Presence Of Several Criteria Research Articles

Pathogenesis, Symptoms and Diagnosis, and Prevention of Dengue Hemorrhagic Fever in Adults

Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the dengue virus, characterized by symptoms such as fever, muscle or joint pain, leukopenia, rash, lymphadenopathy, thrombocytopenia, and hemorrhagic tendencies. In DHF, there is plasma leakage leading to fluid accumulation in body cavities, and in severe cases, it can progress to Dengue Shock Syndrome, characterized by shock. The illness is mainly spread by Aedes aegypti and Aedes albopictus mosquitoes, presenting a substantial worldwide health issue. The diagnosis of DHF requires the presence of several criteria: fever or recent history of acute fever lasting 2-7 days, often biphasic; at least one hemorrhagic manifestation such as positive tourniquet test, ecchymosis, mucosal bleeding, hematemesis, or thrombocytopenia; and evidence of plasma leakage. Young adults are particularly susceptible to dengue fever due to their frequent outdoor activities. In Padang City, West Sumatra Province, in 2020, the age group most affected by the disease was adults aged 15 to 44 years.

DECISION-MAKING AT EVOLUTIONARY SEARCH DURING LIMITED NUMBER OF FUZZY EXPERIMENTS WITH MULTIPLE CRITERIA

Context. The mechanism of decision-making during limited number of fuzzy experiments with multiple criteria are considered. The investigation object is process decision-making for project or control in complex systems with multiple criteria. Objective. It is necessary to determine optimal (most preferred) parameters of the systems with multiple criteria. It is no the mathematical model of the system, there is limited number of fuzzy experiments only. Method. experimental study of a process with several criteria (functions) depending on its parameters; the use of expert fuzzy evaluation to build a matrix of preferences for individual implementations; building a function of choosing preferred solutions based on a preference matrix by constructing a mathematical model of preference recognition, formulation and solving the problem of generalized mathematical programming as the final step in building the selection mechanism. The decision-making mechanism depends on the expert assessment procedure when comparing a limited set of results with each other, as well as on the statement of conditions when solving the problem of generalized mathematical programming. Comparison of a finite number of fuzzy experiments is convenient for expert evaluation. Presentation of the final choice as a result of solving the problem of generalized mathematical programming is convenient for using such a mechanism in automatic control systems already without human intervention. The proposed scheme of decision-making during limited number of fuzzy experiments has been applied to decision-making of project management for pellet burner. Results. Experimental decision-making fuzzy results are presented in the presence of several criteria for a pellet burner of a tubular heater, which confirm the acceptability of the developed decision-making mechanism. It was proposed the new scheme for constructing a selection mechanism for decision-making in systems with several criteria where there is a sample of fuzzy experimental results. Conclusions. The scheme of decision-making is includes the solving the generalized mathematical programming as the final step in building the selection mechanism. For the problem of generalized mathematical programming it may be applied the evolutionary search with choice function in form of preference or in form of lock.

Multi-Criteria Optimization in the Design of High-Load Systems

The current stage of development of science and technology is characterized by a significant complication of the tasks. The development of the economy to produce a situation where the development, implementation and operation of complex technical and socio-technical systems have to be in conditions of fierce competition. This is necessary to reduce the time of development and implementation of new technologies, especially in high-load systems. Highly loaded systems are, by and large, the same websites, only with a very large audience, and as a consequence with a large load, which requires an optimized server part of the site. A qualitative characteristic for a highly loaded system is the bandwidth of this system, it describes the amount of work that must be able to perform the system per unit time. The development of highly loaded systems is time consuming and poorly formalized. Since the production of high-load systems is one of the most dynamically developing areas in the field of information technology, which is demonstrated by a significant annual increase in volumes. In the practical task of decision-making, there is often a situation where you cannot limit yourself to considering a single criterion for choosing a decision. An attempt at mathematical formalization of such problems has led to the creation of the Theory of Multicriteria Optimization, which is used in the development of methods, intended for support of decision makers, in the presence of several criteria. The steps for construction of algorithm of multicriteria optimization in designing of highly loaded systems, carries out search of solutions of a maximum in a multicriteria problem are resulted. The algorithm was based on the descent method in Simplex problems. Simplex method - an algorithm for solving the optimization problem of linear programming by searching the vertices of a convex polyhedron in multidimensional space. Multicriteria optimization is based on finding solutions in problems with a large number of options. Now the type of tasks is very resource-intensive and is calculated using computers. Keywords: high-load data systems, high-load computing system.

