Rare diseases are characterized by a wide diversity of signs and symptoms and vary not only from disease to disease, but also from person to person, and living with a disease leads patients to peculiar experiences and treatments, without limits of time and space, as they extend to various environments and relationships of their lives. The objective of this study is the theoretical interaction between Value Co-creation (VC) and the Stakeholder Theory (ST) with the Shared Decision Making (SDM) health care theory. It is configured as a multiparadigmatic proposal by enabling the analysis of multiple perspectives of different stakeholders in health care. Thus, Co-created Decision Making (CDM) emerges in a logic dominated by service, with emphasis on intangible aspects and the interactivity of the relationships. It goes beyond the clinical office and the doctor-patient relationships, as studied in SDM, extending to all environments and interactions that add value to the patient's treatment. It was concluded that the essence of this new theory proposed here is neither in patient-centered care nor in patient self-care, but in co-created relationships with and between stakeholders in both directions, including non-health care environments that are important to the patient, such as relationships with friends, family, other patients with the same disease, social media, public policies, and the practice of pleasurable activities.

Multi-objective optimization (MOO) is an optimization involving minimization or maximization of several objective functions more than the conventional one objective optimization, which is useful in many fields. Many of the current methodologies addresses challenges and solutions that attempt to solve simultaneously several Objectives with multiple constraints subjoined to each. Often MOO are generally subjected to linear inequality, equality and or bounded constraint that prevent all objectives from being optimized at once. This paper reviews some recent articles in area of MOO and presents deep analysis of Random and Uniform Entry-Exit time of objectives. It further break down process into sub-process and then provide some new concepts for solving problems in MOO, which comes due to periodical objectives that do not stay for the entire duration of process lifetime, unlike permanent objectives which are optimized once for the entire process duration. A methodology based on partial optimization that optimizes each objective iteratively and weight convergence method that optimizes sub-group of objectives are given. Furthermore, another method is introduced which involve objective classification, ranking, estimation and prediction where objectives are classified based on their properties, and ranked using a given criteria and in addition estimated for an optimal weight point (pareto optimal point) if it certifies a coveted optimal weight point. Then finally predicted to find how far it deviates from the estimated optimal weight point. A Sample Mathematical Tri-Objectives and Real world Optimization was analyzed using partial method, ranking and classification method, the result showed that an objective can be added or removed without affecting previous or existing optimal solutions. Therefore suitable for handling time governed MOO. Although this paper presents concepts work only, it’s practical application are beyond the scope of this paper, however base on analysis and examples presented, the concept is worthy of igniting further research and application.

Patient value is an important factor in clinical decision-making, but conventionally, it is not incorporated in the decision processes. In this paper, a value-based therapy recommendation comprehensive model is proposed. A literature analysis is conducted to collect value-based evidence. Categorized values and candidate therapies are used in combination as filtering keywords to build this evidence. Then a formalism model is put forward to integrate the value-based evidence with clinical evidence. The relative importance of two evidence can be adjusted dynamically by decision-makers during the decision-making processes. A prototype system was implemented using a case study for breast cancer and validated for feasibility and effectiveness.

SIGNIFICANCE Putting worth on research and selection of studies by importance are crucial in medical innovation. Practical applications include choosing personal study topics, publication review, study grant selection, and decisions of spending or misspending billions in public health. Multiple studies raised alarm that current methods perform poorly in reproducibility, prediction of best research and objectivity. I propose using the metrics how much disease burden is reduced and calculating objective, numerical research value. The concept is that worth of medical research is not subjective but can be reproducible and numerically quantified. The method increases transparency by giving decision makers an externally accountable proof, and frees peer reviewers to check scientific integrity. Its numerical form can capture small differences important in competition between studies. ABSTRACT Finding value and selecting knowledge by importance are crucial in medical innovation. Applications include individuals designing research, funding organizations selecting grants, journals – publications, institutions – priorities in public health and health policy, and decision makers spending or misspending billions of research funds. Currently finding value of knowledge is done by peer review together with checking scientific integrity. Multiple studies raised alarm that it performs poorly in prediction of highest citations, bias, transparency and quality. The resulting problems include perception of slow medical progress and wasting funds and time. I introduce a standard, objective and numerical method for finding value of medical research. It measures disease burden prevented by new knowledge contained in a study or a publication. In its simple form, it is calculated by multiplying disease prevalence, disease burden, and efficacy of the therapy. It can be modified for risk of failure, multi-disease effect and for ethical considerations. The process is described step-by-step in terms common in medical practice. A quick estimate is often sufficient. The advantage is objectivity, since it is calculated from real world data. This gives transparency and externally accountability of decision making. The second advantage is a numerical form. This can measure small differences in research value which, in sharp competition, determine which studies are selected. A researcher can calculate the value of own future effort. Institutions might ask to provide it at submission. The method is also applicable to broad policy analysis, objective evaluation of scientific achievement and bibliometric studies.

Economic development and advancements in information technology contributed to the shift on accounting objective from commission responsibility view to decision-making useful view. The decision-making useful view claims that the accounting measurement methods should be changed to improve the usefulness of accounting information, to enable information users to make correct decisions. In addition, the development of financial instruments leads to the birth of fair value accounting. In recent years, fair value has been one of the most important measurement methods in the International Accounting Standard and US Generally Accepted Accounting Principles. However, China has been quite cautious when it comes to applying fair value full time, especially after the global financial crisis happened in 2008, wherein fair value accounting was exposed to strong suspicion. Hence, studying the value relevance of fair value is of great significance to exploring the accounting profession and reforming accounting standards. This paper attempts to investigate the value-relevance of fair value based on the data of listed financial companies and manufacturing companies in China. The results indicate that the fair value information in the financial industry has a strong explanatory influence to corporate share price. In contrast, the fair value information shows limited relevance in the manufacturing industry. Finally, consulting with the results of normative analysis and empirical study, this paper suggests several rational advices for the application of fair value in China.

Proactive deprescribing is the process of stopping a medicine before harm occurs. This study aimed to specify and validate with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process framework of steps which we populated with literature-derived activities required to be undertaken by healthcare professionals. We distributed a survey to healthcare professionals in-ternationally requesting for each activity; the frequency of its occurrence in practice and whether it was important. Extended response questions invited barriers and enablers to deprescribing. The 263 survey respondents were from 25 countries. A proactive deprescribing process was developed comprising four steps: (1) Identify a patient for potential stop of a medicine, (2) Evaluate a patient for potential stop of a medicine, (3) Stop a medicine(s), (4) After a medicine has been stopped, and 17 activities. All activities were considered important by ≥70% respondents. Nine activities re-quired healthcare professionals to undertake in direct partnership with the patient and/or care-giver, of which seven were only sometimes undertaken. Deprescribing interventions should focus on addressing the barriers and enablers of healthcare professionals undertaking the activities that require direct partnership with the patient and/or caregiver.

This article describes the Analytic Hierarchy Process (AHP) method which can be calculated by several methods. The AHP method is essential for the managerial decision-making to recognize which method is efficient for the calculation and to determine the proper order of criteria. In the article there are included methods that can be used in order to calculate the matrix in the AHP process for setting criteria such as Geometric mean, Arithmetic mean, Row sum of the adjusted the Saaty matrix, Reverse sums of the Saaty matrix columns and Row sums of the Saaty matrix. The paper is focused on the accuracy of the methods used. The results show that the most accurate method is the Saaty method, and the second most accurate method is the geometric mean in order to determine the ranking. This method is easier to use when the same order is achieved as in the Saaty method, followed by Geometric mean, which is favourable for fast and easy determination of alternatives using in the AHP process. The survey carried out among managers graduated from Universities and Colleges in Slovakia showed that the respondents considered the Saaty method as the most complex and also the most difficult method and the geometric mean average method the simplest method. 44% of respondents stated that they are capable to use a program to calculate the AHP. 46% of respondents said they had experience with some method related to the managerial decision-making process. 72% of managers regarded as important to manage some method for decision-making in their managerial position.

Outcomes of repeated decision--making processes may be affected by adversarial actors, without being noticed. Adversaries may try to gain knowledge about a particular decision--making process, identify its decision--makers, and guess which underlying decision support model is used. Then they can simulate the process, and craft different scenarios to affect its decision outcomes. Therefore, designers of decision support systems need to incorporate this in the decision modeling phase. The purpose of this study is to demonstrate this for the repeated decision--making in a patent application process. In this process, two sequential decision outcomes can be affected by adversarial actors: a company's decision to which type of patent office to send a patent request to, and the decision of a specialized patent officer to grant an application, or not. It is motivated that the company's decision--maker is \emph{bounded} rational. A theory for information--theoretic bounded rational decision--making under uncertainty proposed by Ortega et al.\ is adopted to model this type of decision--maker. A framework is provided to simulate a number of scenarios that adversaries may deploy to affect decision outcomes of a repeated patent application decision--making process. The framework is also utilized for statistically testing the presence of the scenarios, and to demonstrate how to discourage adversaries from deploying them.

This study presents a path planning method for a mobile robot to be effectively operated through a multi-objective decision-making problem. Specifically, the proposed Fuzzy analytic hierarchy process (FAHP) determines an optimal position as a sub-goal within the multi-objective boundary. The key features of the proposed FAHP are evaluating the candidates according to the fuzzified relative importance among objectives to select an optimal solution. In order to incorporate FAHP into path planning, an AHP framework is defined, which includes the highest level (goal), middle level (objectives), and the lowest level (alternatives). The distance to the target, robot’s rotation, and safety against collision between obstacles are considered as objective functions. Comparative results obtained from the artificial potential field and AHP/FAHP simulations show that FAHP is much preferable for the mobile robot’s path planning than typical AHP.

Global climate change and associated environmental extremes present a pressing need to understand and predict social-environmental impacts while identifying opportunities for mitigation and adaptation. In support of informing a more resilient future, emerging data analytics technologies can leverage the growing availability of Earth observations from diverse data sources ranging from satellites to sensors to social media. Yet, there remains a need to transition from research for knowledge gain to sustained operational deployment. In this paper, we use the Wisdom-Knowledge-Information-Data (WKID) Innovation framework to inform solutions-oriented science in an integrated Research to Commercialization (R2C) model that explores market viability for value-added analytics. We conduct a case study using this R2C model to address the wicked wildfire problem. By integrating WKID and human centered design (HCD), through an industry-university partnership called the Climate Innovation Collaboratory between the University of Colorado Boulder and Deloitte Consulting, we systematically evaluated 39 different user stories across 8 user personas and identified common gaps, how to define information technologies that add value, and how to develop a marketable product. This R2C model could enable transition of knowledge to operational implementation informing policy and decision makers, tasked with addressing some of our most challenging environmental problems.

The value of an NBA basketball player varies at each crucial point in time, depending on the player’s career and performance. This study constructs a player’s value assessment model. The model comprises two parts. First, from an objective perspective, entropy is employed to measure each player’s achievement in five categories—rebounds, assists, steals, blocked shots, and scores. The total entropy assessment value is calculated and then combined with the players’ scores to develop a player's value matrix to assess the relative value model among players of the same type.

This paper formulates the performance evaluation of cloud services as a multicriteria group decision making problem, and presents a fuzzy multicriteria group decision making method for evaluating the performance of cloud services. Interval-valued intuitionistic fuzzy numbers are used to model the inherent subjectiveness and imprecision of the performance evaluation process. An effective algorithm is developed based on the technique for order preference by similarity to ideal solution method and the Choquet integral operator for adequately solving the performance evaluation problem. An example is presented to demonstrate the applicability of the proposed fuzzy multicriteria group decision making method for solving the multicriteria group decision making problem in real world situations.

In the existing group decision-making fuzzy analytic hierarchy process (FAHP) methods, the consensus among experts has rarely been fully reached. To fill this gap, in this study, a pre-aggregation fuzzy collaborative intelligence (FCI)-based FAHP approach is proposed. In the proposed pre-aggregation FCI-based FAHP approach, fuzzy intersection is applied to aggregate experts’ pairwise comparison results if these pairwise comparison results overlap. The aggregation result is a matrix of polygonal fuzzy numbers. Subsequently, alpha-cut operations are applied to derive the fuzzy priorities of criteria from the aggregation result. The pre-aggregation FCI-based FAHP approach has been applied to select suitable alternative suppliers for a wafer foundry in Taiwan amid the COVID-19 pandemic. The experimental results revealed that the pre-aggregation FCI-based FAHP approach significantly reduced the uncertainty inherent in the decision-making process by deriving fuzzy priorities with very narrow ranges.

