventilation system. Three cases were generated and simulated in this study. The integrated case (a focused case) indicated its potential in comparison with two other fixed single-mode ventilated BIPV/T-DSF cases (non-ventilated cavity and cavity ventilated BIPV/T-DSF cases). The mixed-mode building ventilation algorithm was logically generated and implemented in the integrated case to maximize passive heating and cooling while reducing energy consumption, increasing the indoor thermal comfort level, and preventing the overheating of BIPV. The temperatures of spaces used as major criteria in the developed algorithm were identified through optimization analysis. Three cities were chosen to represent three different climates: hot summer continental and cold winter climate (Daejeon, South Korea), tropical savanna (Bangkok, Thailand), and continental subarctic (Tayshet, Russia). Multi-criteria simulation results showed that implementing the logically created mixed-mode building ventilation algorithm in a transparent BIPV/T-DSF has outstanding potential to improve thermal comfort, especially during moderate weather, and somewhat reduces energy consumption compared to the two other studied cases. [ABSTRACT FROM AUTHOR]

aiman,3 Jenny Ahlstrom,4 Margaret Yung,5 Kathleen L Deering,5 Victoria Kulbokas,5 Joshua L Feldman,6 Erika Kline,6 Noa Biran71Janssen Scientific Affairs LLC, Titusville, NJ, USA; 2Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA; 3Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA; 4HealthTree Foundation, Draper, UT, USA; 5EPI-Q Inc, Chicago, IL, USA; 6Inspire Insights, Arlington, VA, USA; 7Hackensack Meridian Health, John Theurer Cancer Center, Hackensack, NJ, USA Correspondence: Lisa Dwyer Orr, Janssen Scientific Affairs LLC, Titusville, NJ, USA, Tel +1 561 290-9901, Email [email protected] Introduction: Treatment decision-making for multiple myeloma (MM) is complex. Individuals involved in decision-making may value treatment attributes differently based on their role as a patient, care partner, or physician. This study describes those attributes, and what is most important by role. Methods: We conducted a cross-sectional online survey with consenting adult patients with MM, MM care partners, and physicians treating MM. Respondents were recruited from US panels (Inspire and M3 Global Research) between September and December 2022. Survey items were informed by a targeted literature review, qualitative interviews, and a steering committee comprising clinical experts, a patient advocate, patient, and care partner. Descriptive statistics were generated and reported in aggregate. Results: Email invitations were sent to 8071 Inspire members interested in or posting about MM. Of these, 4427 viewed the invitation, 941 responded, and 156 patients and care partners completed the survey (17% of respondents). For physicians, 5588 were invited via Email by M3 Global Research, with 761 viewing the invitation, 214 accessing the survey link, and 137 completing the survey (64% of respondents). Duration of response, side effects, and patients' quality-of-life (QoL) were the top three treatment attributes selected across the three cohorts; alignment of these attributes was consistent among patients regardless of disease severity. Separately, patients rated QoL and the amount of caregiving needed during/after treatment as the most important factors for future treatment decisions. If more effective MM treatments were offered, care partners were more willing to assume greater family burden (77%) compared to patients (49%), and patients were more accepting of potential serious side effects (50%) than were care partners (34%). Conclusion: Patients with MM, care partners, and physicians consider and value various treatment decision-making factors. Recognizing and addressing these differences is critical to meeting patients' preferences, needs, and optimizing patient outcomes. [ABSTRACT FROM AUTHOR]

Navigation aids limit the need for decision-making, possibly hindering memory for routes traveled. We manipulated type of navigation at encoding, within virtual-reality. In the Active condition participants self-initiated decision-making about routes, to find a target, and in the Guided condition followed a pre-defined path overlaid onto virtual streets. In both, they had volitional control using hand-held controllers, allowing head and body rotation in a swivel chair. In the Passive condition they viewed a pre-defined route, with no control of movement. At retrieval, participants were asked to reproduce their exact route from the initial starting point. Route memory was better following Active and Guided encoding than Passive. A visual navigation aid does not impair route memory if volitional movement is maintained. [ABSTRACT FROM AUTHOR]