DECISION-MAKING DURING LIMITED NUMBER OF EXPERIMENTS WITH MULTIPLE CRITERIA

Context. The mechanism of decision-making during limited number of experiments with multiple criteria are considered. The investigation object is process decision-making for project or control in complex systems with multiple criteria.Objective. It is necessary to determine optimal (most preferred) parameters of the systems with multiple criteria. It is no the mathematical model of the system, there is limited number of experiments only.Method. A scheme is proposed for constructing a selection mechanism for decision-making in systems with several criteria for which there is a sample of experimental results. The scheme includes the following procedures: an experimental study of a process with several criteria (functions) depending on its parameters; the use of expert evaluation to build a matrix of preferences for individual implementations; building a function of choosing preferred solutions based on a preference matrix by constructing a mathematical model of preference recognition, formulation and solving the problem of generalized mathematical programming as the final step in building the selection mechanism. The decision-making mechanism depends on the expert assessment procedure when comparing a limited set of results with each other, as well as on the statement of conditions when solving the problem of generalized mathematical programming. Comparison of a finite number of experiments is convenient for expert evaluation. Presentation of the final choice as a result of solving the problem of generalized mathematical programming is convenient for using such a mechanism in automatic control systems already without human intervention.Results. The proposed scheme of decision-making during limited number of experiments has been applied to decision-making of project management for pellet burner. Experimental decision-making results are presented in the presence of several criteria for a pellet burner of a tubular heater, which confirm the acceptability of the developed decision-making mechanism.Conclusions. It was proposed the new scheme for constructing a selection mechanism for decision-making in systems with several criteria where there is a sample of experimental results only. The scheme of decision-making is includes the solving the problem of generalized mathematical programming as the final step in building the selection mechanism. For the solving the problem of generalized mathematical programming may be applied the evolution search algorithm.

A case of food supply chain management with AHP, DEMATEL, and TOPSIS

AbstractThe bullwhip effect leads to considerable inefficiencies along the food supply chain such as missed production schedules, poor customer service, excessive inventory, and misguided capacity plans. To tackle this problem, it is necessary, apart from other interventions, to continuously monitor the performance of food suppliers so that the demand information flow, order batching, transportation planning, and inventory management can be substantially improved. Therefore, supplier assessment has then become critical decision‐making support for identifying and addressing inefficiencies of food providers, which ends up reducing the variation of several key logistics parameters for upstream members of the food supply chain. In addition, such assessment is of multicriteria nature given the presence of several criteria from different domains and various food suppliers. With these considerations in mind, this paper proposes a hybrid approach integrating the analytic hierarchy process (AHP), decision‐making trial and evaluation laboratory (DEMATEL), and the technique for order of preference by similarity to ideal solution (TOPSIS) for evaluating the performance of pork suppliers. Thereby, the economic and operational burden caused by the bullwhip effect throughout the pork supply chain can be alleviated. AHP was first used to determine the criteria and subcriteria weights. Then DEMATEL was applied to assess the interdependence and feedback between the decision elements. Finally, TOPSIS was implemented to discriminate between high‐performance and low‐performance pork suppliers. A case study from the Colombian pork supply chain is presented to validate the proposed approach. The results of this study evidenced that the most important criterion was the “service level” and the most influencing factor was the “financial profile.” In addition, based on the supplier assessment results, improvement plans, and new negotiation, strategies were established for each supplier in order to diminish the bullwhip effect along the pork supply chain.

Оптимальное управление в дифференциальной игре двух лиц с векторными функциями выигрыша и экспертным оцениванием

  Представлено решение дифференциальной игры двух лиц с векторными функциями выигрыша и экспертным оцениванием. При наличии нескольких критериев игрокам необходимо искать разумный компромисс, который заключается в выборе такого управления, что доставляет лучшие значения одновременно всем критериям. Например, в экономике необходимо добиться максимально возможных прибыли и выпуска, одновременно с этим определенного уровня качества и рентабельности производимой продукции. Но наличие нескольких критериев в задаче управления является выражением неопределенности, которая отражает нечеткость знания игроками своих целей. Выявление единой целевой функции снимает эту проблему. Один из подходов связан с использованием экспертных оценок, которые представляют собой количественную информацию об относительной важности компонент функции выигрыша, относительно которых проводится линейная свертка. Компромиссные векторы от экспертов позволяют свести игровую задачу к стандартной бескоалиционной дифференциальной игре, которая решается методом динамического программирования Беллмана. Этот подход позволяет найти явный вид равновесного оптимального управления.

Diagnostic performance of prothrombin time point-of-care to detect acute traumatic coagulopathy on admission: experience of 522 cases in trauma center.

