Reliability of information can directly affect the accuracy of decision-making. Compared with classical fuzzy sets, Z-number takes into account the uncertainty in information generation process and ...reliability of information. Z-number can also be an intuitive and effective description form of decision information. Existing research on the distance measure of Z-number is rare, and most of the research works cannot reflect well the advantages of Z-information and the characteristics of Z-number. Given this research gap, this paper simultaneously considered the randomness and fuzziness of Z-number and defined the comprehensive weighted distance measure of Z-number. To extend classic VlseKriterijum-ska Optimizacija I Kompromisno Resenje (VIKOR) method to the Z-information environment, we suggested the Z-VIKOR method based on the proposed distance measure. This method is convenient and effective for the direct computation of Z-numbers. We also provided an example of multicriteria decision-making for selecting regional circular economy development plan to illustrate the feasibility and validity of our proposed method. We then verified the applicability and superiority of our method through comparative analyses with other existing methods.
A circular economy (CE) is proposed to mitigate resource shortage and environmental pollution. Given the inevitable conflict between the new development mode and traditional economic benefits, ...practical experience shows that CE implementation needs the support of outside forces, such as government policy interventions or environmental organisations’ propaganda guidance. On the basis of existing studies, the present work establishes a systematic economic model in accordance with the characteristics, objectives and principles of CE. The equilibrium solution and critical condition of government and non-government participation models are obtained through game analysis. We select the industrial waste water circulation of some provinces in China to illustrate the feasibility and effectiveness of the proposed model. Overall, our results indicate that the gap between the critical price and unit processing cost determines the promotion of CE and government intervention. Moreover, government intervention is critical to building a waste management department in its early stage.
Decision makers (DMs) have different cognitive levels in practical experience, information reserve, and thinking ability. Thus, decision information is often not completely reliable. As a tool that ...can effectively represent information reliability, Z-number has been studied by many scholars in recent years. Current research on Z-number assumes that differences in various parts of a Z-number can complement one another. However, in many cases, the preference of DMs for each part is difficult to determine, or DMs believe that the differences in various parts cannot be complementary. Therefore, to solve such decision problems, this paper attempts to extend the traditional MABAC method to the Z-information environment by introducing the directed distance and regret theory. The proposed method simultaneously considers the randomness and fuzziness of Z-number. An example about regional circular economy development program selection is provided to illustrate the feasibility of the proposed method. Results show that the proposed method can solve complex decision problems rationally and effectively, and it has broad application prospects.
A Pd‐catalyzed enantioselective linear‐allylic alkylation of vinyl benzoxazinanones with a series of 3‐substituted oxindoles was reported in the presence of a chiral oxamide‐phosphine ligand ...(COAP−Bn) under mild reaction conditions. A series of optically active multifunctional 3,3′‐disubstituted oxindole derivatives bearing a quaternary stereogenic center and a linear aryl amino side chain were respectively obtained in 55–98% yields with 96–99% ee for 3‐(hetero)aryl substituted oxindoles. The developed protocol demonstrates that the COAP ligands could serve as a privileged chiral ligand to construct diverse chiral 3,3‐disubstituted oxindole compounds with various quaternary stereogenic centers, such as aza‐, thio‐ or all‐carbon quaternary stereogenic centers. The salient features of the method include broad substrate scope, N‐protecting group free, base‐free, and high regio‐ and enantioselectivity.
Background: Combined therapy with tyrosine kinase inhibitors (TKIs) and anti-PD-1 antibodies has shown high tumor response rates for patients with unresectable hepatocellular carcinoma (HCC). ...However, using this treatment strategy to convert initially unresectable HCC to resectable HCC was not reported. Methods: Consecutive patients with unresectable HCC who received first-line therapy with combined TKI/anti-PD-1 antibodies were analyzed. Tumor response and resectability were evaluated via imaging every 2 months (±2 weeks) using RECIST v1.1. Resectability criteria were (1) R0 resection could be achieved with sufficient remnant liver volume and function; (2) intrahepatic lesions were evaluated as partial responses or stable disease for at least 2 months; (3) no severe or persistent adverse effects occurred; and (4) hepatectomy was not contraindicated. Results: Sixty-three consecutive patients were enrolled. Of them, 10 (15.9%) underwent R0 resection in 3.2 months (range: 2.4–8.3 months) after the initiation of combination therapy. At baseline, these 10 patients had a median largest tumor diameter of 9.3 cm, 7 had Barcelona Clinic Liver Cancer stage C (vascular invasion) disease, 2 had stage B, and 1 had stage A. Before surgery, 6 patients were evaluated as a partial response, 3 stable disease, and 1 partial response in the intrahepatic lesion but a new metastatic lesion in the right adrenal gland. Six patients (60%) achieved a pathological complete response. One patient died from immune-related adverse effects 2.4 months after hepatectomy. After a median follow-up of 11.2 months (range: 7.8–15.9 months) for other 9 patients, 8 survived without disease recurrence, and 1 experienced tumor recurrence. Conclusions: Combination of TKI/anti-PD-1 antibodies is a feasible conversion therapy for patients with unresectable HCC to become resectable. This study represents the largest patient cohort on downstaging role of combinational systemic therapy on TKI and PD-1 antibody for HCC.
