An integrated interval-valued intuitionistic fuzzy technique for resumption risk assessment amid COVID-19 prevention.

Currently, China has achieved a remarkable achievement on the containment of COVID-19, which creates a favorable condition for the gradual resumption of normal life. However, COVID-19 infections continue to rise in many nations and some sporadic cases occur from time to time in China, which still poses some risks to the resumption. Hence, it is imperative to develop some reasonable techniques to assess the resumption risk. This paper aims to investigate an integrated interval-valued intuitionistic fuzzy (IVIF) technique to adroitly assess the resumption risk based on DEMATEL (decision making trial and evaluation laboratory), BWM (best-worst method) and SPA (set pair analysis). This integrated technique is called IVIF-DBWM-SPA, where the IVIF-DBWM (combined by the IVIF-DEMATEL and IVIF-BWM) is used to determine the global criteria weights and the IVIF-SPA is employed to generate the ranking order of the alternatives. The IVIF-DEMATEL and IVIF-BWM are used to determine the weights of dimensions and the weights of criteria under each dimension, respectively. In this IVIF-BWM, two bi-objective programming models are constructed by regarding experts' pessimistic and optimistic attitudes, respectively. Combined experts' intrapersonal and interpersonal uncertainties simultaneously, a bi-objective programming model is proposed to derive the dynamic weights of experts. Based on the determined weights of experts and criteria, an IVIF-SPA is developed to assess the risk levels of all alternatives. The validity of the proposed technique is demonstrated with a real case of college resumption risk assessment amid COVID-19. Some sensitivity and comparison analyses are provided to show the merits of the proposed technique.

A three-way decision method with tolerance dominance relations in decision information systems.

In recent years, various medical diagnosis problems have been addressed from the perspective of multi-attribute decision making. Among them, the three-way decision theory can provide a novel scheme to solve medical diagnosis issues under the framework of multi-attribute decision making via considering transforming relationships between loss functions and decision matrices. In this paper, we primarily explore a three-way decision method with tolerance dominance relations in ordered decision information systems. In existing three-way decision models, all objects can be divided into two states, we utilize decision attributes to obtain the set of two states in ordered decision information systems. Then, in order to improve the accuracy of patient classifications, the paper simultaneously considers the influence of loss and gain functions for each object, and uses loss and gain functions to obtain net profit functions as new measurement functions. Meanwhile, a class of three-way decisions in terms of multi-attribute decision making rules based on a tolerance dominance relation is established. In light of the proposed three-way decision method, we further construct a multi-attribute decision making method by using tolerance dominance relations and the constructed method is applied to a medical diagnosis issue of Lymphography. Finally, a comparison analysis and an experimental evaluation are performed to illustrate the feasibility and effectiveness of the presented methodology.

Long-term outcomes in inferior ST-segment elevation myocardial infarction patients with right ventricular myocardial infarction.

OBJECTIVE: To evaluate the prognostic influence of the presence of right ventricular myocardial infarction (RVMI) on patients with inferior ST-segment elevation myocardial infarction (STEMI) in the contemporary reperfusion era. METHODS: 9308 patients with inferior STEMI were included from the prospective, nationwide, multicenter China Acute Myocardial Infarction Registry, including 1745 (18.75%) patients with RVMI and 7563 (81.25%) patients without RVMI. The primary outcome was two-year all-cause mortality. The secondary outcome was major adverse cardiac and cerebrovascular event (MACCE) defined as a composite of all-cause mortality, recurrent MI, revascularization, stroke, and major bleeding. RESULTS: After two-year follow up, there were no significant differences between inferior STEMI patients with or without RVMI in all-cause mortality (12.0% vs 11.3%; adjusted HR: 1.05; 95% CI: 0.90 to 1.24; P = 0.5103). Inferior STEMI with RVMI was associated with higher risk of MACCE (25.6% vs 22.0%; adjusted HR: 1.17; 95% CI: 1.05 to 1.31; P = 0.0038), revascularization (10.3% vs 8.1%; adjusted HR: 1.23; 95% CI: 1.03 to 1.48; P = 0.0218), and major bleeding (4.6% vs 2.7%; adjusted HR: 1.56; 95% CI: 1.18 to 2.07; P = 0.0019). Primary percutaneous coronary intervention (PCI) and thrombolysis were independent predictors to decrease all-cause mortality. For patients who received timely reperfusion, RVMI involvement did not increase all-cause mortality, whereas for those who did not undergo reperfusion, RVMI increased all-cause mortality (20.3% vs 15.7%; HR: 1.34; 95% CI: 1.10 to 1.63). CONCLUSION: RVMI did not increase all-cause mortality for inferior STEMI patients in contemporary reperfusion era, whereas the risk was increased for patients with no reperfusion treatment.