We identify and present Brazil's most common behavioral and heuristic biases in judicial decision-making. Through bibliographic and specific cases, we notice the occurrence of the representativeness heuristic, availability heuristic, anchoring heuristic (anchoring effect), confirmation bias, and affect heuristic bias in Brazilian judicial decisions. We also present the current state of Brazilian legislation and its amendments that aim at impartiality in the production, the assessment of evidence, and the judge's conviction. Finally, we present the suggestions and initiatives that aim to mitigate biases and heuristics in judicial decision-making in Brazil, especially with awareness techniques, the replacement of judges by algorithms, and the review of judicial decisions by collegiate bodies. [ABSTRACT FROM AUTHOR]

Introduction: Improved access to rehabilitation is highlighted as a key pathway to achieving the World Health Organisation's (WHO) goal of ensuring healthy lives and promoting well‐being for all (Sustainable Development Goal 3). This article is the second in a two‐part series outlining the findings from the Rehabilitation Choices study, which aimed to identify how health professionals and consumers in Australia are informed to make decisions about rehabilitation, and their experience with barriers and enablers to accessing that rehabilitation. In this study, we present the perspectives of consumers with different health conditions and a range of experiences with rehabilitation services. Methods: This was a qualitative study using focus groups and semi‐structured interviews. People with self‐reported lived experience of rehabilitation and carers were recruited using maximum variation sampling. Thematic analysis of data was conducted using an inductive approach. Results: Fifty‐six consumers with diverse lived experiences of rehabilitation (19–80 years, 49 patients, 7 carers) participated in focus groups and interviews to discuss how they sourced information about rehabilitation and their experiences of what made it hard or easy to access rehabilitative care to meet their needs. Four themes were produced from the data: (1) service‐centricity of options limits access, (2) access is the patient's responsibility, (3) enabling decision‐making about rehabilitation with appropriate information and (4) provision of a psychologically safe environment. Conclusions: Any planned (re)design of services to improve consumer access to rehabilitation should consider the themes identified in this study. This will ensure that consumers are provided with rehabilitation options that suit their holistic and unique needs beyond consideration of their medical diagnoses, and are actively supported to navigate this access, provided with information to help them make informed choices and provided a psychologically safe environment to engage effectively with rehabilitation. Patient or Public Contribution: Three consumer research partners with lived experience of rehabilitation as patients or carers were core team members. They were involved in the design and implementation of the recruitment and communications strategies, design of the interview approach and discussion guide, contributed to the interpretation and contextualisation of findings and writing of this manuscript and are included as co‐authors (A. O., T. W. and S. W.). [ABSTRACT FROM AUTHOR]

Introduction: Having a lower extremity amputation is a life‐changing decision for people living with a diabetes‐related foot ulcer. Although previous research has described both positive and negative lifestyle and function outcomes of diabetes‐related amputations, limited research has been conducted on the decision‐making processes leading up to the amputation. This study aimed to explore the perspectives of persons, healthcare practitioners and experts (including academics and specialists) on decision‐making for people with a diabetes‐related foot ulcer who may require a non‐emergency amputation. Methods: A qualitative descriptive study using semi‐structured interviews enabled people to share their thought processes when making decisions for amputation. Twenty‐six participants were interviewed, including nine people with a diabetes‐related foot ulcer or amputation, nine health practitioners and eight experts located across five countries. There were 13 female and 13 male participants. Thematic analysis was used for data analysis. Results: Four themes described the decision‐making considerations for amputation: 'Balancing the evidence in decision‐making', 'Trust, respect and timing of conversations inform decision‐making', 'Tailoring decisions for individual circumstance' and 'Reaching the tipping point in decisions for the future'. Work commitments, functional and lifestyle impacts of amputation, the presence of support networks and clinical wound features formed the evidence for a decision for amputation. Conclusion: Understanding quality of life needs ensured that decisions for amputation addressed expectations and lifestyle needs. Living with a diabetes‐related foot ulcer presented daily challenges that pushed people to a tipping point, at which amputation was considered to overcome these hardships and enable them to move on to the next chapter of their life. Further research is required to understand how person‐centred factors can be better incorporated alongside objective clinical assessments in decisions for amputation. Patient or Public Contribution: People with diabetes‐related foot ulcers, health practitioners and experts shared their perspectives on the decision‐making process for amputation through one‐to‐one interviews. Consideration of the person in the context of their life, environment and personal needs alongside the pathological factors is warranted. Practitioner Points: The decision for amputation incorporates a balance between health concerns, health practitioner assessments and the quality of life expectations and lifestyle needs of the person with DFU.Open discussions about living situation and future goals can determine readiness for amputation and initiate consideration of amputation as a possible option.'Leaving the door open' for people with DFU to have ongoing conversations about amputation supports people to feel in control of their decisions. [ABSTRACT FROM AUTHOR]