Early identification of acute traumatic coagulopathy is a key challenge during initial management to determine whether to initiate early hemostatic support. We assessed the performance of prothrombin time (PT) at point-of-care in trauma patients to detect moderate and severe coagulopathy on admission. All admitted consecutive trauma patients were analyzed retrospectively between April 2014 and July 2015. PT was measured on admission with both a PT point-of-care device (PTr-CGK) and a standard coagulation test (PTr-STD). The results for PTr-CGK and PTr-STD were compared using analysis of agreement, precision, and accuracy. The diagnostic performance of PTr-CGK to predict coagulopathy was established by analysis of receiver operating characteristic curves. The predictive performance of different thresholds and risk factors for misclassification were also studied. Over a 16-month period, 522 patients were included. PTr-CGK estimated PTr-STD with a bias of 0.00 (95% confidence interval [CI], -0.48 to 0.50) and a precision of 0.25. The optimal threshold was 1.4 to predict severe coagulopathy (sensitivity 81% [95% CI, 68%-94%], negative predictive value 98% [95% CI, 97%-99%]), and 1.2 for moderate coagulopathy (sensitivity 80% [95% CI, 72%-88%], negative predictive value 94% [95% CI, 91%-96%]). A low PTr-CGK in the presence of severity criteria (Injury Severity Score ≥ 16, Trauma Associated Severe Hemorrhage score ≥ 12, hemoglobin level<7 g/dL, fibrinogen level<2 g/L, base deficit ≥ 6 mmol/L) was strongly associated with a false-negative risk. The PT point-of-care device is reliable and accurate for the early identification of coagulopathic trauma patients.

DECISION ANALYSIS ON THE BASIS OF EXPERT DATA AND REFLEXIVE PROCEDURES OF THE CONCLUSION

Relevance. At decision-making the situation is rather widespread when difficult objects of management function in the conditions of uncertainty and are characterized by existence of several criteria of a choice, and also by existence the parameters which are badly giving in to measurement or having qualitative character. In such situations it is reasonable to apply expert approaches to receiving estimates and decision-making. It in turn demands the development of special methods of formalization of the considered objects and control systems, and also the corresponding procedures of numerical processing of expert data. Purpose. The purpose of work is development of procedures of calculation of estimates for consequences of interaction of factors of management on the basis of expert data and a method of a choice of rational decisions in the presence of several criteria. Method. A subject of consideration is the method of the expert analysis using reflexive procedures of a multiple-valued logical conclusion for receiving transitive short circuit of estimates of mutual influence of factors and a decision-making method on the basis of the balanced accounting of several criteria. Results. The offered method of decision-making includes two components: procedure of reflections for calculation of transitive short circuit of primary estimates and procedure of formation of the weighed criterion for the balanced accounting of several criteria considering various aspects of a choice. The flexible criterion which formation is based on balancing (the accounting of degree of importance) of maximin and minimax values of initial criteria and on use of a relevant subset of the considered factors is entered into double criteria situations. Calculation of a rational choice of structure of intangible assets of the enterprise is given as an example. Conclusions. Specifics of the considered approach possessing basic novelty consist in the accounting of the uncertainty concluded as in properties of expert data, and available several criteria of a choice. Application of algebra of multiple-valued logic in procedure of reflections allows considering most adequately expert data at estimation of options of adoption of administrative decisions. The flexible criterion is attribute of self-organization of the operated system. The developed method of the expert analysis of factors of management considering consequences of their interaction allows estimating and allocating the most significant factors from the point of view of the set criteria, to make rational decisions as for rapid response to current situation, and at long-term and strategic planning. The numerical example represents informative demonstration of efficiency of the offered approach.

An interactive procedure for multiobjective optimization

The procedure, which in the presence of several criteria (without the possibility of a determination ofthe chief among them) allows you to implement the man-machine interaction, aimed at developinginteractive by one or several compromise solutions that define the acceptable from the point of view ofdecision-makers, the values of the criteria. The algorithmic implementation of the proposed procedureallows to solve problems of multicriteria optimization, in which alternatives are not explicitlyformulated

Healthcare circuits and functional outcomes 3 and 12 months after a stroke in a population-based cohort of 929 patients

