New logarithmic operational laws and their applications to multiattribute decision making for single-valued neutrosophic numbers

Neutrosophic set, initiated by Smarandache, is a novel tool to deal with vagueness considering the truth, indeterminacy and falsity memberships satisfying the condition that their sum is less than 3. This set can be used to characterize the information more accurately than the intuitionistic fuzzy set. Under this set, the objective of this manuscript is to present some new operational laws called as logarithm operational laws with real number base k for the single-valued neutrosophic (SVN) numbers. Various desirable properties of the proposed operational laws are contemplated. Further, based on these laws, different weighted averaging and geometric aggregation operators are developed

Algorithms for possibility linguistic single-valued neutrosophic decision-making based on COPRAS and aggregation operators with new information measures

The objective of this work is to introduce the concept of the possibility linguistic single-valued neutrosophic set (PLSVNS) for better dealing with the imprecise and uncertain information during the decision-making process. The prominent characteristics of this set are that it considers two distinctive sorts of information such as the membership, indeterminacy, non-membership degrees, and their corresponding possibility degree. In it, first, we stated some operational laws, score and accuracy functions, comparison laws between the pairs of the set. Then, we define weighted averaging and geometric aggregation operators (AOs) to collaborate the PLSVNSs into a single one. Further, we present two algorithms based on a complex proportional assessment (COPRAS) method and AOs based method under PLSVNS information to solve the decision-making problems. In these methods, the information related to weights of decision makers and criteria is determined with the help of a distance and entropy measures. Finally, a practical real-life example is provided to expose the materialness and the viability of our work

An epidemiological study to assess bone mineral density and its association with contributing factors among premenopausal and postmenopausal women in selected villages of District Shimla, Himachal Pradesh, India

Background: Development of peak bone mass and premenopausal bone loss is determined by the menstrual status of women. Decline in bone mass with age becomes accelerated during menopause. Menopausal bone loss refers to the accelerated bone loss that occurs during the BM) of premenopausal and post-menopausal women, to identify the contributing factors associated with BMD among pre and post-menopausal women, to compare the level of BMD and the contributing factors of pre-menopausal women with post-menopausal women.Methods: It was quantative research approach and epidemiological analytic research design was used. Total enumeration technique was adopted in this study.Results: Analysis of data was done in accordance with the objectives of the study. Findings show that among premenopausal women 45.10% of the women had osteopenia and 8.20% of the women had osteoporosis, among postmenopausal women 50.00% of the women had oestriopenic and 41.2% of the women had osteoporosis. The analysis shows that factors such as BMI, Health status, life style, age, economic status and dietary patter plays important role to accelerate the level of T-score more than -1 in both group either premenopausal women or post-menopausal women. It shows the significance at the level of p<0.001.Conclusions: The study was completed in July 2016, concludes that there are many factors that can lead to have risk of osteoporosis related fracture. As age is increased the risk is also increased to get the fracture. Every woman can go for screening of BMD test to control the risk of fracture

Development of a Capillary Blood Mail-in Kit for the Measurement of Hemoglobin A1c