Autonomous vehicles (AVs) represent a transformative innovation in transportation, promising enhanced safety, efficiency, and sustainability. Despite these promises, achieving robustness, reliability, and adherence to ethical standards in AV systems remains challenging due to the complexity of integrating diverse technologies. This survey reviews literature from 2017 to 2023, analyzing over 90 papers to explore the integration of knowledge graphs (KGs) into AV technologies. Our findings indicate that KGs significantly enhance AV systems by providing structured semantic understanding, improving real-time decision-making, and ensuring compliance with regulatory standards. The paper identifies that while KGs contribute to better environmental perception and contextual reasoning, challenges remain in their seamless integration with existing systems and in maintaining processing speed. We also address the ethical dimensions of AV decision-making, advocating for frameworks that prioritize safety and transparency. This review underscores the potential of KGs to address critical challenges in AV technologies, offering a hopeful and optimistic outlook for the development of robust, reliable, and socially responsible autonomous transportation solutions. [ABSTRACT FROM AUTHOR]

End-of-life care management presents significant ethical challenges, especially in complex clinical cases such as that of a patient with severe head trauma and multiple complications. Ethical decision-making involves considering the rights, dignity, and preferences of the patient and his or her family, as well as quality of life and relief from suffering. The objective of this research is to design and implement a comprehensive methodology to provide a care plan that respects the dignity and improves the quality of life of patients at the end of life, aligned with their wishes and those of their family. The approach used was the Comprehensive Methodology of Clinical-Ethical Analysis (CMECA), which included a continuous evaluation, pain and symptom management, supportive care, limitations of medical interventions, and preparation for the end of life, with the active participation of the family from a palliative care approach. The resolution of the case was achieved through a shared decision between the parents and the medical team, proceeding with a gradual disconnection of life support. The importance and relevance of the Comprehensive Methodology of Ethical-Clinical Analysis (CMECA) is highlighted, due to its comprehensive approach focused on the patient and in accordance with medical ethics. This method stands out for considering legal and ethical aspects, empathy, and respect for human dignity at all times. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the reproducibility and reliability of Chat-Based GPT (ChatGPT)'s responses to 19 statements regarding the management of hip fractures in older adults as adopted by the American Academy of Orthopaedic Surgeons' (AAOS) evidence-based clinical practice guidelines. Methods: Nineteen statements were obtained from the 2021 AAOS evidence-based clinical practice guidelines. After generating questions based on these 19 statements, we set a prompt for both the GPT-4o and GPT-4 models. We repeated this process three times at 24 h intervals for both models, producing outputs A, B, and C. ChatGPT's performance, the intra-ChatGPT reliability, and the accuracy rates were assessed to evaluate the reproducibility and reliability of the hip fracture-related guidelines. Regarding the strengths of the recommendation compared with the 2021 AAOS guidelines, we observed accuracy of 0.684, 0.579, and 0.632 for outputs A, B, and C, respectively. Results: The precision was 0.740, 0.737, and 0.718 in outputs A, B, and C, respectively. For the reliability of the strengths of the recommendation, the Fleiss kappa was 0.409, indicating a moderate level of agreement. No statistical differences in the strengths of the recommendation were observed in outputs A, B, and C between the GPT-4o and GPT-4 versions. Conclusion: ChatGPT may be useful in providing guidelines for hip fractures but performs poorly in terms of accuracy and precision. However, hallucinations remain an unresolved limitation associated with using ChatGPT to search for hip fracture guidelines. The effective utilization of ChatGPT as a patient education tool for the management of hip fractures should be addressed in the future. [ABSTRACT FROM AUTHOR]