In the realm of construction industry, the management of claims constitutes a pervasive and multifaceted issue, with potential repercussions extending to project delays, cost overruns, work suspensions, and, in extreme cases, project termination. This challenge is a significant and unavoidable hurdle due to the unique features of construction projects, which are complex, involve many stakeholders and come with inherent risks. To address this complex issue, it becomes imperative to undertake a comprehensive appraisal of the claims management procedures employed within the industry, culminating in the presentation of findings within a risk-based framework. The overarching objective of this endeavour is threefold: firstly, to discern the pivotal attributes that affect each category of construction claims; secondly, to establish a coherent decision-making paradigm for the effective administration of such claims; and finally, to provide data that can be harnessed to either address concerns related to claims or enhance the effectiveness of the claims administration process. Keeping this in mind, this study serves to evaluate the factors associated with claim management gathered from a wide overview of literature, encompassing a range of construction projects, varying in terms of types, sizes/capacities and contractual arrangements. Hence, it advanced a refined method within the domain of fuzzy group decision-making, denoted as the Modified Fuzzy Group Decision-Making Approach (FGDMA) in addition to extensive statistical analysis using SPSS.V.25 software. They were applied to assess, analyze and prioritize claim about 108 claim management factors based on the responses obtained from the comprehensive questionnaire survey involving 104 industry professionals. This multi-faceted approach, which combines the insights from previous publications, along with the collective experience of the surveyed professionals with the analytical capabilities of the FGDMA- Statically Factor Analysis, reinforces the robustness and practical applicability of proposed methodology within the context of construction claims management.

The South Asian economy is on the rise but struggling with power shortages and heavy dependence on fossil fuels. For sustained growth, there is a need for access to readily available energy sources, such as electricity. Trading clean electrical energy among neighbouring countries can ensure access to readily available points. South Asia has a diverse range of energy sources, including hydropower, that are available in the region. However, sectorial barriers can impede energy trading. This study has attempted to assess the readiness and barriers to Nepal’s cross-border energy trade with India and Bangladesh using the Analytic Hierarchy Process (AHP). This study also recommends possible measures to strengthen preparedness and address the challenges in energy trade that can be tailored and applied to other cross-country situations.

Background: Consciousness is usually interpreted as a state of being aware of one’s environment as well as self. According to the trilogy paradigm of consciousness (or simply “trilogy”), it is primarily guided by two new mental functions—awareness-based choice selection (ABCS) and discretionary selection of information for awareness (DSIA) or intentional attention—which may play a role in the choice selection during decision making. Method: To test whether ABCS and DSIA could improve the choice selection efficiency, 204 subjects were recruited using social media platforms to complete an anonymous online survey. The survey was designed to examine the role of subtle hints and cues in guiding participants’ attention toward a particular subject of awareness and this in return would increase the likelihood of selecting a correct choice among the proposed options, thereby enhancing the decision-making efficacy. Results: The participants’ attention could be successfully swayed to a particular subject matter (DSIA) in 59−73% of occasions. In addition, using ABCS increased the efficiency of selecting a correct choice among presented options. The analyses further revealed a gap between the selecting a choice during decision-making process and its execution, which is indicative of an appropriation process. Conclusion: The present study shows that sheer knowledge of facts may not be sufficient for selecting a correct choice among presented options effectively. However, as ABCS improves the choice selection efficiency, it plays an instrumental role in determining the subject of awareness, indirectly supporting the notion of DSIA.

Nowadays the freedom to make choices is considered of vital importance for decision-makers. Researchers investigating the psychological effects of choice provided empirical evidence about the many advantages of choice (i.e., increased intrinsic motivation, greater perception of self-determination, better performance, and greater life satisfaction). However, more recent studies demonstrated the downsides of choice. When the decision task difficulty exceeds the natural cognitive resources of human mind, the possibility to choose becomes more a source of unhappiness and dissatisfaction than an opportunity for a greater well-being. We here discuss in a detailed fashion the main findings of research in psychology and consumer behavior showing the bright sides and the downsides of choice.

Background: Nonsurgical treatment in uncomplicated appendicitis is in many cases a reasonable option, despite the sparsity of robust, easy access, externally validated and multimodally informed clinical decision support systems (CDSS). Developed by OpenAI, the Generative Pre trained Transformer 3.5 model (GPT 3), may provide enhanced decision support for surgeons in less certain appendicitis cases or those posing a higher risk for (relative) operative contra indications. Our objective was to determine whether GPT 3.5, when provided high throughput clinical, laboratory and radiological text based information will come to similar clinical decisions as a machine learning model and a board certified surgeon (reference standard) in decision making for appendectomy versus conservative treatment. Methods: In this cohort study we randomly collected patients presenting at the Emergency Department (ED) of two German hospitals (GFO, Troisdorf and University Hospital Cologne) with right abdominal pain between October 2022 and October 2023. Statistical analysis was performed using R, version 3.6.2, on RStudio, version 2023.03.0+386. Overall agreement between GPT 3.5 output and the reference standard was assessed by means of inter observer kappa values as well as accuracy, sensitivity, specificity, positive and negative predictive value with the “Caret” and “irr” package. Statistical significance was defined as p < 0.05. Results: There was agreement between surgeon decision and GPT 3.5 in 102 of 113 cases and all cases where the surgeon decided upon conservative treatment were correctly classified by GPT 3.5. The estimated model training accuracy was 83.3 % (95% CI: 74.0, 90.4), while the validation accuracy for the model was 87.0 % (95% CI: 66.4, 97.2). This in comparison to the GPT 3.5 accuracy of 90.3% (95% CI: 83.2, 95.0), which did not perform significantly better in comparison to the machine learning model (P = 0.21). Conclusions: This to our knowledge first “intended use” for surgical treatment GPT 3.5 study comparing surgical decision making versus algorithm found a high degree of agreement between board certified surgeons and GPT 3.5 for surgical decision making in patients presenting to the emergency department with lower abdominal pain.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

This article offers a pragmatic ‘epistemology of wargaming’ which views wargames as immersive ‘thought experiments’ in which the human players involved use their experiential, empirical, and theoretical knowledge – together with whatever cognitive models they are able to deploy, or develop anew – to generate a conceptual, operational understanding of the adversarial scenario in which they are immersed; and exploit this understanding to craft tactical decisions designed to optimise the likelihood they will achieve their strategic objectives. From this perspective, contemporary interest in the use of ‘AI’-enabled tools to augment the validity of wargaming outputs – where these outputs constitute the decisions players make and the insights such decisions reveal – might most purposefully focus on: the design and implementation of wargames (to strengthen the architecture these provide to support immersive decision-making); and the analysis of players’ decisions (to better understand the cognitive models these involve and reflect). While the focus we suggest might disappoint those keen to replace human players with (semi-) autonomous decision-making machines, as long as the principal objectives of wargaming are to assess and enhance the decision-making capabilities of human players and human personnel, ‘AI’-enabled applications can only ever play a supporting role (albeit a potentially invaluable one) in the design, presentation, implementation, and analysis of wargames. As Irving Berlin might have it: ‘AI’ might soon be able to do most things better than us, but it can never replace humans when only a human will do.

Safety is very important in aviation since a loss of safety frequently results in both fatalities and financially damaging situations that are typically unrecoverable. Thus, achieving safety as much as possible is the primary goal of practically all aviation technology work. In this study, an Adaptive Neuro-Fuzzy Inference System (ANFIS)-based classifier is created to estimate the fault risk factor of airplanes. Five categories of real fleet data belonging to structure, electrical, avionic, motor systems, and incident statistics of the planes have been used for classifier development. A risk factor determination for each plane is the output of the developed intelligent classifier, and it can be used to identify general overhaul candidate planes and stop defects and crashes before they happen. The obtained results show that using ANFIS provides a great capability in processing many inputs and outputs depending on different types and classes in the aviation industry and thus predicting the failure risk of the airplane efficiently.

This thesis presents findings from an online experiment aimed at evaluating individuals' attitudes towards their own cognitive biases that lead to objective mistakes. In a number of incentivized decision problems, a participant in the experiment might make a mistake and choose a dominated lottery (FOSD lottery), which is likely to result from a particular heuristic or cognitive bias. In this case, she is then confronted with her error under one of two treatments: a confrontation with an explanation only regarding the mistake or one with the addition of the supposed mechanism (bias). Following this explanation, her comfort level with her choice is measured. A bias that acted as a mechanism for the observed error could be considered advantageous (i.e., useful given alternative costs) or disadvantageous (i.e., mostly harmful) in other decision-making scenarios encountered during one's lifetime. Consequently, the perception of cognitive biases is subjective and may vary among decision makers, who may emphasize either the positive or negative aspects of such biases. The proposed methodology allows to determine whether these biases are perceived as useful rules of thumb, despite leading to a dominated lottery choice in that particular context, or unfavorable.Results revealed significant differences between the two treatments and across five different decision problems. Interestingly, the results showed that in only 60% of the cases, the participants felt uneasy about their mistakes. In the remaining instances, the participants demonstrated either indifference or a sense of comfort with their choice of a dominated lottery. The net effect of providing information on the cognitive biases that presumably lead to the mistakes, measured as the difference between treatments, revealed a negative perception of the mechanism behind the error in one problem, contentment with the mechanism for another, and no significant effect for the remaining biases.

Little is known about fertility preservation within the TGD community. Few receive adequate counseling placing them at risk for decision regret. The goal of this project was to develop, and pilot test the Transgender Fertility Preservation Knowledge Scale (TFPKS) to support the development and evaluation of health education resources. A community engaged; cross sectional retrospective design was used. Participants (n=189) provided information describing demographics, healthcare decision-making preferences, experiences/knowledge of fertility preservation, and treatment decision regret. The sample included 189 TGD adults. Most were white and aged 26-35 (33.3%) and not offered a consultation (73.0%). Many (41.2%) report they would have participated if offered. Knowledge regarding fertility preservation to support this desire was low. Most participants identified a patient-centered (69.4%) decision making preference. Much remains to address the healthcare inequities within the TGD population regarding fertility preservation. Overall participants had low levels of knowledge to support decision making. Further, healthcare system and individual barriers to fertility preservation remain prevalent. A foundational step towards addressing these disparities, is the identification of a valid and reliable instrument to measure TGD knowledge of fertility preservation.

Machine safety is not only a prerequisite for successful production, but also the foundation for sustainability and growth of any manufacturing organisation. The latest approaches in this rapidly developing field are the integration of effective risk management tools and strategies into occupational health and safety (OHS) systems. In this article, using a specific example from practice, we will show how using multi-criteria decision making (AHP) support Machinery Safety Decision Making (MSDM) from the point of reducing losses. Using Classification and Regression Tree Analysis (CART), we estimated the efficiency, cost-effectiveness and thus the sustainability level of the relevant safety measures. These were proposed risk reduction measures that typically raised uncertainty among managers regarding the estimation of cost-effectiveness. The advantage of application decision trees approach is possibility to identify and establish relatively homogeneous groups of undesirable events and their impact on the organisation's objectives. A comprehensive model has been developed to support management decision making in manufacturing organizations in implementing and improving safety measures in line with manufacturing sustainability goals.

Investment management is a common process and practice used for achieving a desirable investment goal or outcome. Investment assessment should be carried out at various stages of project realization in accordance with capital investment volume. Investment risk management implies the effective control of all procedures and monitoring of risks in all phases of the investment project. Because of the reason that a single indicator in probability calculation of achieving optimal return from the investment does not exist, performing sufficiently reliable estimates of the quality of investments becomes a tedious task. There are many indicators, factors, and criteria required for consideration to reach the effective solution of the investment problem. Unfortunately, the systematic variation of economic situations in the marketplace stipulates the continuous and frequent changes of investment conditions and environment in which the investor should act and operate. Hence, the rules required for providing a reasonable quality of investment projects can be based only on investor’s management strategy and rely on investor’s intuition and practice. The importance of classification in investment management and decision making process is undeniable. The objects to be classified are described using assessments in accordance with various criteria which can be both quantitative and qualitative. With a competent formulation of the investment process, both methods are used in parallel. There exist various decision making approaches for the investment management, and simple additive weighting (SAW) is one of the well-known multi-criteria decision making (MCDM) methods aiming to provide an optimal decision for decision maker when solving various real-life problems, and particularly, investment problem. In this paper, fuzzy simple additive weighting (FSAW) method in group decision making is applied to undertake the capital investment expenditure for purchasing cars with the purpose of renting them to the public. The development of existing FSAW method is accomplished and this process involves the sensibility of outcomes to changes in the rate of fuzziness represented with decisions taken. Eventually, the degree of fuzziness involved in an analysis that directly attempts to model the immanent vagueness and imperfectness in particular precedency judgments made, is determined. A numerical example illustrates the importance and effectiveness of the suggested approach with the aim of ranking alternatives and hence, determining the most preferred alternative in MCDM problem.

