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Milestones Next Steps: Results of a Feedback Questionnaire

Milestones Next Steps: Results of a Feedback Questionnaire

MP38-13 HAS ACTIVE SURVEILLANCE OF PROSTATE CANCER BECOME SAFER? LESSONS LEARNED FROM A GLOBAL CLINICAL REGISTRY: MOVEMBER GAP3 CONSORTIUM

You have accessJournal of UrologyCME1 Apr 2023MP38-13 HAS ACTIVE SURVEILLANCE OF PROSTATE CANCER BECOME SAFER? LESSONS LEARNED FROM A GLOBAL CLINICAL REGISTRY: MOVEMBER GAP3 CONSORTIUM Paul Doan, Lin Zhu, Sebastiaan Remmers, Daan Nieboer, Jozien Helleman, Peter Carroll, Kyochul Koo, Andrew Hayen, James Thompson, and Chris Bangma Paul DoanPaul Doan More articles by this author , Lin ZhuLin Zhu More articles by this author , Sebastiaan RemmersSebastiaan Remmers More articles by this author , Daan NieboerDaan Nieboer More articles by this author , Jozien HellemanJozien Helleman More articles by this author , Peter CarrollPeter Carroll More articles by this author , Kyochul KooKyochul Koo More articles by this author , Andrew HayenAndrew Hayen More articles by this author , James ThompsonJames Thompson More articles by this author , and Chris BangmaChris Bangma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active Surveillance (AS) has matured into a widely applied treatment for low-intermediate risk prostate cancer (PCa). The safety of AS protocols has always been a key concern due to the risk of missing progression. This concern is reflected in national statistics for the uptake of AS which vary widely, in Europe 75-95% of low-risk cancers are treated with AS, in Australia 71%, in the USA 50% and in Asia 10-56%. Potentially, diagnostic tools such as mpMRI have improved the safety of AS protocols. This study aims to describe the evolution of AS protocols overtime including criteria for selection and long-term clinical outcomes for over 26000 patients in the GAP3 database. Thus, assessing the safety and acceptability of AS as a treatment for PCa. METHODS: From October 2022 we have released an updated version of the GAP3 database containing 26999 patients from 25 sites and 15 countries (v4.1.1). We performed an analysis of patients who started on AS between 2000 and 2016. The D’Amico risk classification and baseline characteristics of patients were assessed over time. We assessed treatment free survival (TFS) and metastases free survival (MFS) as clinical endpoints with Kaplan Meier curves RESULTS: Table 1 compares the baseline characteristics over different time periods demonstrating increased numbers of patients enrolled to AS. During the 2000-2004 and 2013-2016 periods the highest proportion of intermediate risk cancers were enrolled. TFS and MFS are demonstrated in Figures 1a,b. During the time periods assessed TFS rates have remained the same however there has been improvement in MFS in more recent times. CONCLUSIONS: There is increasing use of AS for prostate cancer over time and MFS has improved. However, a proportion of intermediate risk cancer patients still develop metastases. Thus, further improvement in selection and monitoring of these patients is required. Source of Funding: The Movember Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e529 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Doan More articles by this author Lin Zhu More articles by this author Sebastiaan Remmers More articles by this author Daan Nieboer More articles by this author Jozien Helleman More articles by this author Peter Carroll More articles by this author Kyochul Koo More articles by this author Andrew Hayen More articles by this author James Thompson More articles by this author Chris Bangma More articles by this author Expand All Advertisement PDF downloadLoading ...

Государственный интерес как система инакомыслия: военно-дипломатическая модель Мишеля Фуко

The modern Russian state is parasitic. But its dominant minorities still talk about a certain “special role” of Russia in European and world history, although many unforeseen and negative consequences of the ideology of the “special way” have already been established. For more than a hundred years, there have been five versions of the domestic history in Russia – statist, liberal and Western, nationalist, civilizational, postcolonial. Each of them cannot be refuted based on the study of historical sources. So, the truth of all is about the same, and each has the right to exist. However, an updated version of the textbook “state school” has been introduced into the practice of school education, in which the history of Russia is viewed as an uncontested process of transformation of the Moscow Principality into the Russian Empire and the Soviet Union. Thereby, the government consciously narrows the intellectual and political horizons of the younger generations and the entire population. In addition, under the influence of color revolutions the government began to cultivate a negative assessment of revolutions, although its representatives themselves admit that “the export of color revolutions is our Kremlin propaganda invention.” Over the past thirty years, Russia has been promoting a counter-revolutionary ideology, which manifests itself in foreign policy and domestic political rhetoric, and (according to officials) corresponds to the state interests of the country. In fact, the country and the world are offered an archaic version of political domination. Therefore, it is necessary to master and develop new concepts in which a different version of state interests is proposed. The article presents a reconstruction of one of the fragments of M. Foucault's political theory.

