Decision Making with Multi Criteria through Hierarchic Analysis Technique and its Effect on Customer Decision Procedure

Today, world competition situation is in a way that organizations need to increase the quality and increase the customer satisfaction, increase the benefit and decrease in outgoings, all at the sometime together. One side, goods prices increase and sever competition in market between goods, and on the other side, complexity in customers attitude and their vary expectations made disaster in management and share increase of the market. So, increase of effects on customer decision procedure as a new attitude in these situations born. Customer decision procedure is a kind of decision- making that is mode by the users. In general, decision-making is recognition processes through selection among different choices. How many criteria are used to analysis by the users? In addition, what kind of criteria do they consider? In addition, to what extent do they emphasize according to their favorites or goods importance. Hierarchic analysis procedure (AHP) is a decision-making with multi criteria that is suitable complex decisions, and consist of decision elements compare in where recognition of quality has encountered with problem. Ranking in decision choices of AHP is to solve the puzzle complexity AHP procedure by finding the specification through different choices, declare good buying decision

The effect of low-level LASER on pain improvement and function in patients affected anterior knee pain

زمینه و هدف: درد قدام زانو یک مشکل شایع در میان بزرگسالان و جوانان است. این مطالعه به منظور بررسی تاثیر لیزر کم توان در بهبود درد و عملکرد زانو در بیماران مبتلا به درد قدام زانو انجام شد. روش بررسی: در این کارآزمایی بالینی تصادفی دو سوکور 30 بیمار با درد قدام زانو از طریق نمونه گیری در دست رس انتخاب و به صورت تصادفی در دو گروه مورد (15 نفر) و کنترل (15 نفر) قرار گرفتند. در گروه مورد علاوه بر تمرین درمانی از لیزر کم توان گالیوم-آرسناید با توان متوسط خروجی 100 میلی ولت، طول موج 905 نانومتر و میزان انرژی 8 ژول به مدت 3 دقیقه استفاده شد. در گروه کنترل از تمرین درمانی همراه با لیزر روشن بدون خروجی استفاده شد. درمان به مدت 16 جلسه، طی 4 هفته و هر هفته 4 جلسه انجام شد. درد با مقیاس اندازه گیری دیداری درد، عملکرد با مقیاس کاوس و دامنه‌ی فلکسیون زانو با گونیـــامتر قبل و بعد از درمان اندازه گیری شدند. از آزمون های t زوجی وt مستقل برای تجزیه و تحلیل داده ها استفاده شد. یافته‌ها: پس از درمان در هر دو گروه مورد و شاهد میانگین درد زانو و نمره کلی پرسشنامه کاوس کاهش و دامنه فلکسیون نسبت به قبل از درمان افزایش معنی داری داشت (01/0

Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model

Purpose Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016. Methods Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant. Results Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (- 0.93) in percentage of malnourished children under five annually. The slope of - 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of - 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition. Conclusion The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition

Regression of nonalcoholic fatty liver disease detected by sonography: Results of a four years prospective adult population-based study

Background: Today, nonalcoholic fatty liver disease (NAFLD) has become a major health problem owing to its high prevalence. Literature evidence about regression of NAFLD are not as high as its development or progression. Objectives: This cohort study was conducted to reveal the factors influencing the regression of the NAFLD. Methods: A population-based study conducted in Shiraz, Iran. Adults older than 18 years were recruited by multistage randomized sampling in 2012, and then in 2017. Demographic, anthropometric, nutritional, and medical characteristics of each interviewee were entered into a valid and reliable questionnaire. Interviewees were categorized into three groups according to the changing of their NAFLD status between two stages of this study; no change, regressed and progressed. Results: Of the 537 participants, 163 (30.3%) showed regression of their NAFLD compared to 93 (17.3%) that their NAFLD was progressed. Multinomial regression showed that each unit of decrease in BMI (∆ BMI=-1 kg/m2 ) augmented the relative risk (RR) of improvement of NAFLD by 13.3% (RR: 0.867; 95% CI: 0.776-0.969; P = 0.012) and reduced the relative risk of NAFLD deterioration by 14.3% (RR: 1.143; 95% CI: 1.009-1.294; P = 0.035). Conclusions: A significant portion of patients showed regression of their NAFLD by decreasing their BMI. Therefore, BMI as a modifiable variable should be regarded in the management of NAFLD patients Keywords: Non-Alcoholic Fatty Liver, Regression, Progression, Cohort Stud