This research challenges the traditional perspective on consumer behavior, which focuses on external factors shaping the sequential stages of decision-making. Instead, it proposes a paradigm shift by treating the decision-making process itself as an independent variable, exploring its impact on various outcomes like purchasing behavior, brand loyalty, and post-purchase satisfaction. This novel approach offers deeper insights into the intricacies of consumer behavior, particularly in the digital age. By uncovering the reciprocal relationships between the decision-making process and other variables, the research provides a more nuanced understanding of how consumers navigate today's complex landscape. It further delves into how variations in the decision-making process across diverse consumer groups influence various outcomes, recognizing the unique characteristics and needs of different demographics. The research also acknowledges the interplay of psychological, social, and contextual factors that shape both the decision-making process and its downstream effects, offering a comprehensive understanding of the multifaceted influences on consumer behavior. Ultimately, by studying the decision-making process as an independent variable, this research aims to equip businesses and researchers with valuable insights, enabling them to better navigate the ever-evolving world of consumer behavior.

Patient experience is key to patient-centered care and overall healthcare quality. This focus aligns with the growing trend of collaborative care, where patients actively participate in deci-sions alongside providers, leading to better outcomes. Patient experience goes beyond clinical results; it encompasses how patients feel throughout the care journey. Integrating patient per-spectives is essential for high-quality care. The study employed a multicenter, cross-sectional survey design utilizing a questionnaire-based approach. The data collection spanned two loca-tions within the Hospital Clínica Bíblica: San José, and Santa Ana, Costa Rica. The survey target-ed patients receiving treatment across the emergency department, surgery service, and inpatient department. A standardized Picker Patient Experience Questionnaire-33 (PPE-33) was adminis-tered to assess patients' overall experience with received services. A total of 390 questionnaires were analyzed. The participant demographics were as follows: 61.79% female, 56.15% aged be-tween 18 and 44, and 55.67% with undergraduate education. The hospital delivered high-quality service, with strong communication and accessibility (93.7%, 92.6%, and 94.4% positive respec-tively). Improvements are needed in patient rights education (22.7% positive), information about the patient's condition (74.3% positive), discharge instructions (36.5% and 71.4% positive for side effects and warning signs respectively) and addressing patient concerns (26.3% to 44.0%). Patients appreciated their privacy (95.2%), effective pain management (96.2%), respectful com-munication (97.0% and 94.8%), and overall respectful treatment. Satisfaction was influenced by factors like patient needs prioritization, rights communication, sociodemographic, health status, and comfort. The ward of admission had no significant impact on the experience. Enhancing pa-tient experience could boost loyalty and healthcare quality.

Background: Fertility is a crucial component of population maintenance and growth. A declin-ing fertility trend has been observed over the past two decades, and it continues. Objective: The aim of this research was to examine the level of fertility knowledge, factors in-fluencing fertility knowledge, and the relationship between fertility knowledge and the decision to have a child. Methods: A cross-sectional study was conducted on a sample of mothers in five hospitals on the Adriatic coast of the Republic of Croatia, involving 1541 mothers from September 2021 to De-cember 2023. The Cardiff Fertility Knowledge Scale was used for the research. Results: The participants were divided into two groups based on fertility status in women, spe-cifically the period of declining fertility in women. Group 1 included participants aged 18-31 with sustained fertility, and Group 2 included participants aged 32 and older experiencing de-clining fertility. Fertility knowledge was 58.9%. Women with higher educational status showed better results (62.3%). The most common sources of fertility knowledge were the healthcare sys-tem and the internet. Factors associated with the level of fertility knowledge included higher education, marital status, and higher economic status. Conclusion: The research results reveal a lack of fertility knowledge among participants, as well as an intention to have a child in later stages of life. The lack of formal education on this topic leads to information gathering from unreliable sources.

Preconception or prenatal carrier screening for hereditary deafness is an effective early intervention strategy to reduce the incidence of newborn deafness, but current research is limited. This study aimed to investigate the carrier frequencies of common deafness genes in the Chinese population and to follow up on pregnancy outcomes in high-risk couples. Carrier screening for common deafness genes in the Chinese population, including the GJB2 and SLC26A4 genes, was performed using next-generation sequencing technology. Of the 9,993 subjects screened, the carrier rate was 2.86% for the GJB2 gene and 2.63% for the SLC26A4 gene. Of the six high-risk couples, four made alternative reproductive decisions (three with prenatal diagnosis and one with preimplantation genetic testing), with consequent successful termination of the birth of two affected fetuses. The frequencies of preconception or prenatal carrier screening for the deafness genes GJB2 and SLC26A4 in 9,993 subjects from China in this study were 2.86% and 2.63%, respectively. In addition, four out of six high-risk couples made alternative reproductive decisions, followed by the successful prevention of the birth of two affected fetuses. These findings confirmed the clinical utility of preconception or prenatal carrier screening for hereditary deafness.

The goal of this study is to categorize stakeholders in Internet of Things (IoT) security based on their roles in order to address the challenges associated with managing the large amount of data generated by IoT devices. With the increasing number of connected devices, the security risks also escalate, necessitating skilled stakeholders to mitigate these risks and prevent potential attacks. This study proposes a two-part approach that involves clustering stakeholders according to their responsibilities and determining relevant features to enhance decision-making. By grouping stakeholders into shared categories, the study aims to provide a more efficient and effective method for managing IoT security. The insights gained from this research will not only benefit stakeholders involved in IoT security but also assist policymakers and regulators in developing effective strategies.

Finding a suitable support is a key process in the life history of climbing plants. Climbers that find a suitable support have greater performance and fitness than those that remain prostrate. Numerous studies on climbing plant behavior have elucidated the mechanistic details of support searching and attachment. Far fewer studies have addressed the ecological significance of support-searching behavior and the factors that affect it. Among these, the diameter of supports influences their suitability for twining plants. When support diameter increases beyond some point climbing plants are unable to maintain tensional forces and therefore lose attachment to the trellis. Here we further investigate this issue by putting pea plants in the situation to choose between supports of different diameters while their movement was recorded by means of a three-dimensional motion analysis system. The results indicate that the way climbing plants move can vary depending on whether they are presented with one or two potential supports. Furthermore, when presented with a choice between a thin and a thick support, the plants showed a distinct preference for the former than the latter. The present findings shed further light on how climbers make decisions as far as support search is concerned, and provide evidence that plants adopt one of several alternative plastic responses in a way that optimally corresponds to environmental scenarios.

Decision making is a complex process involving various parts of the brain which are active during different times. It is challenging to measure externally the exact instance when any given region becomes active during the decision-making process. Here we try to extract and visualize the dynamic functional brain activation information from the observed fMRI data. We propose the use of a regularized deconvolution model to simultaneously map various activation regions within the brain and track how different activation regions changes with time. Thus, providing both spatial and temporal brain activation information. The activation information can then be further analyzed as per need and requirements. The proposed technique was validated using simulated data and then applied to a simple decision-making task for identification of various brain regions involved in different stages of decision making. The visualization aspect of the algorithm allows us to actually see the flow of activation (and deactivation) in form of a motion picture. The dynamic estimate may aid in understanding the causality of activation between various brain regions in a better way.

The rapid and extensive loss of biodiversity globally has resulted in an increased urgency to capture and conserve the diversity which is present, including genetic diversity within species. However, for many species there is currently no detailed genetic data available to inform the collection and use of material held in ex situ collections and this can hamper the consideration of genetic issues and reduce the likelihood collection represent the diversity present. Even in the absence of direct genetic data, however, it is possible to consider genetic issues using the existing theoretical and empirical evidence-based and biological, ecological and demographic data for a given species. Here a framework to facilitate the consideration of genetic diversity and genetic issues, even where genetic data is lacking, is presented.

The current discussion about a “risk culture” in financial services was triggered by the recent series of crisis (from the US subprime mortgage crisis to the lock-in trap of central banks in the aftermath of the sovereign debt crisis). The last decade saw a long list of hybris, misconduct and criminal activities by human beings on a single or even a collective basis in banks, in the industry or in the whole economy. As a counter-reaction, financial authorities called for a guidance by a “new” risk culture in financial institutions based on a set of abstract, formal and normative governance processes. In the humanities, culture is a paraphrase for the behaviour in collectives and dynamics of organization found in human societies. Therefore, a “risk culture” should be a link between those normative guidelines and the positive “real-world” decision-making in financial services. This paper will focus on “risk culture” from the perspective of human beings interacting in dynamical and intertemporal commercial relations. In this context, “risk” is perceived by economic agents ex-ante as the consequence of the time-lag between the present and the uncertain future development (compared to a probability distribution calculated by observers ex-post). For all those individual decisions – to be made under uncertainty – future “risk” includes the so-called “normal accidents”, i.e. failures that will happen at some uncertain point in time but inevitable, and it is only the questions, when failure will happen and how to maintain function in the first line of defence. Finally, the sum of all decisions with individual responsibility for things to come is the positive economical context of a “risk culture” in the sense of the (rational) behaviour of an honourable merchant in long-term and repeated commercial relations in a merchant community, as this is a heritage of European business culture.

Human decision-making is increasingly supported by artificial intelligence (AI) systems. From medical imaging analysis to self-driving vehicles, AI systems are becoming organically embedded in a host of different technologies. However, incorporating such advice into decision-making entails a human rationalization of AI outputs for supporting beneficial outcomes. Recent research suggests intermediate judgments in the first stage of a decision process can interfere with decisions in subsequent stages. For this reason, we extend this research to AI-supported decision-making to investigate how intermediate judgments on AI-provided advice may influence subsequent decisions. In an online experiment (N=192), we found a consistent bolstering effect in trust for those who made intermediate judgments and over those who did not. Furthermore, violations of total probability were observed at all timing intervals throughout the study. We further analyzed the results by demonstrating how quantum probability theory can model these types of behaviors in human-AI decision-making and ameliorate the understanding the interaction dynamics at the confluence of human factors and information features.

This research investigates the relationship between the long-term orientation of top managers and their strategic decision-making processes, emphasising the comprehensiveness, speed, and inventiveness of decisions. The study employed structural equation modelling to look into the suggested connections using a sample of CEOs. The findings demonstrated a high and positive correlation between long-term orientation and decision comprehensiveness and speed, but not for decision creativity. The study contributes to the growing body of research on how human variations, such as temporal orientation, affect business outcomes and strategic decision-making. Moreover, the fact that a number of the results differed from those of other studies carried out in other contexts highlights how important it is to consider the industry and cultural environment when assessing these connections.

Trenchless technologies are utilized for installing new pipes or repairing and replacing old ones, categorized into construction and rehabilitation/replacement methods. With rapid urbanization, new pipe networks must be established in proportion to population growth. Additionally, due to issues like corrosion and aging, a significant portion of storm sewers, waste sewers, gas, and water pipes need annual replacement or rehabilitation. Traditional open-cut methods are no longer viable due to traffic disruption, safety concerns, environmental impacts, and high costs. Trenchless construction methods address these issues effectively. Construction trenchless methods include horizontal earth boring (no worker entry), pipe jacking, and utility tunneling (worker entry). Horizontal earth boring is further divided into horizontal auger boring, horizontal directional drilling, pipe ramming, microtunneling, pilot tube microtunneling, and compaction methods. The first part of the current study reviews and discusses the design criteria for horizontal auger boring, horizontal directional drilling, pipe jacking, pipe ramming, and microtunneling. Based on these unique project requirements, the optimal trenchless technology can be proposed. In the second part of the research, a hierarchical algorithm is proposed, based on literature concepts, to serve as a decision-making tool for selecting the optimal trenchless construction method. Sometimes, multiple methods may be proposed, with the best one chosen based on equipment availability, skilled teams, budget, and sustainability principles. Although trenchless renewal methods are not the focus of this study, their design criteria are provided in the appendices to offer a comprehensive collection of design requirements for all trenchless technologies.

