AHP Group Research Articles

Guest Editor’s Memo

The words of Dr. Francis Peabody still ring true almost 100 years after they were first uttered. “The secret of the care of the patient is in caring for the patient.” As providers of patients with pulmonary hypertensive vascular disease (PVHD) we direct the pathway for a patient’s medical care which has considerable impacts on their quality of life. It is imperative that our patients are viewed as people beyond their diagnosis. Pulmonary hypertension (PH) is a disease that affects patients across the lifespan. Each stage in the life of a PH patient presents its own unique challenges which require expert collaboration for holistic care and overall wellbeing. In this issue of Advances in Pulmonary Hypertension we have gathered patients, caregivers, physicians, nurses, social workers, and psychologists to address issues that affect all age groups as they navigate their way through life with PH. Our hope is that this will inspire you to think creatively to care your patients and families beyond their diagnosis with the goal of overall wellbeing and quality of life.In the PHPN Corner, Allison D’Souza, RN offers a personal perspective of how living with PH has empowered her to be a better and more compassionate provider in “From Patient to Provider: How My Diagnosis Makes Me a Better Nurse.” She has transitioned from a teenager adjusting to a new diagnosis to a pediatric cardiac ICU nurse guiding young patients to find hope.Dr. Hilary DuBrock and her team at the Mayo Clinic provide an overview of how PH effects quality of life. They synthesize the evidence regarding palliative care in PH and other cardiopulmonary diseases. DuBrock and team make a strong argument to incorporate palliative care in the longitudinal management of patients with PH.In “Perspectives on Mental Health Evaluation in Pediatric Pulmonary Hypertension: A Call to Action” an argument is made for more robust mental health screening practices integrated within care guidelines for pediatric PH. While providers recognize symptoms of anxiety and depression in their patients, few actually screen for anxiety and depression with intention to connect to mental health services. The authors from the AHP group of the Pediatric Pulmonary Hypertension Network (PPHNet) identify the existing barriers to accessing mental health services in pediatrics.In the current age, social media has been integrated into everyday life. Elise Whalen, NP and her co-authors from Texas Children’s Hospital provide a unique discussion on social media participation as a support system among caregivers of children with PH.Finally in the round table discussion, co-editors Claire Parker, NP and Nancy Bair, CNS gather Maddie Bonpin, a pediatric PH patient and her mother, Liza Bonpin, and Dr. Neal Chaisson to discuss transitions throughout the lifespan of a pulmonary hypertension patient.Thank you to all the authors and participants who contributed to this issue. We are thankful for the PHA and Allen Press for their support and guidance to bring this discussion to publication. We hope this issue encourages you to actively engage in the improvement of quality of life and overall wellbeing of your patients.

Managing transitivity and consistency of preferences in AHP group decision making based on minimum modifications

Preference transitivity characterized by ordinal consistency is a fundamental principle for decision making models based on pairwise comparison matrices (PCMs). However, little previous research has addressed ordinal consistency in an optimal way. Further, because ordinal consistency is not considered in the consensus reaching process, non-transitive preferences may still exist in the revised PCMs. In this paper, optimization models are proposed to obtain transitive preferences for solving individual consistency and group consensus problems. First, the conditions satisfying the ordinal consistency of PCMs are analysed and a system of constraints is derived to allow for the ordinal consistency to be explicitly controlled in the optimization model. A mixed integer linear optimization model is then proposed to assist decision makers satisfy both the ordinal and cardinal consistencies. A second mixed integer linear optimization model is then designed to ensure that the consensus level in group decision making problems can be achieved when both the group as a whole and all individuals have acceptably cardinal and ordinal consistencies. Optimization models considering ordinal consistency and classical cardinal consistency indices are open problems needing to be managed in future. Compared with existing methods, the proposed models provide an optimal way to minimize modifications in deriving transitive preferences. Finally, the feasibility and validity of the models are verified through comparisons with classic models.

On the choice of weights for aggregating judgments in non-negotiable AHP group decision making

We propose a formal method to compute a suitable set of coefficients and aggregate individual judgments in a common group preference matrix. In our procedure we assume that there is a large dispersion and decision makers are unwilling or unable to revise their judgments and, in any case, the weights are not negotiable. Our method, based on Frobenius norm, provides a solution which takes into account a new congruence measure between decision makers.