The Prediction Of Alexithymia Using Depression, Anxiety, Stress, And Demographics In Undergraduate Students

Aims: Alexithymia is a psychiatric disorder in which people become emotionally frustrated. This study aims to model the role of depression, anxiety, and stress in alexithymia prediction. Materials and Methods: In this cross-sectional study, 260 undergraduate students were selected via multi-stage cluster sampling. The Toronto Alexithymia Scale (TAS-20) and depression, anxiety and stress scale have been used to collect data. The association between qualitative variables was examined using Chi-square test and LASSO logistic regression was fitted for alexithymia prediction. Results: The mean± SD of participants’ age was 20.7± 3.2 years. Of all, 197 (75.8%) students were female and 236 (90.8%) were single. According to the cutoff point for TAS-20, 30.8% of the students displayed signs of alexithymia. The rate of alexithymia was significantly higher among males (42.9% versus 26.9%, P=0.02) and among nursing (45.9%) and anesthesia (44.8%) students than other undergraduate students. The proportion of students with anxiety, depression, and stress were 45.0%, 15.8%, and 9.2%, respectively. 51.2% of the depressed students had alexithymia, while only 26.9% of non-depressed students were alexithymic (P=0.002). LASSO logistic regression showed that odds of alexithymia was significantly higher among male students (OR=1.40, 95% CI=1.03, 1.90), students with depression (OR=1.73, 95% CI=1.18, 2.54), students who had anxiety (OR=1.42, 95% CI=1.07, 1.89), and nursing students (OR=1.62, 95% CI=1.07, 2.45). Conclusion: The results of this study indicate the importance role of anxiety and depression in predicting alexithymia. Due to the high prevalence of alexithymia among college students, we suggest the routine evaluation of college students for alexithymia

Clustering time trends of breast cancer incidence in Africa: A 27-year longitudinal study in 53 countries

Background: Breast cancer is the most common, frequently diagnosed cancer with the highest incidence among female worldwide. Although the incidence is decreasing in developed countries, it is on increase in most of the African countries. Objective: This study aimed to identify different time trends of breast cancer incidence among African countries using latent mixture approach. Methods: The information includes newly diagnosed breast cancer patients per 100,000 women for 53 African countries in a period of 1990-2016. Latent mixture modeling was performed in Mplus 7.4 software. Results: The overall trend of breast cancer in Africa was increasing. Latent mixture model with 5 clusters was estimated as the best using fit indices and linear growth trajectories were specified for each cluster. Nigeria was the only country which belongs to a cluster with negative slope indicating a slow decrease in the breast cancer incidence; also, Seychelles was the only country that showed a sharp increase over time. 31 countries belonged to a cluster with a slope of 0.08, indicating that the incidence of breast cancer is almost constant over time. Cluster 3 including Algeria, Angola, Botswana, Central African Republic, Cote d�lvoire, Equatorial Guinea, Lesotho, Libya, Namibia, Somalia, Sudan, Swaziland, Uganda and Zimbabwe and cluster 2 including Gabon, Mauritius, Morocco, South Africa, Tunisia and Congo showed a slow and moderate increase in the incidence of breast cancer, respectively. Conclusion: Providing health education programs is essential in African countries with rising trend of breast cancer during the last decades

The Effectiveness of a Sequential Helicobacter Pylori Eradication Regimen on the Severity of Clinical Symptoms in Children with Chronic Gastritis: A Randomized Clinical Trial

Background: The effectiveness of eradicating Helicobacter pylori infection in improving the symptoms of chronic gastritis has been examined; however, the results of the studies have been contradictory, especially in childhood. This study aimed to compare the clinical effectiveness of sequential Helicobacter pylori eradication treatment and proton pump inhibitor alone in children with chronic Helicobacter pylori-positive gastritis.Methods: This randomized double-blinded clinical trial was conducted on 84 children aged 5 to 15 years suffering from Helicobacter pylori-associated active chronic gastritis. The patients in the experimental group received sequential therapy including omeprazole, amoxicillin, clarithromycin, and metronidazole; and those in the control group only received omeprazole. Before the intervention, and 2 and 4 months after it, the severity of clinical symptoms was assessed.Results: After therapeutic regimens, the intervention group was found to have a significantly higher decrease in the severity grades of some symptoms including heartburn, gastroesophageal reflux, and abdominal pain in the epigastric area as compared to the control group (P<0.05). The assessment of the frequency of clinical symptoms in the intervention and control groups also indicated a greater reduction in epigastric pain in the group treated with Helicobacter pylori eradication as compared to the control group (P<0.05).Conclusion: Prescribing a sequential Helicobacter pylori eradication regimen can lead to reducing the severity of clinical symptoms in children suffering from chronic gastritis