Low carbon supply chain management (LCSCM) strategies are required in the Indian manufacturing industries due to rapidly growing energy usage for financial and environmental concerns. LCSCM technologies face a number of challenges that limit their adoption. Eleven hurdles were selected from the literature as well as the recommendations of business and academic experts. These barriers are defined by a number of factors, including a lack of information, financial worries, environmental concerns, and governmental limits, among others. In addition, efforts are being made to quantify the most optimal relevant barriers using Multi criteria decision making (MCDM) techniques such as interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL). MICMAC analysis is used to estimate the sensitivity and priority of barriers based on dependency power and driving power. One of these barriers is a needed factor; three are driving elements; four barriers are linked factors; and three are self-sufficient factors. The findings of this study can help academic specialists, industry representatives, and practitioners in their ongoing attempts to adopt 'LCSCM techniques' in Indian manufacturing industries. The model is appropriately explained and applies the link between the barriers.The objective of this paper is the Evaluation and selection of most influential of Barriers to Adopt Low Carbon Supply Chain Management (LCSCM) in the Indian Manufacturing Sector is interrelated.

Oxytocin is well known for its role in relationships and social cognition and has more recently been implicated in pain relief and pain perception. Connections between prosocial feelings and pain relief are also well documented, however, effects of exogenous oxytocin on social cognition and pain have not been explored. The current study tested whether intranasally-delivered oxytocin affects pain perception through prosocial behaviors. Additionally, moderation of the effects of oxytocin by life history or genetic polymorphisms are examined. Young adults (n=43; 65% female) were administered intranasal oxytocin (24 IU) or placebo in a crossover design on two visits separated by a one-week washout period. Pain was delivered via cold-pressor. Baseline measures for decision-making and social cognition were collected, as well as pain sensitivity and medication history. Saliva samples were collected for analysis of genetic markers, and urine samples were collected to assess oxytocin saturation. Following oxytocin administration, participants reported increased prosocial cognition and decision-making. Pain perception appeared to be adaptive, with procedural order and expectation affecting perception. Finally, behavioral trust and cooperation responses were significantly predicted by genetic markers. Oxytocin may increase a patient’s trust and cooperation and reduce pain sensitivity while having fewer physiological side effects than current pharmaceutical options.

Smartphone Addiction is a social issue caused by excessive smartphone use, affecting decision-making processes. Current research on the risky decision-making abilities of smartphone addicts is limited. This study used the fNIRS brain imaging technique and a Sequential Risk-Taking Task experimental paradigm to investigate the decision-making behavior and brain activity of smartphone addicts under varying risk levels. Using a mixed experimental design, the research assessed decision-making ability and brain activation levels as dependent variables across two groups (addiction and control), two risk amounts (high and low), and two outcomes (gain and loss). The study included 42 participants, with 25 in the addiction group and 17 in the control group. Results indicated that risk level significantly impacted the decision-making ability of smartphone addicts, with high-risk levels leading to weaker decision-making ability and increased risk-taking. However, at low risk levels, decision-making abilities between addicts and healthy individuals showed no significant difference. Furthermore, brain imaging results using fNIRS revealed stronger brain activation in the dlPFC region for smartphone addicts under loss outcome conditions, with no significant differences between the two groups in terms of brain activation at varying risk volumes. These findings are critical in promoting healthy smartphone use, guiding clinical treatment, and advancing brain mechanism research.

Type I contextuality or inconsistent connectedness is a fundamental feature of both the classical as well as the quantum realms. Type II contextuality (true contextuality or CHSH type contextuality) is frequently asserted to be specific to the quantum realm. Nevertheless, evidence for Type II contextuality in classical settings is slowly emerging (at least in the psychological realm). An example is given here of Type II contextuality involving a simple cooperative game. This arises due to the cooperative nature of the game which results in sign intransitivity for expectation values while individual random variables remain consistently connected. This shows that the conditions attributed uniquely to quantum systems may occur in classical settings as well. Sign intransitivity can be observed in preference relations in the setting of decision making and so intransitivity in decision making may also yield examples of Type II contextuality. Previously it was suggested that a fruitful setting in which to search for such contextuality is that of decision making by collective intelligence systems. An experiment was conducted using a detailed simulation of nest emigration by workers of the ant Temnothorax albipennis. In spite of intransitivity, these simulated colonies came close to but failed to violate Dzhafarov’s inequality for a 4-cyclic system. Further research using more sophisticated simulations and experimental paradigms is required

When following a prescribed route, we need to decide at each intersection which way to proceed. The present work addressed several factors that might influence the difficulty of this decision making process. Participants repeatedly followed a route through a virtual maze with twelve or eighteen intersections, and with two or three choices per intersection. One group performed task S, which promoted decision making by the serial order strategy since all intersections looked alike. Another group performed task SA, which allowed the use of the serial order and the associative cue strategy since unique visual cues were presented at each intersection. We found that in both tasks, participants were more accurate in making decisions on routes with twelve rather than eighteen intersections, and more accurate by a similar amount on routes with two rather than three choices. Reaction time in task SA was reciprocal to accuracy; reaction time in task S was generally lower and route-independent. Accuracy in task SA was similar for participants who experienced smooth transport across intersections and those who experienced abrupt transport, while accuracy in task S was lower for participants who experienced smooth rather than abrupt transport across intersections. We conclude that the number of intersections and the number of choices were equivalent determinants of route following difficulty. We further conclude that optic flow during turns at intersections interfered with anticipatory decision making in task S; hence natural (smooth) transport across intersections did not enhance route following performance.

The pace of implementation of renewable electricity storage in Europe is disappointingly slow. Several factors influence it, but there is a need to speed up the rate and increase the volumes in order to promote a 100% transition to renewable energy resources, expand the practice of using renewable energy, and contribute to the improvement of the user's quality of life. Also, an important factor is significantly reducing the global impact on the environment and climate change. Electricity from renewable energy sources such as solar and wind has a seasonal nature that cannot provide the necessary electricity consumption and cover peak loads. Also, the so-called "energy resource crisis" is a very topical problem at the moment, which reinforces the global need to increase the share of renewable energy resources in the overall balance of primary energy resources. It is precisely the wider integration of renewable electricity storage in practice that can help stimulate this. The availability of renewable electricity is constantly increasing and the level of technological innovation is rapidly developing, therefore it is valuable to analyze, look for connections and at the same time the main differences in the ways of accumulation in order to promote its availability from a private house to the national and European scale as a whole. Therefore, this article analyses and compares the different options for renewable electricity storage, from small batteries to large storage systems, arriving at the best solution according to needs, using analysis methods such as multicriteria decision analysis (MCDA) and TOPSIS. After comparing nine criteria, such as the amount of investment required, existing power density, efficiency, duration of operation and others, in both groups, it was concluded that lithium-ion batteries are currently the best solution among batteries, while in the group of large accumulation systems – pumped hydro storage.

This article is a theoretical contribution to mental model research, which currently has different threads. Whereas some researchers focus on the perceived causal structure, others also include decision policies and decisions. We focus on the link between recognized causal structure (“mental models of dynamic systems”) and policies, proposing Johnson-Laird’s theory of mental models as the link. The resulting framework hypothesizes two types of systematic mental model errors: (1) misrepresentation of the system’s structure and (2) failure to deploy relevant mental models of possibilities. Examination of three experiments through this lens reveals errors of both types. Therefore, we propose that the cognitive theory of mental models opens a path to better understand how people construct their decision policies and develop interventions to reduce such mental model errors. The article closes by raising several questions for empirical studies of the reasoning process leading from mental models of dynamic systems to decision policies.

Petrochemicals, which convert oil and gas into products such as plastics, are fundamental to modern societies. Chemists recognize their role in the design of materials and the adverse effects that these may have on the environment, preventing sustainable development. Several methodological frameworks and sustainability assessment approaches have been developed to evaluate the resources used in the petrochemical sector in terms of environmental costs. A combination of Life Cycle Assessment and Emergy Accounting - to assess the environmental support for resource use - is applied in this study of the PET production chain in Europe. The Unit Emergy Values of several intermediates are calculated or updated to facilitate discernment of the quality of energy used and the processes' efficiency. Several routes for synthesizing renewable para-xylene and ethylene glycol from biomass are discussed and confronted with the efforts focused on recycling and recovering the final product providing concurrently a procedure and a valuable data set for future CP actions. The results show that understanding the efficiencies changing across the production chain may help stakeholders make wise choices as to where and when interventions to promote a circular economy are most effective along a petrochemical production chain.

We are of the opinion that during the design of a binary classifier one ought to consider adding an “I don’t know” answer. We provide the case for the introduction of this third category when a human needs to make a decision based on the answer from a binary classifier. We discuss the costs and potential benefits of its introduction. Colloquially, we have used the term “I don’t know”, but formally we refer to it as NotAvailable. A procedure to define NotAvailable predictions in binary classifiers, called all leave-one-out models (ALOOM), is presented as proof of the concept. Furthermore, we discuss the potential benefits of applying ALOOM in real life applications.

Multi-criteria decision-making (MCDM) methods and techniques have been applied to many real-world problems in different fields of engineering science and technology. The evaluation based on distance from average solution (EDAS) method is a new and efficient MCDM method. The aim of this study is to propose a modification to address two exceptional cases in which the EDAS method fails to solve an MCDM problem.

This research article presents the integration of participatory modeling and system dynamics as a novel methodology for the consolidation of social dynamic models for the subsequent evaluation and prioritization of green projects in Colombian post-conflict communities. In the first instance, through participatory work carried out along with the community, it was possible to identify, evaluate and systematize citizen factors in relation to the problems and needs of the region. Second, based on the results obtained, to calibrate a simulation model based on system dynamics that facilitates decision making with regard to the evaluation of green projects. The proposed methodology leads to the conclusion that, with the participation of the community and with a model based on the dynamics of variables such as supply and demand for natural resources of water and land, it is possible to warn decision makers about the variables that can lead to the maximization of investments and thus prioritize and select the most appropriate environmental, social or economic initiatives, that certainly meet the needs or expectations of the involved community. In the future, the model could be used to facilitate the management, administration and control of water and land resources by creating alerts called reserve margins.

The performance of choice-reaction tasks during athletic movement has been demonstrated to evoke unfavorable lower limb biomechanics. However, the mechanism of this observation is unknown. We conducted a systematic review examining the association between 1) the biomechanical and functional safety of unplanned sports-related movements (e.g. jumps/runs with spontaneously indicated landing leg/cutting direction) and 2) markers of perceptual-cognitive function (PGF). A literature search in three databases (Pubmed, ScienceDirect, Google Scholar) identified five relevant articles. Study quality, rated by means of a modified Downs & Black checklist, was moderate to high (average: 13.5/16 points). Four of five papers, in at least one parameter, found either an association of lower PGF and reduced task safety or significantly reduced task safety in low vs. high PGF performers. Yet, as a) the outcomes, populations and statistical methods of the included trials were highly heterogeneous and b) only two out of five studies had an adequate control condition (pre-planned movement task), evidence was classified as conflicting. In sum, PGF may represent a factor increasing injury risk during unplanned sports-related movements but future research strengthening the evidence of this association is warranted.

Uncertainty is the main source of risk of geological hazards in tunnel engineering. Uncertainty information not only affects the accuracy of evaluation results, but also affects the reliability of decision-making schemes. Therefore, it is necessary to evaluate and control the impact of uncertainty on risk. In this study, the problems in existing entropy-hazard model such as inefficient decision-making and failure of decision-making are analysed, and an improved uncertainty evaluation and control process are proposed. Then the tolerance cost, the key factor in the decision-making model, is also discussed. It is considered that the amount of change in risk value (R1) can better reflect the psychological behaviour of decision-makers. Thirdly, common attribute decision models, such as the expected utility-entropy model, are analysed, and then the viewpoint of different types of decision-making issues that require different decision methods is proposed. The well-known Allais paradox is explained by the proposed methods. Finally, the engineering application results show that the uncertainty control idea proposed here is accurate and effective. This research indicates a direction for further research into uncertainty, and risk control, issues affecting underground engineering works.

Recent findings show that preferences for food items can be modified without external-reinforcements using the cue-approach task. In the task, the mere association of food item images with a neutral auditory cue and a speeded button press, resulted in enhanced preferences for the associated stimuli. Here, in a series of 10 independent samples with a total of 255 participants, we show we can enhance preferences using this non-reinforced method for faces, fractals and affective images as well as snack foods, using auditory, visual and even aversive cues. This change was highly durable in follow-up sessions performed one to six months after training. Preferences were successfully enhanced for all conditions, except for negative valence items. These findings promote our understanding of non-reinforced change, suggest a boundary condition for the effect and lay the foundation for development of novel applications.