An efficiency-based interval type-2 fuzzy multi-criteria group decision making for makeshift hospital selection.

Since makeshift hospitals have strong ability in blocking the spread of the virus, how to design some methods to select the reasonable sites of makeshift hospitals is vitally important for containing COVID-19. This paper investigates an efficiency-based multi-criteria group decision making (MCGDM) method by combining the best-worst method (BWM) and data envelopment analysis (DEA) in trapezoidal interval type-2 fuzzy (TrIT2F) environment. This MCGDM method is called TrIT2F-BWM-DEA, where the TrIT2F-BWM is used to determine the weights of criteria and decision-makers, and the TrIT2F-DEA is employed to rank alternatives by measuring their overall efficiencies. Based on cut set theory, the expectation and average expectation (AE) of TrIT2FSs are successively defined. To solve three key issues in the development of the TrIT2F-BWM, this paper proposes a flexible ranking relation of TrIT2FSs to transform the TrIT2F constraints, initiates an efficient theorem to normalize the TrIT2F weights, and designs an input-based consistency ratio to check the reliability of the determined weights. A fully TrIT2F-DEA model is originally built to measure the TrIT2F efficiencies of alternatives. The alternatives are finally ranked according to the AEs of alternatives' TrIT2F efficiencies. A site selection case of Fangcang hospitals and some comparative analyses are provided to confirm the validity and merits of the proposed TrIT2F-BWM-DEA.

Interactive multi-criteria group decision-making with probabilistic linguistic information for emergency assistance of COVID-19.

This paper develops a new method for interactive multi-criteria group decision-making (MCGDM) with probabilistic linguistic information and applies to the emergency assistance area selection of COVID-19 for Wuhan. First, a new possibility degree for PLTSs is defined and a new possibility degree algorithm is devised to rank a series of probabilistic linguistic term sets (PLTSs). Second, some new operational laws of PLTSs based on the Archimedean copulas and co-copulas are defined. A generalized probabilistic linguistic Choquet (GPLC) operator and a generalized probabilistic linguistic hybrid Choquet (GPLHC) operator are developed and their desirable properties are discussed in details. Third, a tri-objective nonlinear programming model is constructed to determine the weights of DMs. This model is transformed into a linear programming model to solve. The fuzzy measures of criterion subsets are derived objectively by establishing a goal programming model. Fourth, using the probabilistic linguistic Gumbel weighted average (PLGWA) operator, the collective normalized decision matrix is obtained by aggregating all individual normalized decision matrices. The overall evaluation values of alternatives are derived by the probabilistic linguistic Gumbel hybrid Choquet (PLGHC) operator. The ranking order of alternatives is generated. Finally, an emergency assistance example is illustrated to validate the proposed method of this paper.

The association between body mass index and in-hospital outcome among patients with acute myocardial infarction-Insights from China Acute Myocardial Infarction (CAMI) registry.

BACKGROUND: The relationship between body mass index (BMI) and in-hospital mortality risk among patients with acute myocardial infarction (AMI) remains controversial. METHODS AND RESULTS: We included 35,964 patients diagnosed with AMI in China Acute Myocardial Infarction registry between January 2013 and December 2016. Patients were categorized into 4 groups according to BMI level: BMI <18.5, 18.5-24.9, 25-30, and ≥30 kg/m2 for underweight, normal, overweight, and obese groups, respectively. Clinical data were extracted for each patient, and multivariable logistic regression analysis was used to examine the association between BMI level and in-hospital mortality. Compared with normal-weight patients, obese patients were younger, more often current smokers, and more likely to have hypertension, hyperlipidemia, and diabetes. Multivariable regression analysis results demonstrated that compared with normal group, underweight group had significantly higher in-hospital mortality (odds ratio [OR]: 1.34; 95% confidence interval [CI]: 1.06-1.69; p = 0.016), while overweight group (OR: 0.86; 95% CI: 0.77-0.97; p = 0.011) and obese group (OR: 0.65; 95% CI: 0.46-0.91; p = 0.013) had lower mortality. All subgroups showed a trend toward lower in-hospital mortality risk as BMI increased. CONCLUSIONS: Our study provided robust evidence supporting "obesity paradox" in a contemporary large-scale cohort of patients with AMI and demonstrated that increased BMI was independently associated with lower in-hospital mortality.