Measurement Invariance and Psychometric Analysis of Oxford Happiness Inventory Scale across Gender and Marital Status

Background: The Oxford Happiness Inventory (OHI) is a self-report tool to measure happiness. A brief review of previous studies on OHI showed the lack of evaluation of OHI fairness/equivalence in measuring happiness among identified groups. Methods: To examine the psychometric properties and measurement invariance of the OHI, responses of 500 university students were analyzed using item response theory and ordinal logistic regression (OLR). Relevant measures of effect size were utilized to interpret the results. Differential test functioning was also evaluated to determine whether there is an overall bias at the test level. Results: OLR analysis detected four items across gender and two items across marital status to function differentially. An assessment of effect sizes implied negligible differences for practical considerations. Conclusions: This study was a significant step towards providing theoretical and practical information regarding the assessment of happiness by presenting adequate evidence regarding the psychometric properties of OHI

Comparison of Formulas for Low-Density Lipoprotein (LDL) Calculation for Predicting the Risk of Metabolic Syndrome

Background: The correlation between serum cholesterol level and the risk of developing atherosclerosis and metabolic syndrome has been well established in previous studies. Serum low-density lipoprotein (LDL-C) measurement is conducted using different methods which are generally divided into two groups, namely direct and indirect. Using indirect methods or calculations such as the Friedewald or Iranian formula for measuring LDL, particularly in developing countries, is quite common. The present study has stepped in to compare the robustness of the extant formulas in prognosticating and determining the incidence of metabolic syndrome. Materials and Methods: In this cross-sectional study, the target population was the community of Fasa cohort study. According to the views of the statistical advisor, 9530 people were included in the study and clinical laboratory examinations were done for each person. Their serum LDL level was measured using the existing formulas. Then, the results of the serum LDL level that was computed with different formulas, were compared with both the status of metabolic syndrome and laboratory tests of individuals. Results: The Iranian formula has the highest area under curve, the sensitivity of 0.73, and specificity of 0.77, higher positive and negative predictive values among other formulas. In Friedewald formula, for example, sensitivity and specificity equal 0.28 and 0.80, respectively. After further analysis, two new models proposed for predicting metabolic syndrome. The results revealed that these two models even outperform the Iranian formula. Conclusion: The Iranian formula for plasma LDL calculation has higher precision and application for predicting and measuring the metabolic syndrome in the Iranian population due to its considerable features. It is required to develop a new formula for each population and even for each sex, if possible. Keywords:Cholesterol; LDL; Lipoproteins; Metabolic Syndrome; Friedwal

Introducing an efficient model for the prediction of placenta accreta spectrum using the MCP regression approach based on sonography indexes: how efficient is sonography in diagnosing accreta?

Background For the first time, we aimed to introduce a model for prediction of placenta accreta spectrum (PAS), using existing sonography indices. Methods Women with a history of Cesarean sections were included. Participants were categorized "high risk" for PAS if the placenta was previa or low-lying. Sonography indices including abnormal placental lacuna, loss of clear zone, bladder wall interruption, myometrial thinning, placental bulging, exophytic mass, utero-vesical hypervascularity, subplacental hypervascularity, existence of bridging vessels, and lacunar flow, were registered. To investigate simultaneous effects of 15 variables on PAS, Minimax Concave Penalty (MCP) was used. Results Among 259 participants, 74 (28.5%) were high risk and 43 individuals had PASs. All sonography indices were higher among patient with PAS (p < 0.001) in the high risk group. Our model showed that utero-vesical hypervascularity, bladder interruption and new lacunae have significant contribution in PAS. Optimal cut off point was p = 0.51 in ROC analysis. Probability of PAS for women with lacunae was between 96 and 100% and probability of PAS for women without lacunae was between 0 to 7%, therefore accuracy of the proposed model was equal to 100%. Conclusions Using the introduced model based on three factors of abnormal lacuna structures (grades 2 and 3), bladder wall interruption and utero-vesical vascularity, 100% of all cases of PASs are diagnosable. If supported by future studies our model eliminates the need for other imaging assessments for diagnosis of invasive placentation among high risk women Keywords:Morbidly adherent placenta; Placenta accreta spectrum; Ultrasonography; Accreta; Diagnosi