The purposes of this study were to identify clinician’s characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the information sources influencing medical decision-making about treatment of schizophrenia. We surveyed 202 psychiatrists during 6 regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic and information sources about their clinical decisions were collected. Most of psychiatrists used second-generation antipsychotic (SGA), and preferentially an oral formulation, in the treatment of schizophrenia. SGA LAI was prescribed to 30.4% of schizophrenic patients. The duration and the type of practice did not influence the class or formulation of antipsychotics used. The clinicians following the higher percentage of schizophrenic patients were associated with the higher use of LAI antipsychotics and the lower use of oral SGA. Personal experience, government regulatory approval and guidelines for the treatment of schizophrenia were the 3 main contributing factors guiding the clinical decision-making of clinicians about treatment of schizophrenia. The more clinicians follow schizophrenic patients, the more they use LAI antipsychotic. The development of specialised programmes with top specialists should lead to better use of LAI in the treatment of schizophrenia.

Urban areas are centres of business and innovation. Freight transport is indispensable for the proper functioning of any modern urban society. Urban areas can’t function without an appropriate freight transport system, due to the need to replenish stocks of food and other goods in retail shops. The complexity of the decisions concerning implementation of measures to improve the movement of goods in the city requires tools designed to support this process. The purpose of this article is to introduce the possibility of applying the Analytic Hierarchy Process (AHP) as well as the Decision Making Trial and Evaluation Laboratory Method (DEMATEL) in choosing a set of measures and in analysing in the field of distribution logistics, which will help to solve the delivery problems and streamline the cargo flows in Szczecin, in the context of sustainable development.

Autonomous systems and intelligent machines are involved in almost all areas of human activity and they are now more and more present in our everyday life. The reason for this extensive use certainly resides in all the benefits these machines offer to the users. In experimental settings, numerous studies have demonstrated the positive effects that the introduction of autonomous systems have on human decision-making and performance. However, studies have shown in addition that the introduction of these systems can have important negative effects as well. Considering that autonomous systems are now introduced in sensitive domains like the military or medicine, we need more than ever a comprehensive understanding of the effects they cause on human performance and decision-making, and particularly in tasks and contexts with a social or moral dimension. The aim of this narrative review is threefold. First, we will provide an overview of the main effects on a human agent’s decision-making and performance produced by the introduction of autonomous systems. Second, we will review the conditions identified as underlying factors of these effects, and see how current models of human – autonomous systems interaction integrate those conditions. Third, we will conclude this review by highlighting new directions for future investigations.

The new Post Accelerating Data and Knowledge Online Society, or ‘Padkos’ requires a new model of decision making. This introductory paper proposes a model where decision making and learning are a single symbiotic process, incorporating man and machine, as well as the AADD (ánthrōpos, apparatus, decider, doctrina) diamond model of individual and organizational decision-making and learning processes. The learning is incorporated by using a newly proposed quadruple loop learning model. This model allows for controlled changes of identity, the process of creating and the sense making of new mental models and assumption, and reflections. The model also incorporates the recently proposed model of quantum decision-making, where time collapse of the opted past and the anticipated future (explicitly including its time horizon) into the present play a key role in the process, leveraging decision-making and learning by human as well as Artificial Intelligence (AI) and Machine Learning (ML) algorithms. The paper closes with conclusions.

The textile industry plays a vital role in the global economy and faces increasing pressures related to sustainability and efficiency. Given the industry's significant environmental impact and the need for improved operational strategies, our review addresses the critical intersection of decision-making methodologies and sustainable practices. Specifically, This review aims to explore the applications of Multi-Criteria Decision-Making (MCDM) techniques within the textile supply chain to enhance operational performance and decision-making processes. Utilizing a systematic literature review method, we analyzed articles from Scopus, Web of Science, and Google Scholar, focusing on those that address MCDM applications in the textile supply chain. The findings reveal a strong emphasis on supplier selection and evaluation as determinants of competitive advantage, with significant trends toward integrating fuzzy set theory and advanced MCDM methodologies to address uncertainties. Additionally, Sustainability emerges as a core theme, emphasizing the necessity for firms to incorporate green practices into decision frameworks. The insights suggest that by adopting innovative analytical techniques, organizations can improve supplier relationships and operational efficiency.

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine: 1) What constitutes the concept of child-centred care in healthcare? 2) How has the concept of child-centred care developed? 3) What is the applicability of child-centred care and what are its limitations? and 4) How does the concept of child-centred care benefit and inform children’s healthcare? In total, 2984 papers were imported for screening, following removal of duplicates and screening, 21 papers were included in the scoping review.The findings suggest that child-centred care is an emerging, ambiguous, poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact of, and benefit from, child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care it needs to establish robust evidence of its effectiveness, impact on children and their families as well as the wider impacts on the healthcare system.

The wastewater circular economy (WW-CE) promises a solution to improve water and sanitation management worldwide. However, the transition from conventional to circular wastewater treatment plants (WWTPs) requires facilitation to aid in decision makers understanding of integral sustainability impacts of alternative WW-CE configurations. This research implemented Life Cycle Sustainability Assessment (LCSA), combining Life Cycle Assessment, Social Life Cycle Assessment and Life Cycle Costing with a Multi-criteria Decision Making (MCDM) model to quantify environmental, socio-cultural, and economic impacts of conventional WWTPs with the WW-CE. Two real WWTPs in Chile have embraced the WW-CEs and adopting the title of Biofactories. These were considered as case studies, compared under three scenarios to demonstrate the sustainability trade-offs of the transition from no sanitation to conventional WWTPs and Biofactory WW-CE configurations. Results demonstrated that the transition to WW-CEs improved integral sustainability according to the LCSA model implemented in both WWPTs. This study highlights the urgent need to adopt sustainable decision-making models to not only improve sanitation coverage, but also improve sustainability performance of the sanitation industry across the globe.

This study addresses the motivations behind Generation Z's attendance at conferences and aims to contribute to a better understanding of their conference participation behavior. The study identified six latent factors that influence conference attendance motivation: Green and Digital Conference Experience, Educational and professional opportunities, Conference costs, Destination and conference stimuli, Stimulating factors, and Conference accessibility. These factors align with Generation Z's unique characteristics and preferences, such as their environmental consciousness, reliance on digital technologies, desire for continuous learning, career advancement, and experiences. The study also found that destination characteristics and educational and professional opportunities are significant motivators for Generation Z's conference attendance across different cultural contexts. Additionally, Generation Z's strong interest in sustainability and financial challenges highlights the need for eco-friendly practices and affordable registration fees to make conferences more appealing and accessible. The study further explores the impact of socio-demographic characteristics, revealing the gender and past conference attendance differences in motivation. Finally, the study discusses the implications for the conference industry and suggests areas for future research to enhance the understanding of conference attendance motivation among Generation Z.

Purpose: To clarify the mechanism of state anxiety on intertemporal decision-making, two studies were conducted to investigate the role of trait anxiety and inhibitory control. Study 1 examined the moderating effect of trait anxiety. Study 2 continued to investigate the mediating effect of inhibition control on the basis of study 1. Methods: A total of 266 Chinese college students participated. Participants’ state anxiety, trait anxiety and intertemporal decision-making were measured by questionnaires (scales) respectively. And inhibition control was evaluated by two-choice oddball paradigm. Results: The results of Study 1 indicated that state anxiety could predict intertemporal decision-making and that the moderating effect of trait anxiety on this relationship was significant. Study 2 found that inhibitory control could completely moderate the relationship between state anxiety and intertemporal decision-making and that this indirect effect was affected by trait anxiety. Conclusion: 1)Individuals with higher trait anxiety are more inclined to make more impulsive and intertemporal decisions when they have a high level of state anxiety; 2)state anxiety allows inhibitory control ability to have a further effect on intertemporal decision-making; and 3)the higher trait anxiety in individuals, the stronger mediating effect of inhibitory control on the relationship between state anxiety and intertemporal decision-making.

This research aimed to determine salient factors affecting the decision to become a beginning organic farmer. New and beginning organic farmers have unique characteristics, showcasing their dedication to environmental justice and social justice at the expense of their own businesses. This research employed a multiple-case case study design. We conducted semi-structured interviews with 40 first-generation farmers who operate organic farms in Arkansas, Florida, or Georgia. We analyzed interview transcripts using the qualitative analysis approach of coding. Our results revealed the reasons that people with little practical knowledge start farms. They are inspired by those around them who succeed and encouraged by influential characters in the field who assure them they can do something they love and be profitable. This research showed that first-generation farmers find inspiration and develop values rooted in food justice. Our findings have implications for developing and implementing current and future programmatic activities that aim to enhance beginning farmer training and workforce development. Identifying sources of inspiration will help researchers and service providers target newer and beginning farmers to support a vibrant food system, including a burgeoning market opportunity, developing strong communities around food, and building grassroots solutions.

Background: Chikungunya virus (CHIKV) diagnosis have become a challenge for primary care physicians in areas where zika virus and/or dengue virus are present. Case definitions for the three arboviral infections are overlapping. Methods: A cross-sectional analysis was carried out. A bivariate analysis was made using confirmed CHIKV infection as the outcome. Variables with significant statistical association were included in an agreement consensus. Agreed variables were analyzed in multiple regression model. The area under the receiver operating characteristic (ROC) curve was calculated to determine a cut-off value and performance. Results: 295 patients with confirmed CHIKV infection were included. A screening tool was made using symmetric arthritis (4 points), fatigue (3 points), rash (2 points) and ankle joint pain (1 point). The ROC curve identified a cut-off value and a score ≥ 5.5 was considered positive to identify CHIKV patients with a sensibility of 64.4% and a specificity of 87.4%, positive predictive value of 85.5%, negative predictive value of 67.7%, area under the curve of 0.72, and an accuracy of 75%. Conclusion: We developed a screening tool for CHIKV diagnosis using only clinical symptoms as well as proposed an algorithm to aid the primary care physician.

Land degradation and climate change are among the main threats to the sustainability of ecosystems worldwide. Therefore, the restoration of degraded landscapes is essential to maintain the functionality of ecosystems, especially those with greater social, economic and environmental vulnerability. Nevertheless, policy-makers are frequently challenged by deciding on where to prioritize restoration actions, which usually includes to deal with multiple and complex needs under an always short budget. If these decisions are not taken based on proper data and processes, restoration implementation can easily fail. To help decision-makers taking informed decisions on where to implement restoration activities, we have developed a semiautomatic geospatial platform to prioritize areas for restoration activities based on ecological, social and economic variables. This platform takes advantage of the potential to integrate R coding, Google Earth Engine cloud computing and GIS visualization services to generate an interactive geospatial decision-maker tool for restoration. Here, we present a prototype version called "RePlant alpha" which was tested with data from the Central Zone of Chile. This exercise proved that integrating R and GEE was feasible, and that the analysis, with at least six indicators and for a specific region was also feasible to implement even from a personal computer. Therefore, the use of a virtual machine in the cloud with a large number of indicators over large areas is both possible and practical.

The notion of free will seems so intuitive to us that it would be hard, even impossible, to imagine that we live in a world without ever exerting any willpower. This view of reality is not only hindrance to inspiration, it poses a serious threat to our moral and social responsibilities. Nonetheless, many scientific and philosophical schools of thought such as determinism purport free will as a mere illusion. As an attempt to rescue free will put forward by libertarianism, compatibilism or physical indeterminism that either exempts our mind from the universal rules of cause and effect by offering our minds a metaphysical status or substitute free will with random will rooted in the laws of quantum mechanics. This manuscript offers an alternative perspective under a new paradigm of consciousness called physical libertarianism that explicates true free will through the unwavering laws of cause and effect. Based on this paradigm, consciousness is the result of interaction of awareness and decision-making process. By applying awareness to the process of decision-making awareness-based choice selection or true free will is conceived. In return, by assigning the power of decision making to the process of awareness discretionary selection of information for attention or intentional attention is emerged. Through integration of these two mental functions, an independent entity called “I” is formed that differentiates natural intelligence from artificial intelligence. While determinism can aptly describe the world of inanimate objects and artificial intelligence, because of “I,” determinism has no jurisdiction over the realm of natural intelligence.

