A multidimensional approach to rank fuzzy numbers based on the concept of magnitude

Ranking fuzzy numbers have become of growing importance in recent years, especially as decision-making is increasingly performed under greater uncertainty. In this paper, we extend the concept of magnitude to rank fuzzy numbers to a more general definition to increase in flexibility and generality. More precisely, we propose a multidimensional approach to rank fuzzy numbers considering alternative magnitude definitions with three novel features: multidimensionality, normalization, and a ranking based on a parametric distance function. A multidimensional magnitude definition allows us to consider multiple attributes to represent and rank fuzzy numbers. Normalization prevents meaningless comparison among attributes due to scaling problems, and the use of the parametric Minkowski distance function becomes a more general and flexible ranking approach. The main contribution of our multidimensional approach is the representation of a fuzzy number as a point in a $n$-dimensional normalized space of attributes in which the distance to the origin is the magnitude value. We illustrate our methodology and provide further insights into different normalization approaches and parameters through several numerical examples. Finally, we describe an application of our ranking approach to a multicriteria decision-making problem within an economic context in which the main goal is to rank a set of credit applicants considering different financial ratios used as evaluation criteria

Influence of the starting day of luteal phase stimulation on double stimulation cycles

BackgroundDouble ovarian stimulation is one of the most used strategies in poor-prognosis patients. There is a high heterogeneity between the studies regarding the execution of this stimulation protocol. The aim of this study was to investigate whether the day on which luteal phase stimulation begins after the first oocyte retrieval affects ovarian response in DuoStim cycles.MethodsThis observational and retrospective study included 541 DuoStim cycles between January 2018 and December 2021 in a private fertility clinic. Patients were assigned to 4 groups according to the timing of the onset of luteal phase stimulation after oocyte retrieval (0-2nd day, 3rd day, 4th day and 5th-6th day). The primary outcome was the number of oocytes retrieved in the luteal phase in each group.ResultsNo differences were found between groups in the number of oocytes collected (5.12 ± 3.56 vs. 5.39 ± 3.74 vs. 5.61 ± 3.94 vs. 5.89 ± 3.92; p=0,6), MII or number of follicles. An increase in the duration of stimulation was found when stimulation started on the 4th day (10.42 ± 2.31 vs. 10.68 ± 2.37 vs. 11.27 ± 2.40 vs. 10.65 ± 2.37 days, p=0,033). A lower number of fertilized oocytes was observed when stimulation began before the fourth day (3.36 ± 2.80 vs. 3.95 ± 2.53 vs. 4.03 ± 2.73 vs. 4.48 ± 3.11; p=0,036). The number of blastocysts was higher when the stimulation started 5-6 days after retrieval (1.82 ± 1.74 vs. 2.13 ± 1.61 vs. 2.33 ± 2.06 vs. 2.91 ± 2.39; p= 0,030).DiscussionThe number of oocytes retrieved does not differ depending on the day that stimulation begins. However, oocytes competence in terms of fertilized oocytes and blastulation, appears to be lower when the second stimulation starts before the fourth day after oocyte retrieval

La protección medioambiental como criterio en la selección de inversiones socialmente responsables: una aproximación multicriterio

[EN] A greater environmental and ethical awareness of companies and organizations is also ap-plied to portfolio selection. This note aims to put forward a multicriteria model of Goal Programming (GP) to design efficient portfolios considering classic financial criteria and environmental criteria[ES] La mayor concienciación medioambiental y ética de empresas y organizaciones se traslada también a la selección de carteras. En esta nota se propone un modelo multicriterio de programación por me-tas para la selección de carteras incorporando a los criterios clásicos financieros, criterios mediambientalesGarcía-Bernabeu, A.; Pla-Santamaria, D.; Bravo, M.; Pérez-Gladish, B. (2015). The Environmental Protection as a selection criterion in Socially Responsible Investments: A multicriteria approach. Economía Agraria y Recursos Naturales - Agricultural and Resource Economics. 15(1):101-112. doi:10.7201/earn.2015.01.06SWORD10111215

Calibrado del programa CSF-Test utilizado como sistema de medida de la función de sensibilidad al contraste

La Función de Sensibilidad al Contraste (CSF) nos proporciona una buena información sobre la calidad del sistema visual de modo que las diferentes modificaciones en la CSF pueden indicar distintos tipos de problemas visuales, ya sean de tipo óptico, patológico o neurológico. Teniendo en cuenta estas consideraciones es necesario disponer de un buen sistema de medida que permita determinar la CSF con precisión, intentando que los errores sistemáticos sean mínimos y no alteren el valor absoluto de las medidas