Response to chemotherapy in juvenile myelomonocytic leukemia and its clinical implications for survival: A retrospective registry-based study of the Korean Pediatric Hematology-Oncology Group

Juvenile myelomonocytic leukemia (JMML) is a life-threatening myeloproliferative neoplasm. The chemotherapeutic effect on survival remains unclear, and feasible standardized response criteria are yet to be established. We aimed to evaluate the chemotherapeutic response and its effect on survival in patients with JMML. A retrospective registry was reviewed for children diagnosed with JMML between 2000 and 2019. Response was assessed according to the criteria proposed by the International JMML Symposium in 2007 (criteria I) and the updated version in 2013 with its modifications (criteria II). A total of 73 patients were included in this study. Complete response (CR) rates were 46.6% and 28.8% using the criteria I and criteria II, respectively. A platelet count ≥ 40 × 109/L at diagnosis was associated with higher CR rates using the criteria II. Patients with criteria I-based CR had a better overall survival (OS) than those without CR (81.1% vs. 49.1% at 5 years). Patients with criteria II-based CR showed better OS (85.7% vs. 55.5% at 5 years) and event-free survival (EFS) (71.1% vs. 44.7% at 5 years) than those without CR. Additionally, a trend toward better EFS was observed in patients with criteria II-based CR than in those with criteria I-based CR but without criteria II-based CR (71.1% vs. 53.8% at 5 years). Chemotherapeutic response is associated with better survival outcomes. Along with splenomegaly, the addition of platelet count recovery, existence of extramedullary leukemic infiltration, and more stringent leukocyte counts to the response criteria allows for a more sensitive prediction of survival outcomes.

Legal status of the intergovernmental organization of the Danube Commission in the conditions of technical progress of shipping

The article presents the legal status of the international intergovernmental organization of the Danube Commission. The Convention on the Regime of Navigation on the Danube in 1948 defined the institutional and legal structure of the DC, which is an integral feature of any international intergovernmental organization and is determined by its purpose, functions and tasks, which were set by the member states in the founding act of this organization. In its work, the DK relies on the rich historical experience of regulating shipping on international rivers in Europe. The priority areas of its activity are the unification of regulatory acts for navigation on the Danube, promotion of improvement of navigation conditions and improvement of shipping safety, creation of other conditions for the integration of the Danube into the European system as the main transport route. Ukraine is a full member of the international intergovernmental organization DC. The basis is the acquisition of membership in the international intergovernmental organization of the Danube Commission of Ukraine in accordance with the Decree of the Presidium of the Verkhovna Rada of the Ukrainian SSR dated February 18, 1949 "On the ratification of the Convention on the Danube Navigation Regime dated August 18, 1948. There are problems related to shipping and ecology, so it is necessary to clearly define the levels of certain regions and sections of the Danube River, namely the improvement of navigation conditions and improvement of navigation safety. Also, certain ecological restorative measures should be proposed in order to prevent the loss of ecological status. With the help of joint projects, opportunities for improving environmental and shipping conditions should be identified. The Danube Commission is designed to determine the prospects for more active development of trade and transportation on the Danube and the technical progress of shipping, the creation of other conditions for the integration of the Danube into the European system as the main transport route. Shipping is regulated by various international legal and national instruments, in particular, guaranteeing the safety of shipping. The updated version of the "Plan of the main works aimed at achieving the recommended dimensions of the navigation, hydraulic and other structures on the Danube River" and the issue of assisting the national administrations of waterways in carrying out annual hydraulic works were considered.