Urban flood risk mapping is an important tool for the mitigation of flooding in view of human activities and climate change. Many developing countries, however, lack sufficiently detailed data to produce reliable risk maps with existing methods. Thus, improved methods are needed that can improve urban flood risk management in regions with scarce hydrological data. Given this, we estimated the flood risk map for Rasht City (Iran), applying a composition of decision-making and machine learning methods. Flood hazard maps were produced applying six state-of-the-art machine learning methods such as classification and regression trees (CART), random forest (RF), boosted regression trees (BRT), multivariate adaptive regression splines (MARS), multivariate discriminant analysis (MDA), and support vector machine (SVM). Flood conditioning parameters applied in modeling were elevation, slope angle, aspect, rainfall, distance to river (DTR), distance to streets (DTS), soil hydrological group (SHG), curve number (CN), distance to urban drainage (DTUD), urban drainage density (UDD), and land use. In total, 93 flood location points were collected from the regional water company of Gilan province combined with field surveys. We used the Analytic Hierarchy Process (AHP) decision-making tool for creating an urban flood vulnerability map, which is according to population density (PD), dwelling quality (DQ), household income (HI), distance to cultural heritage (DTCH), distance to medical centers and hospitals (DTMCH), and land use. Then, the urban flood risk map was derived according to flood vulnerability and flood hazard maps. Evaluation of models was performed using receiver-operator characteristic curve (ROC), accuracy, probability of detection (POD), false alarm ratio (FAR), and precision. The findings showed that the CART method is most accurate method (AUC = 0.947, accuracy = 0.892, POD = 0.867, FAR = 0.071, and precision = 0.929). The results also demonstrated that DTR, UDD, and DTUD played important roles in flood hazard modeling; whereas, the population density was the most significant parameter in vulnerability mapping. These findings indicated that machine learning methods can improve urban flood risk management significantly in regions with limited hydrological data.

The introduction of social commerce ushered in a new era in business-consumer interaction. As a result, more power has passed from the vendor to the buyer, primarily fueling e-commerce acceptance. As a result, understanding consumer behaviour in the context of social commerce adoption has become essential for businesses looking to persuade customers by using the power of social ties and support.Furthermore, such social ties will facilitate trust as the most promising benefit while reducing perceived risk, which has always been a critical problem with online commerce. This study proposes a paradigm for understanding the impact of social commerce on the stages of the consumer decision-making process: need recognition, information search, alternative evaluation, purchase decision, and post-purchase behaviour, with a focus on social support. In this respect, relevant literature in the subject of social commerce either (1) lacks an adequate explanatory model, (2) has a solid theoretical base, or (3) contains practically complex theories with insufficient empirical data. The research model applies the Social Commerce Constructs (SCC): recommendations and referrals, forums and communities, and ratings and reviews to study the respective influence on the consumer decision-making process phases. This paper aims to understand the influence of social commerce on an integrative model that incorporates all customer choice phases while expecting new knowledge. Furthermore, it is advised that this conceptual model be empirically verified to evaluate the practical consequences.

With the revolution of computing and biology technology, data sets containing information could be huge and complex that sometimes are difficult to handle. Dynamic computing is an efficient approach to solve some of the problems. Since neighborhood multigranulation rough sets(NMGRS) were proposed, few papers focused on how to calculate approximations in NMGRS and how to update them dynamically. Here we propose approaches for computing approximations in NMGRS and updating them dynamically. First, static approaches for computing approximations in NMGRS are proposed. Second, search region in data set for updating approximations in NMGRS is shrunk. Third, matrix-based approaches for updating approximations in NMGRS while decreasing or increasing neighborhood classes are proposed. Fourth, incremental algorithms for updating approximations in NMGRS while decreasing or increasing neighborhood classes are designed. Finally, the efficiency and validity of the designed algorithms are verified by experiments.

The use of machine learning (ML) approaches to target clinical problems is called to revolutionize clinical decision-making. The success of these tools is subjected to the understanding of the intrinsic processes being used during the classical pathway by which clinicians make decisions. In a parallelism with this pathway, ML can have an impact at four levels: for data acquisition, predominantly by extracting standardized, high-quality information with the smallest possible learning curve; for feature extraction, by discharging healthcare practitioners from performing tedious measurements on raw data; for interpretation, by digesting complex, heterogeneous data in order to augment the understanding of the patient status; and for decision support, by leveraging the previous step to predict clinical outcomes, response to treatment or to recommend a specific intervention. This paper discusses the state-of-the-art, as well as the current clinical status and challenges associated with each of these tasks, together with the challenges related to the learning process, the auditability/traceability, the system infrastructure and the integration within clinical processes.

Reinforcement learning (RL) is one of the core frameworks in Artificial Intelligence (AI) used for decision-making tasks. In particular, positive reinforcement rewards desirable actions, which helps an AI agent optimize its policy by maximizing the cumulative reward over time. This paper critically reviews how positive reinforcement affects decision-making in AI models. We explore the mechanisms, limitations, and potential biases introduced by positive reinforcement in AI systems and provide insights into real-world applications and ethical considerations.

This study investigates the emerging applications of Artificial Intelligence (AI) in strategic management and its impact on organizational decision-making processes. As AI technology rapidly advances, it has become a crucial component in redefining organizational strategies. According to a global survey by the Boston Consulting Group, over 60% of executives believe that AI can significantly improve key performance indicators and enhance opportunities for strategic differentiation and sustainable competitive advantages. Using a descriptive-survey methodology and questionnaire-based data collection, this research examines the influence of AI on strategic decision-making in large organizations. The statistical population comprises senior managers across various industries, with sampling conducted through convenience sampling. Data analysis was performed using SMART-PLS software, revealing significant improvements in strategic decision-making processes through AI implementation. The study demonstrates that AI, by analyzing complex data sets and identifying hidden patterns, assists managers in making more optimal decisions. Furthermore, AI's predictive analytics capabilities contribute to enhanced strategic planning and risk mitigation in decision-making processes. The research findings indicate a statistically significant positive correlation (r = 0.72, p < 0.001) between AI adoption and the quality of strategic decisions. This paper concludes by proposing that organizations should leverage AI as a tool to strengthen their organizational strategies, while emphasizing the importance of ethical considerations and human oversight. The implications of this research extend to both academic and practical domains, offering insights into the integration of AI in strategic management processes and its potential to revolutionize organizational decision-making paradigms.

Communal lands covers a surface area of 1 million hectares in the Galicia-North Portugal region (northwest Iberian Peninsula). The average size of this land ownership type is 500 ha in Portugal and 200 ha in Galicia. The region has a Gross Domestic Product (GDP) lower than other developed regions of Europe, being considered within Objective 1 of the European Union (EU). For centuries, the baldios and montes veciñais en man común (MVMC) have played a key role in the economy of rural areas of Portugal and Galicia respectively. This function was lost throughout the 20th century due to forestry policies developed especially in the dictatorial regimes established in both Spain and Portugal, bringing about an important decline in agricultural practices. The restoration of democratic regimes returned ownership of the communal lands to the local/rural communities. Taking into account the extent and large average size of these lands, our aim was to describe the potential use and limitations of the communal lands, as well as the influence on sustainable rural development regarding the numerous ecosystem services it offers. An Analytic Hierarchy Process (AHP) was employed to evaluate stakeholders opinions in relation to communal land sustainable management. Both rural areas, i.e. Galicia and North Portugal, have similar characteristics, provide the same type of benefits and require numerous social improvements to achieve sustainable development. Communal lands and small-scale business initiatives can support local produce markets while promoting biodiversity conservation and ecosystem services.

The study investigates the influence of power dynamics on supply chain decision-making processes through a qualitative lens, aiming to understand how various forms of power impact interactions, relationships, and strategic outcomes within supply chains. Using semi-structured interviews with supply chain managers and executives from diverse industries, the research explores the multifaceted nature of power, identifying key sources such as economic leverage, expertise, resource control, and network centrality. Findings reveal that power dynamics significantly shape decision-making by determining negotiation outcomes, governance structures, and operational efficiencies. Economic power, often exercised by larger firms, enables them to dominate negotiations and impose favorable terms, creating pressures on smaller partners and potentially leading to conflicts. Expertise and resource control allow firms with specialized knowledge or unique inputs to influence product development and process innovation, further dictating supply chain configurations. The study differentiates between coercive and non-coercive power strategies, showing that while coercive power enforces compliance, it can erode trust and collaboration. Non-coercive power, on the other hand, promotes positive relationships through incentives and collaborative approaches, fostering trust and alignment of supply chain objectives. Governance structures imposed by dominant firms often reflect their strategic priorities but can burden less powerful partners, highlighting the need for balanced oversight. Power also plays a crucial role in risk management, resilience, sustainability, and innovation within supply chains, with digitalization introducing new dimensions of influence. The research underscores the importance of balanced and equitable power dynamics to enhance cooperation, resilience, and innovation in supply chains. These insights provide valuable implications for practitioners and scholars in developing more effective and adaptive supply chain strategies.

This paper introduces an intelligent model that combines military expertise with the latest ad-vancements in machine learning (ML) and Geographic Information Systems (GIS) to support humanitarian demining decision-making processes. The model is based on direct input and val-idation from field decision-makers for their practical applicability and effectiveness. With a survey polling the inputs of demining experts, 95% of the responses came with an affirmation of the potential of the model to reduce threats and increase operational efficiency. It includes mili-tary-specific factors that factor in the proximity to strategic locations as well as environmental variables like vegetation cover and terrain resolution. With Gradient Boosting algorithms such as XGBoost and LightGBM, the accuracy rate is almost 97%. Such precision levels further enhance threat assessment, better allocation of resources, and around a 30% reduction in the cost and time of conducting demining operations, signifying a strong synergy of human expertise with algo-rithmic precision for maximal safety and effectiveness in demining

This study explores the complexities of sport manager selection, investigating the impact of affirmative action, recruitment strategies, organizational culture, diversity initiatives in board selection, and career advancement insights from coaches' perspectives. To conduct this investigation, a purposive sampling technique was employed, selecting 65 prominent sports managers and coaches from Romania. Participants, aged between 35 to 58 years old, boasted an average of 10 to 20 years of sports experience and were chosen based on specific criteria, including academic qualifications. Data collection occurred over an extended period, spanning from fall 2022 to spring 2024, through semi-structured interviews with sport managers and coaches. The findings unveiled persistent challenges in effectively implementing affirmative action measures, as sport managers grapple with balancing the promotion of deserving candidates while maintaining continuity in board culture. Achieving meaningful diversity necessitates nuanced approaches that consider both candidate quality and cultural compatibility. Moreover, the study sheds light on coaches' perspectives when considering executive council positions, highlighting various pathways to career advancement. Recruitment practices prioritized informal methods, emphasizing board cohesion. Despite the recognized importance of diversity, challenges persist in selecting candidates solely based on demographic representation. The study provides valuable insights into promoting diversity and inclusivity within sports organizations' executive councils. Future research directions may include exploring longitudinal trends and delving into the qualitative experiences of underrepresented groups, with the aim of advancing understanding and promoting equity within sports organizations.

The goal of the paper is to clarify the observed irrationality of decision making in conflict situations considered as one-step games of two players. To solve such situations, we consider the asymmetry in the relation of the players to their own rewards and the rewards of the opponents. Formalization of the decision-making process is based on recently developed non-commutative operators of multivalued logic algebra. The suggested method is applied to solve the well-known Prisoners’ dilemma game and the other situations of conflict, where it results in the expected strategies.

During the Renaissance, Leonardo Da Vinci was the first person to successfully detail the anatomy of the aortic root and its adjacent structures. Ever since, novel insights into morphology, function and their interplay have accumulated resulting in advanced knowledge on complex functional characteristics of the aortic valve (AV) and root. This shifted the vision from the AV as being a static structure towards that of a dynamic interconnected apparatus within the aortic root as a functional unit, exhibiting a complex interplay with adjacent structures via both humoral and mechanical stimuli. This paradigm shift has stimulated surgical treatment strategies of valvular disease that seek to recapitulate healthy AV function, whereby AV disease can no longer be seen as an isolated morphological pathology which needs to be replaced. As prostheses still cannot reproduce the complexity of human nature, treatment of diseased AVs, whether stenotic or insufficient, has tremendously evolved with a similar shift towards treatments options that are more hemodynamically centered such as the Ross procedure and valve-conserving surgery. Native AV and root components allow for an efficient Venturi effect over the valve to allow for optimal opening during the cardiac cycle, while also alleviating the left ventricle. Next to that, several receptors are present on native AV leaflets, enabling messenger pathways based on their interaction with blood and other shear-stress related stimuli. Many of these physiological and hemodynamical processes are under acknowledged but may hold important clues for innovative treatment strategies, or as potential novel targets for therapeutic agents that halt or reverse the process of valve degeneration. A structured overview of these pathways and their implications for cardiothoracic surgeons and cardiologists is lacking. As such, we provide an overview on embryology, hemodynamics, and messenger pathways of the healthy and diseased AV and its implications for clinical practice, by relating this knowledge to current treatment alternatives and clinical decision-making.