Simple Summary: Each patient responds uniquely to treatment, which makes personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) a promising strategy that delivers high-dose radiation at extended intervals for tailored adaptation. Currently, treatment modifications mainly rely on physicians' assessments of tumor size changes. Our study aims to develop a more objective multiomics-based approach for predicting treatment outcomes in PULSAR, including radiomics, dosiomics, and delta features. By leveraging multiomics analysis and machine learning, we intend to transition the adaptation and decision-making process from empirical judgments to a more data-informed strategy, allowing clinicians to swiftly respond to changes in tumor behavior and provide more personalized treatment for each patient. Objectives: This retrospective study aims to develop a multiomics approach that integrates radiomics, dosiomics, and delta features to predict treatment responses in brain metastasis (BM) patients undergoing PULSAR. Methods: A retrospective study encompassing 39 BM patients with 69 lesions treated with PULSAR was undertaken. Radiomics, dosiomics, and delta features were extracted from both pre-treatment and intra-treatment MRI scans alongside dose distributions. Six individual models, alongside an ensemble feature selection (EFS) model, were evaluated. The classification task focused on distinguishing between two lesion groups based on whether they exhibited a volume reduction of more than 20% at follow-up. Performance metrics, including sensitivity, specificity, accuracy, precision, F1 score, and the area under the receiver operating characteristic (ROC) curve (AUC), were assessed. Results: The EFS model integrated the features from pre-treatment radiomics, pre-treatment dosiomics, intra-treatment radiomics, and delta radiomics. It outperformed six individual models, achieving an AUC of 0.979, accuracy of 0.917, and F1 score of 0.821. Among the top nine features of the EFS model, six features came from post-wavelet transformation and three from original images. Conclusions: The study demonstrated the feasibility of employing a data-driven multiomics approach to predict treatment outcomes in BM patients receiving PULSAR treatment. Integrating multiomics with intra-treatment decision support in PULSAR shows promise for optimizing patient management and reducing the risks of under- or over-treatment. [ABSTRACT FROM AUTHOR]

Aim: To identify leadership factors for clinicians during in‐hospital cardiopulmonary resuscitation. Design: Systematic review with synthesis without meta‐analysis. Methods: The review was guided by SWiM, assessed for quality using CASP and reported with PRISMA. Data Sources: Cochrane, EMBASE, PubMed, Medline, Scopus and CINAHL (years of 2013–2023) and a manual reference list search of all included studies. Results: A total of 60 papers were identified with three major themes of useful resuscitation leadership; 'social skills', 'cognitive skills and behaviour' and 'leadership development skills' were identified. Main factors included delegating effectively, while being situationally aware of team members' ability and progress during resuscitation, and being empathetic and supportive, yet 'controlling the room' using a hands‐off style. Shared decision‐making to reduce cognitive load for one leader was shown to improve effective teamwork. Findings were limited by heterogeneity of studies and inconsistently applied tools to measure leadership. Conclusion: Traditional authoritarian leadership styles are not wanted by team members with preference for shared leadership and collaboration. Balancing this with the need for team members to see leaders in 'control of the room' brings new challenges for leaders and trainers of resuscitation. Implications for Nursing Profession: All clinicians need effective leadership skills for cardiopulmonary resuscitation in‐hospital. Nurses provide first response and ongoing leadership for cardiopulmonary resuscitation. Nurses typically display suitable skills that align with useful resuscitation leader factors. Impact: What were the main findings?: Collaboration rather than an authoritarian approach to leadership is preferred by team members. Nurses are suitable to 'control the room'. Restricting resuscitation team size will manage disruptive behaviour of team members. Trial Registration: PROSPERO Registration: CRD42022385630. Patient of Public Contribution: No patient of public contribution. [ABSTRACT FROM AUTHOR]