Biomedical Tissue Engineering, Biomaterials and Medical Devices Poster SessionIt is estimated that in the United States diabetes affects 25 million children and adults, and is a major cause of morbidity and mortality. Cost of diabetes in the United States is over $175 billion a year. To optimize insulin dose diabetic patients regularly measure their blood glucose. Random glucose measurement does not provide indication of long-term glucose control. The long-term indicator of glucose control is the hemoglobin A1c (HbA1c). It provides average blood glucose level of the previous 2 to 3 months. In most cases, for HbA1c testing, patients come to clinical laboratories for blood draw. It is time consuming and inconvenient. In recent years efforts have been made to develop sample mail-in kit where the blood sample can be collected at home and mailed to a testing laboratory. We present the development of a stabilizing solution (SS) and mail-in kit for Hb A1c testing. With this kit, after a simple finger prick, a patient collects blood using a capillary tube. The blood-containing capillary tube is dropped in a tube containing SS, and is mailed to the laboratory in a pre-stamped box in a regular mail. Validation of the kit included 1) Comparing HbA1c levels in the whole blood to hemolysate and SS immediately after preparation of the samples, 2) Stability of HbA1c in SS for 4 and 7 days at 4oC, room temperature and 37oC, 3) mailing the samples in the regular mail and comparing the values of HbA1c in mailed-in samples to the whole blood samples. The data for some of these comparisons are shown in the Table below. No significant difference was found in the values of HbA1c in various test groups. In conclusion, we have developed a convenient mail-in kit for the measurement of HbA1c. The advantages of mail-in kit for HbA1c measurement include patients' satisfaction as it negates the need for venipuncture and laboratory visit for sample collection, and the availability of results to a physician before the patient's visit for optimal care

Genomic profiling of malignant peritoneal mesothelioma reveals recurrent alterations in epigenetic regulatory genes BAP1, SETD2, and DDX3X.

Malignant mesothelioma is a rare cancer that arises from the mesothelial cells that line the pleural cavity and less commonly from the peritoneal lining of the abdomen and pelvis. Most pleural mesotheliomas arise in patients with a history of asbestos exposure, whereas the association of peritoneal mesotheliomas with exposure to asbestos and other potential carcinogens is less clear, suggesting that the genetic alterations that drive malignant peritoneal mesothelioma may be unique from those in pleural mesothelioma. Treatment options for all malignant mesotheliomas are currently limited, with no known targeted therapies available. To better understand the molecular pathogenesis of malignant peritoneal mesothelioma, we sequenced 510 cancer-related genes in 13 patients with malignant mesothelioma arising in the peritoneal cavity. The most frequent genetic alteration was biallelic inactivation of the BAP1 gene, which occurred in 9/13 cases, with an additional two cases demonstrating monoallelic loss of BAP1. All 11 of these cases demonstrated loss of BAP1 nuclear staining by immunohistochemistry, whereas two tumors without BAP1 alteration and all 42 cases of histologic mimics in peritoneum (8 multilocular peritoneal inclusion cyst, 6 well-differentiated papillary mesothelioma of the peritoneum, 16 adenomatoid tumor, and 12 low-grade serous carcinoma of the ovary) demonstrated intact BAP1 nuclear staining. Additional recurrently mutated genes in this cohort of malignant peritoneal mesotheliomas included NF2 (3/13), SETD2 (2/13), and DDX3X (2/13). While these genes are known to be recurrently mutated in pleural mesotheliomas, the frequencies are distinct in peritoneal mesotheliomas, with nearly 85% of peritoneal tumors harboring BAP1 alterations versus only 20-30% of pleural tumors. Together, these findings demonstrate the importance of epigenetic modifiers including BAP1, SETD2, and DDX3X in mesothelial tumorigenesis and suggest opportunities for targeted therapies

Adenomatoid tumors of the male and female genital tract are defined by TRAF7 mutations that drive aberrant NF-kB pathway activation.

Adenomatoid tumors are the most common neoplasm of the epididymis, and histologically similar adenomatoid tumors also commonly arise in the uterus and fallopian tube. To investigate the molecular pathogenesis of these tumors, we performed genomic profiling on a cohort of 31 adenomatoid tumors of the male and female genital tracts. We identified that all tumors harbored somatic missense mutations in the TRAF7 gene, which encodes an E3 ubiquitin ligase belonging to the family of tumor necrosis factor receptor-associated factors (TRAFs). These mutations all clustered into one of five recurrent hotspots within the WD40 repeat domains at the C-terminus of the protein. Functional studies in vitro revealed that expression of mutant but not wild-type TRAF7 led to increased phosphorylation of nuclear factor-kappa B (NF-kB) and increased expression of L1 cell adhesion molecule (L1CAM), a marker of NF-kB pathway activation. Immunohistochemistry demonstrated robust L1CAM expression in adenomatoid tumors that was absent in normal mesothelial cells, malignant peritoneal mesotheliomas and multilocular peritoneal inclusion cysts. Together, these studies demonstrate that adenomatoid tumors of the male and female genital tract are genetically defined by TRAF7 mutation that drives aberrant NF-kB pathway activation

Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

<p>Abstract</p> <p>Background</p> <p>Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit.</p> <p>Methods</p> <p>The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system.</p> <p>Results</p> <p>Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses.</p> <p>Conclusion</p> <p>A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.</p

Most national, mandatory flour fortification standards do not align with international recommendations for iron, zinc, and vitamin B12 levels

Abstract As national flour fortification standards are one of the policy documents developed to guide food fortification, the objective was to compare national, mandatory wheat and maize flour fortification standards to World Health Organization (WHO) fortification guidelines. For each nutrient in 72 countries' standards, the type of compound was noted as 'yes' if it was included in international guidelines or 'no' if it was not. Nutrient levels in standards were classified as lower than, equal to, or higher than those suggested by WHO. If another food (i.e. rice, oil, milk) was mass fortified with a nutrient categorized as "lower than," the classification was changed to "less than recommendation and included in other mass fortified food". At least 61% of standards included one or more recommended compounds for all nutrients in standards for wheat flour alone (iron, folic acid, vitamin A, zinc, vitamin B12,), wheat and maize flour together (iron, folic acid, vitamin A, zinc, vitamin B12) and maize flour alone (thiamin, riboflavin, niacin, pyridoxine); no country included pantothenic acid in its maize flour standard. For folic acid, vitamin A, thiamin, riboflavin, niacin and pyridoxine, at least 50% of standards (1) met or exceeded WHO suggested levels, or (2) were lower than suggested levels and another food was mass fortified with the specific nutrient in the country. For iron, zinc and vitamin B12, less than 50% of standards met (1) or (2). In conclusion, iron, zinc and vitamin B12 may require the most attention in national fortification standards

Future Path Toward TB Vaccine Development: Boosting BCG or Re-educating by a New Subunit Vaccine

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), kills 5,000 people per day globally. Rapid development and spread of various multi drug-resistant strains of Mtb emphasize that an effective vaccine is still the most cost-effectives and efficient way of controlling and eradicating TB. Bacillus Calmette-Guerin (BCG), the only licensed TB vaccine, still remains the most widely administered human vaccine, but is inefficient in protecting from pulmonary TB in adults. The protective immunity afforded by BCG is thought to wane with time and considered to last only through adolescent years. Heterologous boosting of BCG-primed immune responses using a subunit vaccine represents a promising vaccination approach to promote strong cellular responses against Mtb. In our earlier studies, we discovered lipopeptides of ESAT-6 antigen with strong potential as a subunit vaccine candidate. Here, we have investigated that potential as a booster to BCG vaccine in both a pre-exposure preventive vaccine and a post-exposure therapeutic vaccine setting. Surprisingly, our results demonstrated that boosting BCG with subunit vaccine shortly before Mtb challenge did not improve the BCG-primed immunity, whereas the subunit vaccine boost after Mtb challenge markedly improved the quantity and quality of effector T cell responses and significantly reduced Mtb load in lungs, liver and spleen in mice. These studies suggest that ESAT-6 lipopeptide-based subunit vaccine was ineffective in overcoming the apparent immunomodulation induced by BCG vaccine in Mtb uninfected mice, but upon infection, the subunit vaccine is effective in re-educating the protective immunity against Mtb infection. These important results have significant implications in the design and investigation of effective vaccine strategies and immunotherapeutic approaches for individuals who have been pre-immunized with BCG vaccine but still get infected with Mtb

Filtering Medline for a clinical discipline: diagnostic test assessment framework

Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database