The combination of DEA and AHP approach in the selection of contractors participating in tenders

Nowadays, the problem of contractor selection is one of the important activities in companies so that various methods in this area have been proposed up to now. One of the most popular and practical methods in this area is analytical hierarchy process, if in the case of the matter under surveying, the alternatives increased, this method will lose its efficiency and pair-wise comparison will become practically impossible by this method. In this paper with regard to many participant computer companies in service contracts, the method using combination of data envelopment analysis and analytical hierarchy process is proposed. In this research for ranking participant computer companies in service contracts, first, required criteria in contractor selection was determined then the weights of criteria using AHP Group method was determined. In this method, the linguistic terms are utilized to assess alternatives with respect to each criterion by using data envelopment analysis and Simple-Additive-Weighting method, contractor assessment was done, Finally, among the companies that with regard to last section had outrank, the shortlist was made and using AHP Group the weights of criteria with tendered price was calculated and the most appropriate contractors aim computer servicing was determined. Results indicate good past performance criterion have the biggest weight in the most appropriate contractor selection also in finally contractor selection criterions with tendered price must be assessment until the contractor that altogether outrank as contract winner will determined.

The urinary bile acid profiling analysis of asymptomatic hypercholanemia of pregnancy: A pseudo-targeted metabolomics study

BackgroundAsymptomatic hypercholanemia of pregnancy (AHP) is a controversial hypercholanemia, which is difficult to distinguish from intrahepatic cholestasis of pregnancy (ICP). Our aim is to elucidate the characteristics of urinary bile acid (BA) profiling of women with AHP and to find potential biomarkers for the diagnosis and differential diagnosis of AHP. MethodsWe developed a pseudo-targeted approach to perform metabolomics analysis of bile acids (BAs) using ultra-high performance liquid chromatography/hybrid quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS). Urinary BAs profiles were compared among AHP women (n = 20), ICP patients (n = 33) and normal controls (n = 35). ResultsThe profiling of urinary BAs was significantly different among the AHP, ICP and control groups. Compared to the control group, the AHP group had higher levels of four possible sulfated BAs and trihydroxy BAs, including the species of muricholic acid (MCA), cholic acid (CA) and six possible BAs, whereas, 20 possible sulfated BAs, taurochenodeoxycholic acid (TCDCA), tetrahydrocannabinolic acid (THCA), and seven possible BAs were significantly lower in the AHP group than those in the ICP group. Based on the receiver operating characteristic (ROC) analysis, glycocholic acid (GCA) combined with T-ω-MCA were found to be the potential combination biomarker for the diagnosis (area under the curve was 0.960) of AHP, and mono-S, Gtri-S-2 combined with TLCA-S were found to be the potential combination biomarker for the differential diagnosis (area under the curve was 0.990) of AHP and ICP. ConclusionsThe metabolisms of urinary Bas were altered in the AHP group compared with the ICP group and the control group. Urinary BA profiling analysis can serve as an effective tool for the diagnosis of AHP and the differential diagnosis of AHP and ICP.

Clinical characteristics and outcomes of hypersensitivity pneumonitis: a population-based study in China.

Backgrounds:Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) that develops in response to the inhalation of various antigens. The clinical pathologies are very complex and undetermined. The clinical features and outcomes of HP have not been fully elucidated. The aim of this study was to analyze the incidence, clinical features, and outcomes of HP patients and construct a simple clinical model for diagnosing chronic HP (CHP).Methods:The cohort study included 101 patients with HP admitted to the Nanjing Drum Tower Hospital from January 2009 to December 2017. The patients were categorized into acute HP (AHP, n = 72) and CHP (n = 29) groups according to the updated international criteria. The clinical, imaging, treatment, and follow-up data were retrospectively reviewed. All patients were followed up until December 31, 2017. Statistical analysis was performed, and a clinical scoring system for CHP was constructed by SPSS 20.0 software.Results:The incidence of HP was 2.4% in ILD inpatients in our center. Patients in the CHP group were older (t = −2.212, P = 0.029), had more smokers (χ2 = 8.428, P = 0.004), and longer duration of symptoms (t = −4.852, P < 0.001) than those in the AHP group. Weight loss, crackles, digital clubbing, and cyanosis were more common in the CHP group than those in the AHP group (χ2 = 5.862, P < 0.001; χ2 = 8.997, P = 0.003; χ2 = 11.939, P = 0.001; and χ2 = 4.025, P = 0.045, respectively). On chest high-resolution computed tomography (HRCT), reticular patterns, traction bronchiectasis, and accompanying honeycombing were more common in CHP cases than those in AHP cases (χ2 = 101.000, P < 0.001; χ2 = 32.048, P < 0.001; and χ2 = 36.568, P < 0.001, respectively). The clinical scoring system for CHP was established based on the clinical variables (age [A], duration of symptoms [D], smoking history [S], unidentified exposure [U], and chest HRCT [C]; ADSUC) (area under the curve 0.935, 95% confidence interval: 0.883–0.987, P < 0.001). Eleven patients (15.3%) in the AHP group developed CHP, and unidentified exposure was an independent risk factor for the progression of disease (P = 0.038). The survival of patients with CHP, smoking history, unidentified antigens and fibrosis on Chest HRCT were significantly worse (P = 0.011, P = 0.001, P = 0.005, and P = 0.011, respectively) by Kaplan-Meier analysis. Cox multivariate regression analysis revealed that unidentified exposure and total lung volume (TLC pred%) were independent prognostic predictors for HP patients (P = 0.017 and P = 0.017, respectively).Conclusions:The clinical features and outcomes of the CHP patients differ from those of the AHP patients. ADSUC is a simple and feasible clinical model for CHP. Unidentified exposure is an independent risk factor for the progression of AHP to CHP. Unidentified exposure and a low baseline TLC pred% are independent predictors for survival in HP patients.

