A framework for action to improve patient and public involvement in health technology assessment

Background Patient and public involvement (PPI) in the Brazilian Health Technology Assessment (HTA) process occurs in response to a legislative mandate for “social participation.” This resulted in some limited patient participation activities, and, therefore, a more systematic approach was needed. The study describes the development of a suggested framework for action to improve PPI in HTA. Methods This work used formal methodology to develop a PPI framework based on three-phase mixed-methods research with desktop review of Brazilian PPI activities in HTA; workshop, survey, and interviews with Brazilian stakeholders; and a rapid review of international practices to enact effective patient involvement. Patient partners reviewed the draft framework. Results According to patient group representatives, their involvement in the Brazilian HTA process is important but could be improved. Different stakeholders perceived barriers, identified values, and made suggestions for improvement, such as expansion of communication, capacity building, and transparency, to support more meaningful patient involvement. The international practices identified opportunities for earlier, more active, and collaborative PPI during all HTA stages, based on values and principles that are relevant for Brazilian patients and the public. These findings were synthesized to design a framework that defines and systematizes actions to support PPI in Brazil, highlighting the importance of evaluating these strategies. Conclusions Since the publication of this framework, some of its suggestions are being implemented in the Brazilian HTA process to improve PPI. We encourage other HTA organizations to consider a systematic and planned approach with regular evaluation when pursuing or strengthening involvement practices.

Review on fractional vortex beam

As an indispensable complement to an integer vortex beam, the fractional vortex beam has unique physical properties such as radially notched intensity distribution, complex phase structure consisting of alternating charge vortex chains, and more sophisticated orbital angular momentum modulation dimension. In recent years, we have noticed that the fractional vortex beam was widely used for complex micro-particle manipulation in optical tweezers, improving communication capacity, controllable edge enhancement of image and quantum entanglement. Moreover, this has stimulated extensive research interest, including the deep digging of the phenomenon and physics based on different advanced beam sources and has led to a new research boom in micro/nano-optical devices. Here, we review the recent advances leading to theoretical models, propagation, generation, measurement, and applications of fractional vortex beams and consider the possible directions and challenges in the future.

Optimization of Microwave Resonator for Wireless Communication Based on Computer Technology

Wireless communication is a way of information transmission based on wireless network. It mainly includes microwave communication and satellite communication. There is no conductor between the receiving points of transmitting information. Microwave belongs to radio waves, its propagation distance is not far, but its transmission frequency and communication capacity is relatively high. Microwave resonators have been widely used and provide convenient conditions for wireless communication. In this paper, the status quo of wireless communication microwave resonator and some optimization schemes based on computer technology are described, and some obvious effects will be achieved after optimization based on computer technology are summarized.

Association of the RASS Score With Intensity of Symptoms, Discomfort, and Communication Capacity in Terminally Ill Cancer Patients Receiving Palliative Sedation: Is RASS an Appropriate Outcome Measure?

BackgroundPalliative sedation is sometimes needed for refractory symptoms, and the Richmond Agitation-Sedation Scale (RASS) is one of the key measures. The primary aim of this study was to explore the association between the RASS score and degree of distress quantified by other measures: Support Team Assessment Schedule, item 2 (STAS), Discomfort Scale for Dementia of Alzheimer Type (Discomfort Scale), and Non-communicative Patient’s Pain Assessment Instrument (NOPPAIN), as well as a communication capacity measured by the Communication Capacity Scale, item 4 (CCS).MethodsThis was a prospective observational study on terminally ill cancer patients who received continuous infusion of midazolam to relieve refractory symptoms in a palliative care unit of a designated cancer hospital. Primarily responsible palliative care physicians rated RASS, Discomfort Scale, NOPPAIN, and CCS just before starting infusion, and 1 hour, 4 hours, 24 hours, and 48 hours after midazolam infusion, and ward nurses rated STAS at the same time. Since the ward nurses regularly evaluated STAS to titrate midazolam during palliative sedation as routine work, we regarded STAS rated by ward nurses as a standard of distress measure.ResultsA total of 249 assessments were performed for 55 patients. The RASS score was moderately to highly associated with symptom intensity measured by STAS, discomfort measured by the Discomfort Scale, and pain measured by NOPPAIN (r = 0.63 to 0.73). On the other hand, communication capacity measured by CCS is not parallel with the RASS score, and demonstrated a valley-shape. In 82 assessments with RASS of -1 to -3, 11 patients (13%) were regarded as having physical symptoms of STAS of 2 or more.ConclusionsRASS can roughly estimate physical distress in patients receiving palliative sedation, but a measure to more precisely quantify the symptom experience is needed.