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•Relation of particle size of PS-MPs to the toxic effects on metabolism.•Smaller PS-MPs cause hepatic inflammation and little fibrosis.•Larger PS-MPs trigger lipid metabolic disorders ...via inducing gut microbiota dysbiosis.
Microplastic (MP) is an emerging environmental pollutant and exposure to MPs has been associated with numerous adverse health outcomes in both wild and laboratory animals. The toxicity of MPs depends on concentration, exposure time, chemical composition and size distribution, but the impacts of particle size remain inconclusive yet. In this study, adult marine medaka (Oryzias melastigma) were exposed to different size of polystyrene MPs (PS-MPs) with concentration of 10 mg/L for 60 days and the growth performance, lipid metabolism, immune parameters and gut microbiome were determined. Results indicated that particle size is a dominant factor causing lipid metabolism disorders and hepatic toxicity in PS-MPs-exposed fish. The bodyweight, adipocyte size and hepatic lipid contents were significantly increased in 200 μm PS-MPs-exposed fish, while 2 and 10 μm PS-MPs-exposed fish exhibited liver injury principally manifested asthepresence oflittlefibrosis and inflammation. Given that larger particles could not enter the circulatory system, the impacts of PS-MPs on intestinal microbial biota homeostasis were further investigated. The results not only showed the characterization of gut microbial communities in Oryzias melastigma, but also indicated that microbial diversity and composition were altered in gut of fish exposed to PS-MPs, in particular 200 μm PS-MPs. The differentially abundant bacterial taxa in PS-MPs-exposed fish mainly belonged to the phylum Verrucomicrobia, Firmicutes and Fusobacteria. And furthermore, increased abundance of Verrucomicrobia and Firmicutes/Bacteroidetes ratio and decreased Fusobacteria were correlated with the increased bodyweight. Intestinal microbiome should play a critical role in regulating host lipid metabolism in fish exposed to lager size of PS-MPs.
•An integrated decision support model for new energy investment is established.•Z-numbers are introduced to reliably describe experts’ evaluation information.•An effective information processing ...method is proposed.•DEMATEL is used to analyse complex new energy evaluation factors.•ELECTRE III is used to deal with the non-compensability among criteria.
As conventional energy resources are limited and polluting, new energy resources, being renewable and environmentally friendly, have been receiving increasing attention in recent years. However, no study on new energy investment, which acts a significant role in promoting the development and use of new energy resources, has been conducted. To cover this gap, an applicable decision support model is established by integrating Z-numbers, regret theory and elimination and choice translating reality III (ELECTRE III) to address new energy investment risk evaluation problems. In this way, Z-numbers are used to describe the decision-making information involved in the problems, a suggested method is combined with regret theory to determine the utility, rejoice and regret values of Z-information, and ELECTRE III is introduced to handle multiple criteria evaluation comprehensively. To elucidate and validate the application of the established model, a case study for new energy investment in Qingshuitang Industrial Zone is conducted and in-depth results analysis and discussion are implemented. The study shows that solar energy is the best investment project and environment is the most important investment factor. Moreover, the results demonstrate that the established model can effectively support new energy investment decision-making and it performs better than other existing methods.