Infrastructure decisions today significantly impact future generations' quality of life, especially as severe storms and rising sea levels increasingly threaten communities across the United States. Decision-makers at all levels, including those involved in disaster prevention and response, must address climate change. However, those in infrastructure design and construction often prioritize immediate gains over long-term resilience. Engineering teams typically employ decision tools to manage complexity, but these methods may not highlight the long-term consequences of their choices. This study tests whether integrating Virtual Reality (VR) technology with engineering decision-making tools, can enhance engineers’ ability to visualize the future impacts of their infrastructure projects. A group of engineering students (n = 56) was given a case study on updating roadwork systems in Norfolk, Virginia, an area vulnerable to flooding. The control group viewed images depicting current and future conditions of sea-level rise (year 2100), while the intervention group experienced the same information but through an immersive VR scenario. Participants selected achievement levels for each credit using the Envision system, with total points reflecting the resilience and sustainability of decisions. The results indicate that participants who engaged with the VR experience, achieved higher scores than those who received the images. The results also indicate a variation in VR's impact based on political affiliation, with Democrats responding more positively to the VR experience than Republicans. The findings highlight that integrating VR into decision-making tools can be a crucial advancement in infrastructure planning, enabling engineers to make more informed, sustainable choices for a resilient future. [ABSTRACT FROM AUTHOR]

Background: Public health campaigns have often used persuasive techniques to promote healthy behaviors but the use of persuasion by doctors is controversial. We sought to examine older women's perspectives. Methods: We conducted semi‐structured interviews with 20 community‐dwelling older women from the Baltimore metropolitan area. We asked whether participants thought it was ethically appropriate for doctors to try to persuade patients and explored their rationales. We probed about commonly used persuasive techniques and two example decisional contexts—stopping mammograms and moving out of one's house after multiple falls. We used qualitative thematic analysis to code the transcripts and summarized results into major themes. Results: We found mixed views on the ethical appropriateness of persuasion (theme 1); supporters of persuasion were motivated by the potential benefit to patients' health, whereas opponents thought patients should be the ultimate decision‐makers. Perspectives depended on the persuasive technique (theme 2), where emotional appeals elicited the most negative reactions while use of facts and patient stories were viewed more positively. Perspectives also varied by the decisional context (theme 3), where higher severity and certainty of harm influenced participants to be more accepting of persuasion. Participants suggested alternative communication approaches to persuasion (theme 4) that emphasized respect for patients. Conclusions: Our findings suggest that the type of persuasive technique and the decisional context are important considerations in the ethical debate around the use of persuasion. Limiting the use of persuasion to high‐stakes decisions and using facts and patient stories rather than emotional appeals are likely more acceptable. [ABSTRACT FROM AUTHOR]

The term “digital twin” is becoming increasingly prevalent in both research and politics with regard to infrastructure structures. Industry is making significant advancements in the fields of automation and autonomy. While numerous definitions are in circulation, some of which are identical, many are similar in nature. This work examines the digital twin from its original industry perspective and considers its relevance to the constructional engineering sector. The objective of this study is to provide an overview of the current approaches in the Industry 4.0 and constructional engineering industry, examining the associated technical opportunities and challenges. The study compares the definitions, requirements and projects executed in this field. The technologies under examination are contrasted on the basis of their position within the data model. The preliminary findings suggest that some solutions for Industry 4.0 have already been developed for the construction engineering sector. However, it must be acknowledged that some solutions have yet to be fully validated. [ABSTRACT FROM AUTHOR]

This paper aims to explore the effect of an artificial intelligence-enabled decision support system (AIDSS) on decision-making processes within a university setting, focusing on the ICT department of a selected South African university. The research objectives revolve around the effectiveness of AIDSS in enhancing decision-making in higher education institutions. Convenience sampling was employed in this study and a questionnaire administered to 28 participants. These methods were chosen to gather insights into the practical application of AI technology in the context of IT operational decision-making. The major findings of this research reveal that AIDSS has the potential to significantly improve decision-making processes in higher education. Despite these advancements, the research acknowledges the ethical and societal implications arising from AI integration, underscoring the importance of achieving a balance between technical advancement and the upholding of human values. As a major policy implication, this study underscores the importance of embracing AI technologies in higher education institutions to enhance decision-making processes, thus improving the efficiency and effectiveness of IT operations. The original contribution of this research lies in its exploration of the practical use of AIDSS in South African higher education, offering insights into how AI can be harnessed to advance decision-making. [ABSTRACT FROM AUTHOR]