ROLE OF FIBRINOLYTIC ACTIVITY OF BLOOD IN PATHOGENESIS OF NON-ALCOHOLIC FATTY LIVER DISEASE AND CHRONIC KIDNEY DISEASE (ORIGINAL RESEARCH)

The aim of the research − to find out of changes fibrinolytic activity of blood in patients with non-alcoholic fatty liver on the background of obesity, depending on the presence of comorbid chronic kidney disease. Material and methods of research: 444 patients were examined: 84 of them were with NAFLD and class I obesity (group 1), which contained 2 subgroups: 32 patients with non-alcoholic steatosis (NAS) and 52 patients with non-alcoholic steatohepatitis (NASH); 270 patients with NAFLD with comorbid class I obesity and CKD І–ІІІ stage (group 2), including 110 patients with NAS and 160 patients with NASH. The control group consisted of 90 patients with CKD of І–ІІІ stage with normal body weight (group 3). To determine the dependence of the NAFLD course on the form and stage of the CKD, the group of patients was randomized according to age, sex, degree of obesity, and activity of NASH. Research results. The study of fibrinolytic activity of blood showed that total fibrinolytic activity (TFA) of blood plasma in patients of all groups was significantly lower than the control indexes: in patients with NAS – by 7.1%, patients with NAS with CKD – by 14.9%, patients with NASH – by 17.2%, patients with NASH with CKD – by 18.9%, patients with CKD – by 10.6% (p &lt;0.05) with the presence of a probable intergroup difference between groups with comorbidity and isolated course of CKD (p &lt;0.05). The suppression of TFA occurred through the decrease of EF: in patients with NAS the index is significantly lower than that in the controls by 1.2 times, in patients with NAS with CKD – by 1.4 times, in patients with NASH – by 1.7 times, in the group of patients with NASH and CKD – by 1.9 times, while in the group of patients with CKD, the suppression of EF was registered – 1.3 times (p &lt;0.05). At the same time, the NEF in patients of all groups increased in comparison with the AHP group: in patients with NAS – by 1.2 times, in patients with NAS with CKD – by 1.3 times, in patients with NASH – by 1.4 times, in the group of patients with NASH with CKD – 1.5 times, while in the group of patients with CKD the activation of NEF was registered 1.2 times (p &lt;0.05), with the presence of a probable difference between the groups with comorbidity and isolated course of CKD (p &lt;0.05). Conclusion. Analysis of hemostasis and fibrinolysis indices in examined patients with NASH, depending on the stage of CKD showed that with the growth of the CKD stage, the activity of the cohort increases, with the exception of the fibrinogen content (most likely due to coagulopathy consumption), the activity of the anti-coagulants decreases, the total and enzymatic activity of fibrinolysis is reduced, and non-enzymatic compensator increases. Thus, metabolic intoxication, oxidative stress, which accompany the flow of NAFLD with obesity and CKD, promote the activation of the kallikrein-kinin system, the formation of plasma and thrombin, with subsequent disturbance of equilibrium between them, the development of stasis, slag phenomenon, the formation of platelet and erythrocyte aggregates in blood circulation system. The consequence of significant activation of hemocoagulation against the suppression of total fibrinolytic activity (TFA) is the local clotting of blood in the arteries.

Phosphodiesterase type 5 inhibitor attenuates chronic ischemia-induced prostatic hyperplasia in a rat model.