Carbon Capture, Utilization, and Storage (CCUS) is a promising technology for mitigating climate change and reducing carbon emissions. However, selecting suitable sites for CCUS projects can be ...challenging due to regional differences in economic strength, ecology, and government policies. This results in a multi-criteria decision problem that is complicated by the fact that the information used for evaluation is often unreliable and uncertain, leading to risks in the decision-making process. Furthermore, decision-makers may not always act rationally, complicating the decision-making process. To address these challenges, we propose an extended Z-VIKOR method that considers the fuzziness and incompleteness of the available information in multiple criteria decision-making problems. Our method also incorporates a risk preference-based prioritized distance measure that reflects the decision-makers' attitudes toward risk. By fully considering Z-information and introducing three priority coefficients to reduce computational complexity, our approach can identify suitable sites for CCUS projects under different risk preferences. Finally, we study alternative cities in Guangdong Province for the CCUS project using the proposed methodology and conclude that Zhanjiang and Shenzhen have certain advantages in developing the project. In summary, our proposed methodology addresses the challenges associated with CCUS site selection by incorporating incomplete reliable information and reflecting decision makers' attitudes towards risk. This approach can help guide decision-makers in selecting suitable sites for CCUS projects and ultimately contribute to the global effort to combat climate change.
•The CCUS site selection evaluation system is built including the cost of the different stages of carbon neutrality.•CCUS site evaluation information in the form of Z-numbers for decision making.•The novel distance measure introduces the risk preferences of the decision maker is proposed.•The proposed method identifies Zhanjiang and Shenzhen as optimal sites for developing CCUS projects.•Sensitivity analysis and comparative analysis prove the conclusion are relatively stable.
Lung cancer remains a major health problem despite the considerable research into prevention and treatment methods. Through a deeper understanding of tumors, patient‐specific ex vivo spheroid models ...with high specificity can be used to accurately investigate the cause, metastasis, and treatment strategies for lung cancer. Biofabricate lung tumors are presented, consisting of patient‐derived tumor spheroids, endothelial cells, and lung decellularized extracellular matrix, which maintain a radial oxygen gradient, as well as biophysicochemical behaviors of the native tumors for precision medicine. It is also demonstrated that the developed lung‐cancer spheroid model reproduces patient responses to chemotherapeutics and targeted therapy in a co‐clinical trial, with 85% accuracy, 86.7% sensitivity, and 80% specificity. RNA sequencing analysis validates that the gene expression in the spheroids replicates that in the patient's primary tumor. This model can be used as an ex vivo predictive model for personalized cancer therapy and to improve the quality of clinical care.
A facile route to construct a highly accurate sophisticated ex vivo lung tumor spheroid model for considering patient‐specific therapies. The LdECM provides native‐tissue‐mimetic physicochemical cues that support the organization of spheroids with a hypoxic signature. The developed patient‐derived tumor spheroid model for the prediction of the optimal chemotherapy or target therapy drug for the patient.
Multidisciplinary rounds (MDRs) are scheduled, patient-focused communication mechanisms among multidisciplinary providers in the intensive care unit (ICU).
i-Dashboard is a custom-developed ...visualization dashboard that supports (1) key information retrieval and reorganization, (2) time-series data, and (3) display on large touch screens during MDRs. This study aimed to evaluate the performance, including the efficiency of prerounding data gathering, communication accuracy, and information exchange, and clinical satisfaction of integrating i-Dashboard as a platform to facilitate MDRs.
A cluster-randomized controlled trial was performed in 2 surgical ICUs at a university hospital. Study participants included all multidisciplinary care team members. The performance and clinical satisfaction of i-Dashboard during MDRs were compared with those of the established electronic medical record (EMR) through direct observation and questionnaire surveys.
Between April 26 and July 18, 2021, a total of 78 and 91 MDRs were performed with the established EMR and i-Dashboard, respectively. For prerounding data gathering, the median time was 10.4 (IQR 9.1-11.8) and 4.6 (IQR 3.5-5.8) minutes using the established EMR and i-Dashboard (P<.001), respectively. During MDRs, data misrepresentations were significantly less frequent with i-Dashboard (median 0, IQR 0-0) than with the established EMR (4, IQR 3-5; P<.001). Further, effective recommendations were significantly more frequent with i-Dashboard than with the established EMR (P<.001). The questionnaire results revealed that participants favored using i-Dashboard in association with the enhancement of care plan development and team participation during MDRs.
i-Dashboard increases efficiency in data gathering. Displaying i-Dashboard on large touch screens in MDRs may enhance communication accuracy, information exchange, and clinical satisfaction. The design concepts of i-Dashboard may help develop visualization dashboards that are more applicable for ICU MDRs.
ClinicalTrials.gov NCT04845698; https://clinicaltrials.gov/ct2/show/NCT04845698.
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