Modified matrix minima method for subset constrained transportation problem and its performance evaluation with respect to the optimal solution by mathematical model

Purpose of the study: The transportation problem has a huge application in logistics. Therefore, dealing a transportation problem with permissible constraints is always an interesting area. In the present paper, we have tried a version of transportation problem which is constrained in nature. We have explored strategies for dealing the subset constrained transportation problem.
 Methodology: An updated version of matrix minima method is proposed in this paper. This version is used for subset constrained transportation problem only. We have also applied the mathematical model for solving the same subset constrained transportation problem.
 Main Findings: The mathematical model gives an optimal solution of the constrained transportation problem with the help of software. It is found that the proposed updated matrix minima method does not guarantee the optimality. However, we use the matrix minima approach for having an idea of the closer feasible solution. It is found that the mathematical model is always a superior way to find an optimal solution.
 Applications of this study: The study has a huge application in logistics.
 Novelty/Originality of this study: An updated version of matrix minima method is proposed. The method is applied on constrained transportation problem and the results are compared with the optimal solution.

Using the MouseWalker to Quantify Locomotor Dysfunction in a Mouse Model of Spinal Cord Injury.

The execution of complex and highly coordinated motor programs, such as walking and running, is dependent on the rhythmic activation of spinal and supra-spinal circuits. After a thoracic spinal cord injury, communication with upstream circuits is impaired. This, in turn, leads to a loss of coordination, with limited recovery potential. Hence, to better evaluate the degree of recovery after the administration of drugs or therapies, there is a necessity for new, more detailed, and accurate tools to quantify gait, limb coordination, and other fine aspects of locomotor behavior in animal models of spinal cord injury. Several assays have been developed over the years to quantitatively assess free-walking behavior in rodents; however, they usually lack direct measurements related to stepping gait strategies, footprint patterns, and coordination. To address these shortcomings, an updated version of the MouseWalker, which combines a frustrated total internal reflection (fTIR) walkway with tracking and quantification software, is provided. This open-source system has been adapted to extract several graphical outputs and kinematic parameters, and a set of post-quantification tools can be to analyze the output data provided. This manuscript also demonstrates how this method, allied with already established behavioral tests, quantitatively describes locomotor deficits following spinal cord injury.

Variability of Atmospheric CO2 Over the Arctic Ocean: Insights From the O‐Buoy Chemical Observing Network

AbstractAs the Arctic climate rapidly warms, there is a critical need for understanding variability and change in the Arctic carbon cycle, but sparse spatial coverage of observations has hindered progress. This work analyzes measurements of atmospheric CO2 in the Arctic from long‐term on‐ice measurements (the O‐Buoy Network), as well as coastal observatories from 2009 to 2016. The on‐ice measurements showed smaller seasonal amplitudes than coastal observatories, in contrast to the general observation of poleward increases of seasonal cycle amplitude. Average on‐ice measurements were also lower than their coastal counterparts during winter and spring, contradicting the expectation that CO2 increases poleward in boreal winter. We compared the observations to CO2 simulated in an updated version of GEOS‐Chem 3‐D chemical transport model, which includes new tracers of airmass history and CO2 sources and sinks. The model reproduced the observed features of the seasonal cycle and showed that terrestrial biosphere fluxes and synoptic transport explain most CO2 variability (both synoptic and interannual) over the Arctic Ocean surface. The polar airmass partially isolates the Arctic Ocean surface air from terrestrial CO2 exchange, which explains the reduced seasonal cycle amplitude and winter maxima. All Arctic coastal sites had similar CO2 interannual variability, particularly in summer, which was largely reproduced by the model. The interannual variability observed over sea ice, however, was distinct from the coastal sites and not reproduced by the model. Air‐sea CO2 exchange in and around sea ice, which was once thought to be negligible, may be an important driver of interannual variability over the Arctic Ocean.