Oceans cover about 70% of the Earth's surface, and about 95% remain unexplored for various reasons. Underwater wireless communication has been revolutionised with the help of Internet of Things networks. Recently, applications such as collecting marine data, marine monitoring, disaster prevention, historical exploration, oil and gas exploration, shipwreck exploration, maritime security, and monitoring of aquatic species and water pollution, and several applications have become possible. However, the problem of routing, information transfer, and resource preservation in the fluid underwater environment remains unsolved. In this research, we were looking for a solution to make routing more efficient, considering the various and practical criteria for the quality of service of the underwater IoT network. One of the outstanding features of this research is the possibility of dynamically weighing the parameters involved in routing and taking optimal and distributed decisions between network components. The proposed method has achieved acceptable results in terms of quality of service compared to recent methods.

Among the plethora of financial management tools available, stock investments stand out as the most recognizable and widely accepted option. However, investors often make buying and selling decisions based on unverified information provided by stock analysts. Since the credibility of this information remains uncertain, it frequently results in investment losses. Ordinary investors relying solely on rumors often miss out on prime opportunities for buying and selling stocks. In the current volatile investment landscape, various investment strategies cater to different situations. If individuals can effectively identify opportunities within this complex environment and dynamically adapt suitable investment strategies at any given time, substantial returns can be achieved. The ability of investors to promptly detect shifts in the current stock market environment and make accurate decisions regarding stock selection, timing, and capital allocation strategies is of utmost importance. This study presents a dynamic framework for investment decision support, which utilizes evolutionary strategies to determine the optimal timing for key strategic tools such as stock selection, timing, and capital allocation. By leveraging historical data for training and testing, this approach aims to assist investors in adapting to the ever-changing stock market environment. If investors can successfully identify and implement an appropriate investment strategy to aid in making accurate decisions, it is possible to achieve significant excess returns.

This paper describes RTMN 2.0 - an extension of the modeling language RTMN. RTMN combines process modeling and robot execution. The reusability and intuitive robot programming allows people without programming expertise to plan and control robots. While RTMN focuses on the ease of use and flexibility of robot programming by providing an intuitive modelling language, RTMN 2.0 concentrates on Human Robot Collaboration (HRC), which represents the current trend of the industry shift from ‘mass-production’ to ‘mass-customization’. While traditional robot systems provide high payload capabilities and repeatability, they suffer from limited flexibility and dexterity. Therefore, human-robot collaboration is a suitable arrangement to leverage the unique capabilities of both humans and robots for increased efficiency and quality in industrial scenarios. HRC has made a great impact on the robotic industry: increased efficiency, reduced costs and improved productivity, which can be adopted to make up for the skill gap of a shortage of workers in the manufacturing industry. The extension in RTMN 2.0 includes the following notations: HRC tasks, requirement, Key Performance Indicator (KPI), condition check and decision making, join/split and data association. With all these additional elements RTMN 2.0 covers the full scale of agile manufacturing – light out and collaborative.

This literature review focuses on the development of an ontology for public policy problems in Ethiopia. The study aims to provide a structured representation of concepts, relationships, and knowledge specific to the Ethiopian policy context. The research follows a systematic ontology development process that incorporates domain-specific knowledge and stakeholder involvement.The review begins by describing the steps involved in the ontology development process, including problem identification and scoping, requirement analysis, ontology modeling, and stakeholder involvement. It emphasizes the importance of engaging policymakers, subject matter experts, and researchers throughout the process to validate the ontology and ensure its relevance and effectiveness in addressing Ethiopian policy problems.The application of the developed ontology to specific policy problems is then discussed. Examples include agricultural policy analysis, healthcare policy evaluation, and education policy planning. The review highlights how the ontology can support policy analysis, decision-making, and evaluation by capturing relevant concepts, simulating policy scenarios, and assessing policy impacts.Furthermore, the review identifies potential challenges and limitations in the ontology development process, such as data availability, expert knowledge engagement, and the evolving policy landscape. These challenges need to be addressed to ensure the ontology's accuracy and usability in addressing Ethiopian policy problems.Finally, the review provides suggestions for further research and improvement, such as integrating the ontology with data sources, fostering collaborative ontology development, exploring semantic reasoning and inferencing techniques, and promoting interoperability and standardization. These suggestions aim to enhance the ontology's capabilities and its contribution to the field of ontology development for public policy problems.In conclusion, the development of an ontology for public policy problems in Ethiopia offers a valuable tool for policymakers, researchers, and stakeholders to understand, analyze, and address complex policy challenges. The ontology's relevance and applicability to the Ethiopian context, stakeholder involvement, and support for policy analysis make it a significant contribution to the field of ontology development for public policy.

Efficient natural resource management prevents and reduces negative impacts, such as environmental damage, misappropriation of resources, and conflicts; several strategies can be leveraged to conserve, protect, and enhance natural resources. Multi-criteria decision analysis (MCDA) is useful in providing solutions to addressing decision-choice problems. In this study, the natural resource under evaluation is the chestnut forest, with the objective of valorising its supply chains. The methodology applied is A'WOT, which allows previously identified factors through a qualitative SWOT matrix, to be ordered through an objective quantification using AHP (Analytic Hierarchy Process), which is a multicriteria decision-support method. The survey was conducted with a group of chestnut resource (n=20) experts. The SWOT matrix identified a total of 20 factors: 6 strengths and 6 weaknesses and 4 factors each for opportunities and threats. The results express a clear stakeholder interest, which identifies the significant role of civil society in directing management choices for the provision and enhancement of ecosystem and vocational services. This study evaluated the adaptability of decision-support tools applied to a real case of forest resource management to identify and order factors useful to enhance the resource and stimulate the supply chains to achieve greater added value. In a general sense, the methodological potential emerged to replicate or improve the research in other geographical regions, whether regional or extra-regional, or even on a larger scale, such as on a national level.

Stemming from the Bulgarian case study developed within a European research project (ECHOES, Horizon 2020), the paper discusses the links between: (a) the urgent need to operationalize EU energy transition policy in the housing domain; (b) the complexity of factors influencing the policy implementation in different contexts – geographical, economic, and technical but also social and cultural; and (c) the important role of the urban level in policy implementation. Under the specific spatial planning context of Bulgaria, the local collective energy-related decision-making in the housing field evolves through the interaction – formal (at the municipal level of governance) and informal (individuals, households and homeowners’ associations taking decisions on self-organization and collective action). The authors claim that interdisciplinary context-sensitive research would contribute to a better understanding for the ongoing energy-related decision-making processes at the local level and would enable the development and implementation of effective and efficient policy instruments in support of energy transition in the housing sector in Europe.

Trace amine-associated receptors (TAARs) are a family of G protein-coupled receptors present in mammals in the brain and in several peripheral organs. Apart from its olfactory role, TAAR5 is expressed in the major limbic brain areas and regulates brain serotonin functions and emotional behaviors. However, most of its functions remain undiscovered. Given the role of serotonin and limbic regions in some aspects of cognition, we used a temporal decision-making task to unveil a possible role of TAAR5 in cognitive processes. We found that TAAR5 knock-out (KO) mice showed a generally better performance due to a reduced number of errors and displayed a greater rate of improvement at the task than WT littermates. However, task-related parameters, such as time accuracy and uncertainty have not changed significantly. Overall, we show that TAAR5 modulates specific domains of cognition, highlighting a new role in brain physiology.

Among many research areas to which Ron Yager contributed are decision making under uncertainty (in particular, under interval and fuzzy uncertainty) and aggregation – where he proposed, analyzed, and utilized the use of Ordered Weighted Averaging (OWA). The OWA algorithm itself provides only a specific type of data aggregation. However, it turns out that if we allows several OWA stages one after another, we get a scheme with a universal approximation property – moreover, a scheme which is perfectly equivalent to deep neural networks. In this sense, Ron Yager can be viewed as a (grand)father of deep learning. We also show that the existing schemes for decision making under uncertainty are also naturally interpretable in OWA terms.

This article addresses the generic dynamic decision problem of how to achieve sustained market growth by increasing two interdependent organizational resources needed (1) to increase and (2) to sustain demand. The speed and costs of increasing each resource are different. Failure to account for this difference has been reported to lead to policies that drive a quick increase of demand followed by decline. Three generic policies derived from the literature have been implemented in a system dynamics model. Simulation shows that all three policies can generate sustained exponential growth but differ in performance. These results suggest that even policies which risk generating overshoot and collapse can avoid it. This poses two questions for further research: (1) what is the reasoning of human decision-makers when choosing between these policies and (2) how can the important but easily overlooked features of such decision situations be made sufficiently salient to be accounted for?

Offshore vessels (OVs) often requires precise station-keeping and some vessels, for example, vessel involves in geotechnical drilling generally use Spread Mooring (SM) or Dynamic Positioning (DP) systems. Most of these vessels are equipped with both systems to cover all ranges of water depths. However, determining which systems to use for a particular operational scenario depends on many factors and requires significant balancing in terms of cost-benefit. Therefore, this research aims to develop a platform that will determine the cost factors for both the SM and DP station keeping systems. Operational information and cost data are collected for several field operations, and Artificial Neural Networks (ANN) is trained using those data samples. After that, the trained ANN is used to predict the components of cost for any given environmental situation, fieldwork duration and water depth. Later, the total cost is investigated against water depth for both DP and SM systems to determine the most cost-effective option. The results are validated using two operational scenarios for a specific geotechnical vessel. This decision-making algorithm can be further developed by adding up more operational data for various vessels and can be applied in the development of sustainable decision-making business models for OVs operators.

Nowadays, customers play a very important and vital role in the field of global economy. As a result, companies give special significance to the customers to survive and grow in the field of economic competition in the modern world and increase their relationship with the buyers of their products and services throughout their lifetime. Marketing growth through mobile phones has provided further motives for performing more researches in the field of customer behavior and attitude in mobile marketing. The goal of the current study is to analyze the effective factors on customer behavior in mobile marketing. The variables used in this study are perceived ease of use, individual knowledge, user’s mobile phone technology, customers’ negative attitudes, and customers’ positive attitudes. The current research is practical in terms of objective and is descriptive-analytic in terms of methodology. Data were gathered by distributing a questionnaire among 284 students of Tehran University. Data were analyzed by structural equation modeling using Lisrel and Expert Choice software. Test results showed that ease of use, individual knowledge, mobile phone technology, positive attitude, and negative attitude variables have a meaningful effect on customer behavior in mobile marketing. The confirmation of all the assumptions of the research supports the importance of the customer behavior analysis in mobile phone services.

Forests across the world stand at the crossroad with climate and land use changes shaping their future. Despite the demonstration of political will and global efforts, forest loss, fragmentation and land degradation continue unabated. No clear evidence exists that these initiatives are working. Why are policies designed to halt deforestation and increase restoration of forest landscapes failing? A key reason for this apparent ineffectiveness lies in the failure to recognize the agency of the stakeholders involved and the adaptive capacities of the systems we seek to steer. Landscapes do not happen. We make them. They are the result of the sum of individual actions and decisions made by all stakeholders, and the interactions between these and biophysical processes. Likewise, forest transitions are not ecological, but social and behavioral. They are a product of the way humans manage ecosystems. Decision-makers need to integrate better representations of people’s agency in their mental models. We suggest possible solution pathways to overcome this key current barrier. These involve eliciting mental models behind policy decision, changing perspectives to better understand divergent points of view and refining strategies through explicit theories of change. Games designed to represent the constraints and opportunities that exist in the landscapes can help decision makers in these task.