Many elderly men suffer from benign prostatic hyperplasia (BPH). Recently, chronic ischemia in the prostate has been suggested to be related to BPH. Thus, the impact of chronic ischemia on the development of prostatic hyperplasia and the efficacy of phosphodiesterase type 5 (PDE5) inhibitor for hyperplasia were evaluated in a rat model with chronic ischemia induced by local atherosclerosis. Eighteen male Sprague-Dawley rats were divided into three groups: sham operation, regular diet, placebo (SRP); arterial endothelial injury, high cholesterol diet, placebo (AHP); or arterial endothelial injury, high cholesterol diet, and tadalafil as a PDE5 inhibitor (AHT). The endothelial injury in the common iliac arteries was performed using a 2-Fr Fogarty arterial embolectomy catheter through an incision in the femoral artery into the common iliac artery. Diet and oral drugs were administrated for 8 weeks after surgery. At 8 weeks, blood flow to the ventral prostate (VP) was measured using laser speckle blood flow analysis, and the VP was histologically evaluated. In the AHP group, prostatic blood flow was reduced, and mean VP weight and the interstitial area were significantly enlarged compared with the SRP group. In the AHT group, tadalafil administration obviously ameliorated the reduction of prostatic blood flow relative to the AHP group. Importantly, mean VP weight and the morphological changes in the AHT group were significantly smaller than those in the AHP group. Enlargement of the VP resulted from chronic ischemia induced by local arteriosclerosis. Also, administration of tadalafil attenuated VP enlargement. Chronic ischemia in the prostate might thus contribute to the development of BPH, and PDE5 inhibitors might provide an innovative approach to preventing BPH.

Application of fuzzy group analytic hierarchy process in partner selection of international joint venture projects

Partner selection is gradually recognized as an essential factor in gaining success in a cooperative settings. In this paper, a novel approach based on fuzzy AHP group decision-making for partner selection of joint venture projects is proposed. In this approach, rst, the in uential factors for selection of appropriate partners based on literature review and interviews with experts are identi ed. Then, using a method considering the risk, knowledge, and educational background of decision-makers, the impact of decision-makers is calculated. Pairwise comparison matrices are performed, and the weights of criteria are calculated based on two methods (multiplicative and additive). Then, the calculated weights of criteria and the potential partners have been ranked via an ecient ranking index. Finally, the application of this methodology to a real case study in National Iranian Petrochemical Company (NPC) is conducted. The contribution of this study is developing a fresh systematic approach for partner selection of international joint ventures and application in a real-life case study to present an operational guideline to the petrochemical industries. The results of this study reveal that the equipment of the partner, its nancial capacity, trusts and management skills are the most important criteria for establishing the durable partners in the international joint venture of NPC.

Sensitivity of the AHP Group Solution to Hierarchy-Wise Consistency Measures

Sensitivity of the AHP Group Solution to Hierarchy-Wise Consistency Measures

Deriving Weights of the Decision Makers Using AHP Group Consistency Measures

In AHP group decision making it is desirable that decision makers achieve the highest degree of consensus concerning the group priority vector at both levels, local and the final. Based on this philosophy, we have developed a method to derive local group priority vector respecting the three group consistency measures: geometric cardinal consensus index (GCCI), group minimum violation coefficient (GMV) and ordinal consensus measure (OCM). Consistency of individual de- cisions against the group decision serves as an input to determine the weights of decision makers participating in the group and generate the group local priority vector. Proposed method rewards cooperation between members of the group and raises chances for their consensus.

Research and Application on Improved Group Decision Making AHP Algorithm

This paper analyzes the shortcomings of the traditional AHP method and proposes group decision making from a single decision-making. In group decision making the weight of experts is very important. This paper discusses the existing methods of determining experts’ weights, introduces the method of the similarity of the cosine of the vectors’ angle, and the weight of experts is determined dynamically according to the similarity of the judgment matrix given by experts. When determining the weight of experts, judgment matrixes experts give need to pass the consistency test. In this paper, AHP group decision making method is applied to the load balancing system to determine the index weight influencing on load balancing. The experiment in the paper shows that this method can reduce calculation of consistency test and make the decision-making results more effective.

Notes on the Early International Development of Humanistic Psychology

This article details highlights of the early international development of humanistic psychology from 1969 to 1972 and chronicles the initial international presentations of humanistic psychology organized by Harari at the International Congress of Social Psychiatry in London in 1969, followed by a series of international meetings. The First International Invitation Conference on Humanistic Psychology took place in 1970 at the Vrije (Free) University of Amsterdam. The conference president was C. Buhler, the program chair was S. Krippner, and the author was the conference chair. During this period, a British AHP group expanded and developed an active program. The Second International Invitation Conference on Humanistic Psychology took place the following year at the University of Wurzburg, which had played a significant role in the early history of humanistic psychology. Buhler was the conference president; the local conference president was W Arnold, distinguished chair of the Psychology Department; and Krippner and Harari were the program and conference chairs, respectively. In fairly quick succession, meetings were organized in Europe, Asia, and Latin America. Local groups were organized in a number of countries. Presentations were made at international congresses of psychology in Liege and Ibkyo in 1971 and 1972 and at our own International Conference on Humanistic Psychology.