There are few epidemiologic data about stroke collected on a large, non-selected and representative population of stroke patients. We present a population-based cohort study, which included all adult ischemic (IS) or hemorrhagic (HS) stroke cases recorded in the Rhône area (1.7 million inhabitants) for seven months. The aim was to provide an accurate description of: the demographic characteristics of stroke patients, their healthcare circuits (pre-hospital, acute and secondary phases), their activity limitations 3 and 12 months after stroke through the modified Rankin Scale (mRS) and the Barthel Index (BI), and to identify factors associated with the mRS 1 year after stroke by an univariate and then multivariate analysis. Nine hundred and twenty-nine stroke cases have been recorded (697 IS, 232 HS, mean age: 74.1 years, sex ratio = 1). Only 44.5% of patients were oriented prior to hospital admission by the emergency medical dispatch service. 85.4% of patients were first admitted to an emergency department, whereas 8.8% of patients were admitted directly to stroke unit. Only 17% of stroke patients were referred to stroke unit during their healthcare circuit, and more than 55% have never been admitted in a neurology department. Mortality rate was 12.1% one month after stroke and 31% three months after stroke in the ischemic group, compared with 34 and 52% respectively in the hemorrhagic group. Mortality did not increase between the third and the twelfth month post-stroke. A favorable functional outcome (mRS ≥ 2) one year after stroke has been obtained for 47% of IS and 34.6% of HS. The mean BI at one year was 68.5 among surviving patients. Age > 80 years, female sex and presence of severity criteria in acute phase were significant factors associated with non-favorable outcome. In this study, carried out with an exhaustive population within a region and a one-year follow-up with few missing data, the results show a morbi-mortality after stroke higher than the one reported in previous studies. The results also confirm the better prognosis of IS.

Dermoscopic patterns of common facial inflammatory skin diseases

Several common inflammatory dermatoses, such as rosacea, seborrheic dermatitis (SD), discoid lupus erythematosus (DLE) and granulomatous skin diseases manifest as erythematous macules or plaques on the facial skin. Although clinical examination represents the cornerstone of diagnosis, the broad variety of clinical features and uncommon presentations of these diseases may cause at times diagnostic and therapeutic uncertainty. Dermoscopy, in addition to its well-documented value in evaluation of skin tumours, is continuously gaining appreciation also in the field of general dermatology. To describe and compare the dermoscopic patterns of common facial inflammatory skin diseases including SD, erythematotelangiectatic rosacea (ER), sarcoidosis, lupus vulgaris (LV), DLE and granuloma faciale (GF). Dermoscopic images of lesions from patients with histopathologically confirmed diagnosis of SD, ER, sarcoidosis, LV, DLE or GF were retrospectively evaluated for the presence of several criteria. Selection of the dermoscopic variables included in the evaluation process was based on the data available in the literature and on our preliminary observations. One hundred and fifteen dermoscopic images were included in the study. SD was dermoscopically characterized by dotted vessels and yellow scales, whereas ER was typified by a characteristic pattern of vascular polygons. Sarcoidosis and LV very commonly exhibited orange-yellowish areas and linear branching vessels. Features related to follicle abnormalities and linear branching vessels were the most common dermoscopic criteria of DLE and GF. This study provides new insights into the dermoscopic variability in common facial inflammatory dermatoses.

Is Munchausen syndrome by proxy really a syndrome?

SPECIFICITY Dr Morley is right that many of the criteria used to identify situations in which Munchausen syndrome by proxy should be suspected are relatively non-specific and cannot be considered as diagnostic on their own. Nevertheless the presence of several criteria does, if nothing else, raise the chances that the child is at risk. All paediatricians would obviously agree that it is crucial to listen carefully to the information provided by the carers and I am sure we would all also agree that at times we fail in this respect. Although it is obviously true that the child will probably spend more time with the carer under suspicion than other family friends and relatives, natural recurrent events usually are witnessed by others at some time or another. It is therefore essential to obtain independent corroborative evidence rather than relying on the statement of the carer. It is also important to stress that the onset of the event must be seen as otherwise the cause will remain in doubt.2 Inconsistent histories are a more useful pointer than has been claimed by Dr Morley. Much weight has been placed on the importance of identifying inconsistencies in the description of events in the diagnosis of child abuse. If they are helpful in that condition they are also useful in the identification of Munchausen syndrome by proxy. It is possible to make a case that the only diagnostic role of overt cardiorespiratory (or electroencephalographic)3 monitoring is that a sequence of events can be documented which may differ very considerably from the history described by the carer. Sadly, along with child physical and sexual abuse Munchausen syndrome by proxy does occur and can constitute a real threat to the survival of the child. Inevitably if we are to identify these children, we will have to suspect some carers who are totally innocent. Dr Morley's article reminds us of the effects of these suspicions on the carer and the family. We cannot, however, put our heads in the sand and pretend that Munchausen by proxy does not occur.