Gender Biases and Diagnostic Delay in Inflammatory Bowel Disease: Multicenter Observational Study

Background: Female gender could be a cause of diagnostic delay in inflammatory bowel disease (IBD). The aim of this study was to investigate the diagnostic delay in women vs men and potential causes. Methods: This multicenter cohort study included 190 patients with recent diagnosis of IBD (disease duration <7 months). Reconstruction of the clinical presentation and diagnostic process was carried out in conjunction with the semistructured patient interview, review, and electronic medical records. Results: The median time from symptom onset to IBD diagnosis was longer in women than in men: 12.6 (interquartile range, 3.7-31) vs 4.5 (2.2-9.8) months for Crohn’s disease (CD; P = .008) and 6.1 (3-11.2) vs 2.7 (1.5-5.6) months for ulcerative colitis (UC; P = .008). Sex was an independent variable related to the time to IBD diagnosis in Cox regression analysis. The clinical presentation of IBD was similar in both sexes. Women had a higher percentage of misdiagnosis than men (CD, odds ratio [OR], 3.9; 95% confidence [CI], 1.5-9.9; UC, OR 3.0; 95% CI, 1.2-7.4). Gender inequities in misdiagnosis were found at all levels of the health system (emergency department, OR 2.4; 95% CI, 1.1-5.1; primary care, OR 2.5; 95% CI, 1.3-4.7; gastroenterology secondary care, OR 3.2; 95% CI, 1.2-8.4; and hospital admission, OR 4.3; 95% CI, 1.1-16.9). Conclusions: There is a longer diagnostic delay in women than in men for both CD and UC due to a drawn-out evaluation of women, with a higher number of misdiagnoses at all levels of the health care system.This study was supported by Instituto de Salud Carlos III (PI 18/01547), GETECCU (Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa, Grant 2017) and SVPD (Sociedad Valenciana de Patología Digestiva, Grant 2017)

Mutation study of Spanish patients with Hereditary Hemorrhagic Telangiectasia

<p>Abstract</p> <p>Background</p> <p>Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant and age-dependent vascular disorder characterised mainly by mutations in the Endoglin (ENG) or activin receptor-like kinase-1 (ALK1, ACVRL1) genes.</p> <p>Methods</p> <p>Here, we have identified 22 ALK1 mutations and 15 ENG mutations, many of which had not previously been reported, in independent Spanish families afflicted with HHT.</p> <p>Results</p> <p>We identified mutations in thirty-seven unrelated families. A detailed analysis of clinical symptoms was recorded for each patient analyzed, with a higher significant presence of pulmonary arteriovenous malformations (PAVM) in HHT1 patients over HHT2. Twenty-two mutations in ALK1 and fifteen in ENG genes were identified. Many of them, almost half, represented new mutations in ALK1 and in ENG. Missense mutations in ENG and ALK1 were localized in a tridimensional protein structure model.</p> <p>Conclusion</p> <p>Overall, ALK1 mutations (HHT2) were predominant over ENG mutations (HHT1) in our Spanish population, in agreement with previous data from our country and other Mediterranean countries (France, Italy), but different to Northern Europe or North America. There was a significant increase of PAVM associated with HHT1 over HHT2 in these families.</p

Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

The value of serial lung ultrasound (LUS) in patients with COVID-19 is not well defined. In this multicenter prospective observational study, we aimed to assess the prognostic accuracy of serial LUS in patients admitted to hospital due to COVID-19. The serial LUS protocol included two examinations (0–48 h and 72–96 h after admission) using a 10-zones sequence, and a 0 to 5 severity score. Primary combined endpoint was death or the need for invasive mechanical ventilation. Calibration (Hosmer–Lemeshow test and calibration curves), and discrimination power (area under the ROC curve) of both ultrasound exams (SCORE1 and 2), and their difference (DIFFERENTIAL-SCORE) were performed. A total of 469 patients (54.2% women, median age 60 years) were included. The primary endpoint occurred in 51 patients (10.9%). Probability risk tertiles of SCORE1 and SCORE2 (0–11 points, 12–24 points, and ≥25 points) obtained a high calibration. SCORE-2 showed a higher discrimination power than SCORE-1 (AUC 0.72 (0.58–0.85) vs. 0.61 (0.52–0.7)). The DIFFERENTIAL-SCORE showed a higher discrimination power than SCORE-1 and SCORE-2 (AUC 0.78 (0.66–0.9)). An algorithm for clinical decision-making is proposed. Serial lung ultrasound performing two examinations during the first days of hospitalization is an accurate strategy for predicting clinical deterioration of patients with COVID-19

Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients

Objective: Psychological factors, such as stress, anxiety, and depression, are frequently related to inflammatory bowel disease (IBD). However, few studies have examined these factors in patients newly diagnosed with IBD. The aim of the present study was to test the psychological burden in patients with a recent diagnosis of IBD and the factors related to this psychological burden. Methods: We performed a prospective, multi-center, observational study in patients with a new diagnosis of IBD (≤6 months). The patients were recruited from four different Spanish hospitals. Clinical and demographic characteristics were collected. Patients were evaluated using the Hospital Anxiety and Depression Scale and quality of life questionnaire for patients with inflammatory bowel disease (IBDQ-32). The Scale of Stress Perceived by the Disease was used to assess stressful life events. Results: We included 156 patients newly diagnosed with IBD [69 women; 80 Crohn’s disease (CD) and 76 ulcerative colitis (UC)], with a mean age of 42.3 (SD 16.21) years. A total of 37.2% of patients had symptoms of anxiety and 17.3% had symptoms of depression. Quality of life was affected in 30.1% of patients. Factors related to anxiety in early IBD were being a woman and having CD. The only factor related to depression was the presence of comorbidity. Being a woman and having suffered previous stressful life events were factors related to impaired quality of life. Conclusion: Anxiety, depression, and impaired quality of life are frequent in patients with a recent diagnosis of IBD. This psychological burden is greater in women.This study was funded by Instituto de Salud Carlos III (PI 18/01547), ISABIAL (Alicante Institute for Health and Biomedical Research, UGP-23-071 and UGP-22-105), GETECCU (Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa, Grant 2017), and SVPD (Sociedad Valenciana de Patología Digestiva, Grant 2017)

Red de seguimiento e indicadores de calidad de la titulación máster universitario en prevención de riesgos laborales

El profesorado de la red participó durante el curso 2013/14 en un proyecto para el seguimiento e indicadores de calidad de la titulación máster universitario en prevención de riesgos laborales. Este Máster comenzó a impartirse en la Escuela Politécnica Superior de la Universidad de Alicante en el curso 2012/13. En el curso 2015/16 al Máster en prevención de riesgos laborales le corresponde la renovación de su acreditación, en base a los resultados de la docencia de los cursos 2013/14 y 2014/15, por lo que los resultados del presente proyecto son de interés para la renovación de la acreditación de la titulación

Peripheral Inflammatory Indexes Neutrophil/Lymphocyte Ratio (NLR) and Red Cell Distribution Width (RDW) as Prognostic Biomarkers in Advanced Solitary Fibrous Tumour (SFT) Treated with Pazopanib

Simple Summary Pazopanib treatment in advanced solitary fibrous tumour patients, assessed in the prospective GEIS-32 phase II clinical trial, has shown longer progression-free survival and overall survival versus chemotherapy treatment in control patients. In recent years, the interest in the prognostic and predictive value of different peripheral inflammatory indexes, such as neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and red cell distribution width, has been increased in sarcomas, showing significant results in different soft tissue sarcomas. However, they have not been previously analysed in solitary fibrous tumour (SFT) patients. These indexes were retrospectively analysed in the typical- and malignant-SFT cohorts treated with pazopanib of the GEIS-32 trial to evaluate their predictive or prognostic value. Pazopanib was assessed prospectively in the GEIS-32 phase II study (NCT02066285) on advanced solitary fibrous tumour (SFT), resulting in a longer progression-free survival (PFS) and overall survival (OS) compared with historical controls treated with chemotherapy. A retrospective analysis of peripheral inflammatory indexes in patients enrolled into GEIS-32 was performed to evaluate their prognostic and predictive value. Patients received pazopanib 800 mg/day as the first antiangiogenic line. The impacts of baseline neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and red cell distribution width (RDW) on PFS, OS, and Choi response were evaluated by univariate and multivariate analysis. Metastasis-free interval (MFI), mitotic count, and ECOG were also included as potential prognostic factors. Sixty-seven SFT patients, enrolled in this study, showed a median age of 63 years and a female/male distribution of 57/43. The median follow-up from treatment initiation was 16.8 months. High baseline NLR, PLR, and standardised RDW were significantly associated with worse PFS and OS. NLR, RDW, MFI, and mitotic count were independent variables for PFS, while RDW and ECOG were independent for OS. Further, NLR and mitotic count were independent factors for Choi response. High baseline NLR and RDW values were independent prognostic biomarkers for worse outcome in advanced SFT patients treated with pazopanib