Cardioprotective Effects of Malvidin Against Isoproterenol-Induced Myocardial Infarction in Rats: A Mechanistic Study.

BACKGROUND Malvidin (alvidin-3-glucoside) is a polyphenol that belongs to the class of natural anthocyanin, which is abundantly found in red wines, colored fruits, and the skin of red grapes. Therefore, the current investigation was intended to evaluate the effect of malvidin against myocardial infarction induced by isoproterenol in the rats. MATERIAL AND METHODS The cardioprotective effects was assessed by determining the effect of malvidin on the activities of endogenous antioxidants - catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH) - and on the levels of lipid peroxidation and serum marker enzymes. The serum levels of IL-6 and TNF-α were also determined using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS The present study demonstrated a significant cardioprotective effect of malvidin by restoring the defensive activities of endogenous antioxidants - catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH) - and by reducing the levels of lipid peroxidation and serum marker enzymes lactate dehydrogenase (LD) and creatine kinase (CK). Malvidin significantly ameliorated the histopathological changes and impaired mitochondria in the cardiac necrosis stimulated with isoproterenol. Additionally, the results also demonstrated that nuclear translocation of Nrf-2 and subsequent HO-1 expression might be associated with nuclear factor kappa B (NF-κB) pathway activation. CONCLUSIONS Our findings suggest that malvidin exerts cardioprotective effects that might be due to possible strong antioxidant and anti-inflammatory activities. Therefore, this study provides the basis for the development of malvidin as a safe and effective treatment of myocardial infarction.

Is Overexpression of Ki-67 a Prognostic Biomarker of Upper Tract Urinary Carcinoma? A Retrospective Cohort Study and Meta-Analysis.

BACKGROUND: Upper tract urinary carcinoma (UTUC) is a relatively uncommon but aggressive disease. The Ki-67 antigen is a classic marker of cellular proliferation, but there is still controversy regarding the significance and importance of Ki-67 in tumor progression. METHODS: In this study, we first detected Ki-67 expression in UTUC patients by immunohistochemistry (IHC). Subsequently, we quantitatively combined the results with those from the published literature in a meta-analysis after searching several databases. RESULTS: IHC results demonstrated that patients with muscle-invasive tumors (T2-T4) had higher Ki-67 expression than those with non-muscle-invasive tumors (Tis-T1), suggesting that high Ki-67 expression may be associated with the aggressive form of UTUC. Kaplan-Meier curves showed that patients with high Ki-67 expression had significantly poorer cancer-specific survival (CSS) and disease-free survival (DFS). Furthermore, multivariate analysis suggested that Ki-67 expression was an independent prognostic factor for CSS (hazard ratio, HR=3.196) and DFS (HR=3.517) in UTUC patients. Then, a meta-analysis of the published literature investigating Ki-67 expression and its effects on UTUC prognosis was conducted. After searching the PubMed, Medline, Embase, Cochrane Library and Scopus databases, 12 articles met the eligibility criteria for this analysis. The eligible studies included a total of 1740 patients with a mean number of 82 patients per study (range, 38-475). The combined results showed that increased Ki-67 levels were associated with poor survival and disease progression, with a pooled HR estimate of 2.081 and 2.791, respectively. In subgroup analysis, the pooled HR was statistically significant for cancer-specific survival (HR=2.276), metastasis-free survival (HR=3.008) and disease-free survival (HR=6.336). CONCLUSIONS: In conclusion, high Ki-67 expression was associated with poor survival in patients with UTUC, as well as a high risk of disease progression, although these findings need to be interpreted with caution. Large-scale, adequately designed, prospective trials are needed to further confirm the value of Ki-67 in prognosis of UTUC patients.