Trends of Randomized Clinical Trials Citing Prior Systematic Reviews, 2007-2021

Systematic reviews can help to justify a new randomized clinical trial (RCT), inform its design, and interpret its results in the context of prior evidence. To assess trends and factors associated with citing (a marker of the use of) prior systematic reviews in RCT reports. This cross-sectional study investigated 737 Cochrane reviews assessing health interventions to identify 4003 eligible RCTs, defined as those included in an updated version but not in the first version of a Cochrane review and published 2 years after the first version of the Cochrane review was published. The primary outcome was the citation of prior systematic reviews, Cochrane or others, as determined by screening references of eligible RCTs. Factors that may be associated with the citation of prior systematic reviews were also examined. Among 4003 eligible RCTs, 1241 studies (31.0%) cited Cochrane reviews, 1698 studies (42.4%) cited prior non-Cochrane reviews, and 2265 studies (56.6%) cited either type of systematic review or both; 1738 RCTs (43.4%) cited no systematic reviews. The percentage of RCTs citing prior Cochrane reviews, non-Cochrane reviews, and either or both types of review increased from 28 studies (15.3%), 46 studies (25.1%), and 65 studies (35.5%) of 183 RCTs before 2008 to 42 studies (40.8%), 65 studies (64.1%), and 73 studies (71.8%) of 102 RCTs since 2020, respectively; the annual increases were 1.9% (95% CI, 1.4%-2.3%), 3.3% (95% CI, 2.9%-3.7%), and 3.0% (95% CI, 2.5%-3.5%), respectively. The proportion of RCTs citating prior systematic reviews varied considerably across clinical specialties, ranging from 28 of 106 RCTs (26.4%) in ophthalmology to 386 of 553 RCTs (69.8%) in psychiatry (P < .001). RCTs with 100 participants or more (risk ratio [RR], 1.16; 95% CI, 1.03-1.30), nonindustry funding (RR, 1.43; 95% CI, 1.27-1.61), and authors from high-income countries (RR, 1.10; 95% CI, 1.03-1.17) were more likely to cite systematic reviews than those with fewer than 100 participants, industry funding, and authors from low- and middle-income countries, respectively. A journal requirement to cite systematic reviews was not associated with the likelihood of citing a systematic review. This study found that the citation of prior systematic reviews in RCT reports improved over time, but approximately 40% of RCTs failed to do so. These findings suggest that reference to prior evidence for initiating, designing, and reporting RCTs should be further emphasized to assure clinical relevance, improve methodological quality, and facilitate interpretation of new results.

Моделирование воспитательно-образовательного пространства в современной начальной школе

The article discusses the idea of modeling the educational space of a modern elementary school within the framework of the working program of upbringing of an educational organization. A detailed analysis of the main structural components of the Approximate working program of education is given: target, content, organizational. It highlights the targets set out in it, which are formulated in accordance with the updated version of the Federal State Educational Standard for Primary General Education. On this basis, the ways of constructing a working program of education for elementary school are determined.

Forgotten Scholars: Rediscovering Women in Medieval and Early-Modern Academia for Gender-Inclusive Place Naming in Universities

In our universities, many places have names after great scholars of all times. For example, in our region,we find: Place Montesquieu, Auditorium Erasmus, Justus Lipsius Straat, etc. A small minority of places are named after women. This is true in any country. Now, more and more universities adopt the following political statement: increasing the visibility of women in the public domain is one of the possible levers to promote equality between women and men. To help administrators of European Universities in this task, we provide here a list ofwomen who were either professors at a university or member of an science academy before the year 1800. These women from the past started to blaze the trail, and it is to them that we must look for inspiration. This list is an updated version of the appendix to our paper David de la Croix, Mara Vitale, Women in European academia before 1800 — religion, marriage, and human capital, European Review of Economic History, 2023;, heac023, https://doi.org/10.1093/ereh/heac023

PatternLab V Handles Multiplex Spectra in Shotgun Proteomic Searches and Increases Identification

Complex protein mixtures typically generate many tandem mass spectra produced by different peptides coisolated in the gas phase. Widely adopted proteomic data analysis environments usually fail to identify most of these spectra, succeeding at best in identifying only one of the multiple cofragmenting peptides. We present PatternLab V (PLV), an updated version of PatternLab that integrates the YADA 3 deconvolution algorithm to handle such cases efficiently. In general, we expect an increase of 10% in spectral identifications when dealing with complex proteomic samples. PLV is freely available at http://patternlabforproteomics.org.

A Review of Upgradeable Smart Contract Patterns based on OpenZeppelin Technique

The Ethereum blockchain is one of the main public platforms to run smart contracts and enable decentralised applications. Since data stored in a blockchain is considered immutable, smart contracts deployed in Ethereum are regarded as tamper-proof and therefore offer strong protection against attacks aiming at tinkering with the execution flow of an application. Yet, like any other software, a smart contract needs to be maintained over time to fix bugs or add new features. Deploying every updated version as a brand-new smart contract in Ethereum leads to problems such as migrating the contract state from the old version and enabling clients to point to the new version in a timely fashion. The OpenZeppelin framework addresses this limitation by providing libraries that enable the deployment of upgradeable smart contracts. This is achieved by relying on proxies that act as intermediaries between clients and smart contracts, allowing the latter to be updated transparently. In this paper, we present the upgradeable smart contract patterns supported by OpenZeppelin and compare them in terms of security, cost, and performance. To show this paradigm’s prevalence in Ethereum, we also analyse the usage of OpenZeppelin Upgradeable smart contracts over the last four years.