This study addresses the complexity of assessing river water quality, a multifaceted process influenced by numerous water quality parameters (WQPs) characterized by inherent uncertainties and diverse judgment information from decision-makers. These uncertainties and diverse judgment information can be effectively represented and simulated using Neutrosophic sets. In this study, we propose an effective water pollution rating system, the Neutrosophic water quality index (NWQI), to derive a water pollution score (NWQI-score) for rating water pollution levels. We demonstrate the application of our methodology through an assessment of water quality indices for rating pollution in the Gomati River, the largest river in Tripura, India. Using the NWQI, we highlight the NWQI score as a pivotal indicator for evaluating the river's water quality. For assessing water quality, we consider six crucial parameters, namely Total hardness, Biochemical oxygen demand, Total suspended solids, Electrical conductivity, pH, and total dissolved solids, sampled at five strategic sites along the river. Sampling was conducted from January 2024 to July 2024, guided by the distribution of waste discharge points. Finally, we conclude the study, summarizing findings and suggesting future research directions. [ABSTRACT FROM AUTHOR]

Background Subacromial pain syndrome (SAPS), the most common cause of shoulder pain, can be treated through different treatments with similar effects. Therefore, in terms of deciding on the right treatment fit, patient preferences need to be understood. We aimed to identify treatment characteristics that delineate interventions (attributes) and corresponding sets of specific categorical range (attribute-levels) for SAPS. Methods This multiple method study systematically reviewed both qualitative and quantitative studies on patient preferences for treatment of SAPS, which informed semi-structured interviews with 9 clinicians and 14 patients. The qualitative data from the interviews was analyzed using the framework analysis formulated by Ritchie and Spencer. Attributes and attribute levels of the systematic review and interviews were summarized and categorized. Results The search resulted in 2607 studies, 16 of which met the eligibility criteria. The review identified 120 potential attributes, which were synthesized into 25 potential attributes. Fourteen new potential attributes were identified through the interviews, equaling a total of 39 attributes across 11 categories. Levels for 37 attributes were identified through systematic review and interviews, we were unable to identify levels for 2 attributes. Conclusions This study identified attributes and attribute levels for the treatment of SAPS. There was a discrepancy in the frequency of the represented attributes between the literature and interviews. This study may improve the understanding of patient preferences for the treatment of SAPS and help individualize care. Our study informs a future discrete choice experiment and supports shared decision-making in clinical practice. [ABSTRACT FROM AUTHOR]

Atypical visual processing has been reported in developmental conditions like autism and dyslexia, and some accounts propose a causal role for visual processing in the development of these conditions. However, few studies make direct comparisons between conditions, or use sufficiently sensitive methods, meaning that it is hard to say whether atypical visual processing tells us anything specific about these conditions, or whether it reflects a more general marker of atypical development. Here I review findings from two computational modelling approaches (equivalent noise and diffusion modelling) and related electroencephalography (EEG) indices which we have applied to data from autistic, dyslexic and typically developing children to reveal how the component processes involved in visual processing and decision-making are altered in autism and dyslexia. The results identify both areas of convergence and divergence in autistic and dyslexic children's visual processing and decision-making, with implications for influential theoretical accounts such as weak central coherence, increased internal noise, and dorsal-stream vulnerability. In both sets of studies, we also see considerable variability across children in all three groups. To better understand this variability, and further understand the convergence and divergence identified between conditions, future studies would benefit from studying how the component processes reviewed here relate to transdiagnostic dimensions, which will also give insights into individual differences in visual processing and decision-making more generally. [ABSTRACT FROM AUTHOR]