The development of major economic sectors can provide the bedrock on which long-lasting national economic prosperity is formed. Iceland’s tourism sector is an example of a rapidly expanded industry in recent years, to the extent that it has become the largest sectoral contributor to the nation’s economy. The growth of the sector has led to a number of sustainability impacts, thus presenting opportunities and challenges in terms of meeting the seventeen Sustainable Development Goals (SDGs) of the United Nations. Using the case study of Iceland, this paper aims to advance conceptual understanding of the synergies and trade-offs between a nation’s tourism sector and performance across the 169 targets of the SDGs. Empirical results were derived from four theme-based focus groups, comprised of expert participants, who were tasked with completing scoresheets concerning their perception of the extent of synergies and trade-offs for each target. The majority (126 in number) of the mean scoresheet outcomes for the SDG targets revealed neither synergies nor trade-offs. However, 32 synergies and 11 trade-offs were identified. Many of the target synergies related to new economic opportunities, such as jobs, employment and training for young people. Target trade-offs tended to be environmental and social. In particular, concern was voiced about the greenhouse gas emissions of the Icelandic tourism sector, which derives from international aviation, cruise ships and rental car usage. The outcomes of this study are of particular relevance to tourism companies, policy-makers and governance institutes, all of whom are increasingly endeavouring to link their activities with the fulfilment of the SDGs, maximising synergies, mitigating the extent of any potential trade-offs, and potentially transforming trade-offs into synergies. Furthermore, the results are likely of interest to academics focused on researching the broad sustainability impacts of economic sectors and their contribution to meeting the visionary goals of the SDGs.

This paper reports the efforts made and experiences gained in developing the Flood Prevention and Emergency Response System (FPERS) powered by Google Earth Engine, with focus on its applications at the three stages of floods. At the post-flood stage, FPERS integrates various remote sensing imageries, including Formosat-2 optical imagery, to detect and monitor barrier lakes, synthetic aperture radar imagery to derive an inundation map, and high-spatial-resolution photographs taken by unmanned aerial vehicles to evaluate damage to river channels and structures. At the pre-flood stage, a huge amount of geospatial data are integrated in FPERS and are categorized as typhoon forecast and archive, disaster prevention and warning, disaster events and analysis, or basic data and layers. At the during-flood stage, three strategies are implemented to facilitate the access of the real-time data: presenting the key information, making a sound recommendation, and supporting the decision-making. The example of Typhoon Soudelor in August of 2015 is used to demonstrate how FPERS was employed to support the work of flood prevention and emergency response from 2013 to 2016. The capability of switching among different topographic models and the flexibility of managing and searching data through a geospatial database are also explained, and suggestions are made for future works.

This paper formulates a new strategy for participatory forest management consisting of encouraging public participation as long as it increases empathy among participants. The strategy requires the homogeneous representation of the opinion of a participant (i.e. to determine how they assess a forest plan and identify the best one). Utility assessments are prepared for participants through pair-comparisons between meaningful points in the territory and from value functions based on forest indicators. The best plan is designed by applying combinatorial optimization algorithms to the utility of a participant. The calculating of empathy -of one participant relative to another - is based on the equivalence of their respective utilities when the current forest plan is modified. This involves calculating the opinions that are due to systematic changes in the collective plan for those participants that each participant supposes will affect the utility of the other participants. Calculating empathy also requires knowing the interactions among participants, which have been incorporated through agent-based simulation models. Application of the above methodology has confirmed the association between increases in empathy and convergence of opinions in different scenarios: well and medium-informed participants and with and without interaction among them, which verifies the proposed strategy. In addition, this strategy is easily integrated into available information systems and its outcomes show advantages over current participatory applications.

Manufacturing organizations shall recognize sustainability as a business occasion to capitalize on, rather than an undesirable pressing situation. Still, empirical evidence shows that this opportunity is hard to capture and communicate in global strategic decisions, through planning by tactical management, to daily operational activities. This paper systematically reviews the modeling challenges at the crossroad of value and sustainability decisions making, spotlighting methods and tools proposed in literature to link sustainability to customer value creation at strategic, tactical and operational level. While statistical results show that the topic of sustainability and value modeling is trending in literature, findings from content analysis reveal that recent attempts to promote a value-based view in the sustainability discussion remain at a strategic level, with most of the proposed indicators being suited for managerial decision-making. The lack of support at operational level points to the opportunity of cross-pollinating sustainability research with value-centered methodologies originating from the aerospace sector. The Value Driven Design framework is proposed as main hub from which to derive models supporting engineers and technology developers in the identification of win-win-win situations, where sustainable improvements are aligned with business advantages.

The use of DL algorithms in the domain of DM for AVs has garnered significant attention in the literature in the last years, showcasing considerable potential. Nevertheless, most of the solutions proposed by the scientific community encounter difficulties in real-world applications. This paper aims to provide a realistic implementation of a hybrid DM module in an AD stack, integrating the learning capabilities from the experience of DRL algorithms and the reliability of classical methodologies. This work encompasses the implementation of concatenated scenarios in simulated environments, and the integration of AD modules. Specifically, the authors address the DM problem by employing a POMDP formulation and offer a solution through the use of DRL algorithms. Furthermore, an additional control module to execute the decisions in a safe and comfortable way through a hybrid architecture is presented. The proposed architecture is validated in the CARLA simulator by navigating through multiple concatenated scenarios, outperforming the CARLA Autopilot in terms of completion time, while ensuring both safety and comfort.

Unhealthy concentrations of ozone in the Uinta Basin, Utah, can occur after sufficient snowfall and a strong atmospheric anticyclone creates a persistent cold pool that traps atmospheric ozone and its precursors emitted from oil and gas operations. The winter-ozone system has two clear outcomes—occurrence or not—that is well understood by domain experts and supported by archives of atmospheric observations. Rules of the system can be formulated in natural language (“sufficient snowfall and high pressure leads to high ozone"), lending itself to analysis with a fuzzy-logic inference system. This method encodes human expertise as machine intelligence in a more constrained manner than alternative, more complex inference methods such as neural networks, increasing user trustworthiness of our model prototype before further optimization. Herein, we develop an ozone-forecasting system, Clyfar, based on knowledge of system dynamics and informed by an archive of meteorological conditions and ozone concentration. The inference system demonstrates proof-of-concept despite rudimentary tuning. We describe our framework for predicting future ozone concentrations if input values are drawn from numerical weather prediction forecasts as a proxy for observations as the system’s initial conditions. Our model is computationally cheap, allowing us to sample uncertainty with substantially more ensemble members than in traditional NWP. We evaluate hindcasts for one winter, finding our prototype demonstrates promise to deliver useful guidance for users concurrent with optimization of system parameters using machine learning.

Autonomous underwater vehicles are not easily programmable such as autonomous vehicles. This is because route and motion planning for autonomous vehicles depend on a global map that considers the road's smoothness and traffic regulations in real time. However, this is not the case for underwater vehicles as we have to consider the external factors such as wind and tide that may pull autonomous underwater vehicles outside their route and affect the course of travel. This is where decision-making is important for autonomous underwater vehicles. An example is the avoidance of the loss of subsea vehicles as they can dynamically make routing decisions and return to their destinations.This paper exposes the decision-making process for autonomous underwater vehicles. Firstly, an analysis of internal factors such as buoyancy and the overall of the vehicle, and how they affect motion are conducted—secondly, the implementation of a design process that deals with the stages of motion and route planning. Finally, a survey is conducted on already implemented research for algorithms, to incorporate external factors for high-level decision-making.

Recently, the concept of participatory democracy developed in the early 1970s has come back into fashion to revitalize the public involvement in political decision-making processes. Public par-ticipation in forest policy has been fully conceptualized by the scientific community in the late 1990s and early 2000s, but in many contexts the practical application remains unfulfilled. The aim of this study is to identify and analyze the participatory techniques used in literature to increase knowledge and facilitate its transferability into forest policies and strategies. A literature review was carried out to offer an overview of the participatory techniques adopted in the deci-sion-making process. At the end of literature review, 25 participatory techniques were identified based on over 2,000 publications. Afterwards, the participatory techniques were assessed using seven indicators (degree of participation, type and number of participants, time scale, cost, po-tential influence on policy). The results showed that the type of actors involved in the participa-tory technique is a key variable for the complexity and usefulness of the process, while the number of participants influences how information is disseminated. The Principal Component Analysis highlighted that the participatory techniques can be divided in three groups: the first group includes those techniques with a high degree of participation and a contextual high po-tential influence on policies, the second one includes techniques with a costs in terms of re-sources, while the third one consists of those with a large number of participants and reduced time requirements.

The dynamic and unpredictable nature of modern supply chains necessitates the development of resilient systems capable of withstanding various disruptions. This qualitative study examines the impact of collaborative practices on supply chain resilience, providing an in-depth analysis of their contributions to the robustness and adaptability of supply chains. Through extensive interviews with industry professionals, including supply chain managers, logistics coordinators, and strategic planners, the study identifies key collaborative practices—such as information sharing, joint decision-making, and coordinated response strategies—that significantly enhance resilience. These practices facilitate proactive risk management, improve response times during disruptions, and foster innovation through shared knowledge and resources. Thematic analysis of the collected data reveals that strong relationships among supply chain partners and integrated approaches that leverage each participant's strengths are crucial for effective risk mitigation and recovery. Additionally, the study underscores the role of technology in enabling real-time information sharing and decision-making, which are essential for effective collaboration. The findings highlight the importance of investing in robust collaborative networks and adopting supportive technologies to enhance communication and coordination. This research contributes to the existing body of knowledge by offering a nuanced understanding of how strategic implementation of collaborative practices can build more resilient supply chains. It provides practical recommendations for businesses seeking to improve their resilience, emphasizing the qualitative aspects of collaboration and its impact on supply chain management. Overall, this study presents a comprehensive exploration of how collaboration can bolster supply chain resilience, offering valuable insights for practitioners and scholars focused on creating stable and sustainable supply chain operations in the face of growing uncertainties.

Introduction: Neoadjuvant chemotherapy in breast cancer offers the possibility to facilitate breast and axillary surgery, it is a test of chemosensibility in vivo with significant prognostic value and may tailor adjuvant treatment according to response. Material and Methods: a retrospective single institution of 482 stage II and III breast cancer patients treated with neoadjuvant chemotherapy based on anthracycline and taxans plus antiHEr2 in those Her2 positive cases. Survival was calculated at 5 and 10 years. Kaplan Meier with log rank test were calculated for difference according to TNM, pathological and molecular surrogated subtype, TILs cut-off 20%, response to chemotherapy and the presence of vascular invasion. Results: In the univariate those factors that influenced long-term patient outcome were TNM (p=0.000); pathologic subtype (p=0.003); Tils cut off 20%; achieving pCR (p=0.000), RCB (p=0.000) and vascular invasion (p=0.000). After a mean follow up of 126 months, Luminal tumors presented a substantial difference of survival rates calculated at 5 or 10 years (81.2% compared to 74.7%) whereas for TNBC was 75.3 and 73.5, respectively. The greatest difference was seen according to response those patients with pCR presented a 10yDDFS of 95.5 vs 72.4% for those patients without pCR. This difference was especially meaningful in TNBC were 10y DDFS according to the RCB 0 to 3 was 100%, 80.6%, 69% and 49.2% respectively. Patients with a special bad prognosis in our series were lobular carcinomas with 10y DDFS of 42.9% vs 79.7%, p= 0.001 for ductal carcinomas; and those patients with vascular invasion at the surgical specimen with a 10yDDFS of 59.2% vs 83.6, p=0.,000 for those patients without vascular invasion. Conclusion: long-term outcomes after neoadjuvant chemotherapy can help patient and clinician make well-informed decisions.

Multi-stakeholder participation processes in watershed management face challenges due to limited monitoring and baseline data, resulting in a lack of awareness among stakeholders about the current state of the watershed. This knowledge gap often leads to conflicts of interest, where the broader impacts of individual decisions are overlooked. To overcome these limitations, this paper explores the design and implementation of a Serious Game (SG) aimed at co-producing a watershed management plan at the basin scale within the specific context of the Campoalegre River basin in Colombia. By providing an interactive platform, the SG facilitates collaboration between local actors, who may be unfamiliar with existing watershed plans, and decision-makers. The goal is to create a participatory space where stakeholders can comprehend the watershed management plan structure and prioritize actions based on various climatic, social, and economic conditions. Following the application of the SGs, stakeholders demonstrated an improved understanding of the basin, fostering increased participation, open debate, and the proposal of actions. These outcomes serve as valuable inputs for the implementation of water management planning policies, showcasing the potential of SGs in bridging knowledge gaps, and fostering effective multi-stakeholder engagement.