A Model for Tacit Communication in Collaborative Human-UAV Search-and-Rescue

Tacit communication can be exploited in human robot interaction (HRI) scenarios to achieve desirable outcomes. This paper models a particular search and rescue (SAR) scenario as a modified asymmetric rendezvous game, where limited signaling capabilities are present between the two players—rescuer and rescuee. We model our situation as a co-operative Stackelberg signaling game, where the rescuer acts as a leader in signaling its intent to the rescuee. We present an efficient game-theoretic approach to obtain the optimal signaling policy to be employed by the rescuer. We then robustify this approach to uncertainties in the rescue topology and deviations in rescuee behavior. The paper thus introduces a game-theoretic framework to model an HRI scenario with implicit communication capacity.

A Wireless Network Communication Capacity Control Technology Based on Fuzzy Wavelet Neural Network

The communication capacity control of the computer wireless network is the basis for realizing the efficient communication of massive data. In order to study the communication capacity control technology of the computer wireless network, improve the control effect of a large amount of data communication, and calculate the capacity of the wireless network in real time, this paper uses the fuzzy wavelet neural network to predict the wireless network channel. After the interference-free channel is obtained, the load balancing strategy of the ant colony optimization algorithm is used to filter the channel, and the channel allocation sequence with the most balanced load distribution is obtained, and a priority selection list is generated. After discretizing the channels in the largest discretization selection list, the channel sequence is allocated to the pair of nodes with communication requests according to the greedy coloring algorithm, so as to realize the communication capacity control of the computer wireless network. The test results show that the technology can guarantee good communication performance in both static and dynamic networks and can effectively complete network communication of massive data, and the communication capacity control effect is good.

Social integration as security and dynamic stability factor of the European political system

In the article, the looks into different possibilities of social integration of people, social groups, pointing to the cause of marginalization – the low level of culture, communication capacity, selfknowledge. Regardless of the social status of the person: poor, employed, unemployed or immigrant, social inclusion is stimulated by the individual’s interest in knowing, acting, and manifesting himself. Social integration can and must be stimulated by state institutions, as well. Otherwise, dissatisfaction among the marginalized will lead to destabilization of the political system and social conflicts. The social integration of immigrants is a way of mitigating the social crisis that has occurred in European countries. The key objectives of the investigation are: to analyze the challenges to the security and instability of the political system of the European States; to define social integration and inclusion as a factor of the dynamic stability of the political system; to interpret marginalization as a destabilizing factor; to analyze the social integration of immigrants through knowledge and communication.

Robust Networking: Dynamic Topology Evolution Learning for Internet of Things

The Internet of Things (IoT) has been extensively deployed in smart cities. However, with the expanding scale of networking, the failure of some nodes in the network severely affects the communication capacity of IoT applications. Therefore, researchers pay attention to improving communication capacity caused by network failures for applications that require high quality of services (QoS). Furthermore, the robustness of network topology is an important metric to measure the network communication capacity and the ability to resist the cyber-attacks induced by some failed nodes. While some algorithms have been proposed to enhance the robustness of IoT topologies, they are characterized by large computation overhead, and lacking a lightweight topology optimization model. To address this problem, we first propose a novel robustness optimization using evolution learning (ROEL) with a neural network. ROEL dynamically optimizes the IoT topology and intelligently prospects the robust degree in the process of evolutionary optimization. The experimental results demonstrate that ROEL can represent the evolutionary process of IoT topologies, and the prediction accuracy of network robustness is satisfactory with a small error ratio. Our algorithm has a better tolerance capacity in terms of resistance to random attacks and malicious attacks compared with other algorithms.