PrePPI: A Structure Informed Proteome-wide Database of Protein–Protein Interactions

We present an updated version of the Predicting Protein-Protein Interactions (PrePPI) webserver which predicts PPIs on a proteome-wide scale. PrePPI combines structural and non-structural evidence within a Bayesian framework to compute a likelihood ratio (LR) for essentially every possible pair of proteins in a proteome; the current database is for the human interactome. The structural modeling (SM) component is derived from template-based modeling and its application on a proteome-wide scale is enabled by a unique scoring function used to evaluate a putative complex. The updated version of PrePPI leverages AlphaFold structures that are parsed into individual domains. As has been demonstrated in earlier applications, PrePPI performs extremely well as measured by receiver operating characteristic curves derived from testing on E. coli and human protein–protein interaction (PPI) databases. A PrePPI database of ∼1.3 million human PPIs can be queried with a webserver application that comprises multiple functionalities for examining query proteins, template complexes, 3D models for predicted complexes, and related features (https://honiglab.c2b2.columbia.edu/PrePPI). PrePPI is a state-of-the-art resource that offers an unprecedented structure-informed view of the human interactome.

PF-D-Trimer, a protective SARS-CoV-2 subunit vaccine: immunogenicity and application

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had and continues to have a significant impact on global public health. One of the characteristics of SARS-CoV-2 is a surface homotrimeric spike protein, which is primarily responsible for the host immune response upon infection. Here we present the preclinical studies of a broadly protective SARS-CoV-2 subunit vaccine developed from our trimer domain platform using the Delta spike protein, from antigen design through purification, vaccine evaluation and manufacturability. The pre-fusion trimerized Delta spike protein, PF-D-Trimer, was highly expressed in Chinese hamster ovary (CHO) cells, purified by a rapid one-step anti-Trimer Domain monoclonal antibody immunoaffinity process and prepared as a vaccine formulation with an adjuvant. Immunogenicity studies have shown that this vaccine candidate induces robust immune responses in mouse, rat and Syrian hamster models. It also protects K18-hACE2 transgenic mice in a homologous viral challenge. Neutralizing antibodies induced by this vaccine show cross-reactivity against the ancestral WA1, Delta and several Omicrons, including BA.5.2. The formulated PF-D Trimer is stable for up to six months without refrigeration. The Trimer Domain platform was proven to be a key technology in the rapid production of PF-D-Trimer vaccine and may be crucial to accelerate the development and accessibility of updated versions of SARS-CoV-2 vaccines.

Revisiting the emission line source detection problem in integral field spectroscopic data

AbstractWe present a 3‐dimensional matched filtering approach for the blind search of faint emission‐line sources in integral‐field spectroscopic datasets. The filter is designed to account for the spectrally rapidly varying background noise due to the telluric air glow spectrum. A software implementation of this matched filtering search is implemented in an updated version of the Line Source Detection Cataloguing tool (LSDCat2.0). Using public data from the MUSE‐Wide survey we show how the new filter design provides higher detection significances for faint emission line sources buried in between atmospheric [OH]‐bands at Å. We also show how, for a given source parameterization, the selection function of the improved algorithm can be derived analytically from the variances of the data. We verify this analytic solution against source insertion and recovery experiments in the recently released dataset of the MUSE eXtreme Deep Field (MXDF). We then illustrate how the selection function has to be rescaled for 3D emission line source profiles that are not fully congruent with the template. This procedure alleviates the construction of realistic selection functions by removing the need for computationally cumbersome source insertion and recovery experiments.

Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk

Few clinical trials have examined brief non-pharmacological treatments for reducing suicide risk in older Veterans, a high-risk group. Problem Solving Therapy (PST) is a promising psychosocial intervention for reducing late life suicide risk by increasing adaptive coping to problems through effective problem solving and related coping skills. The current randomized clinical trial will compare the efficacy of six telephone-delivered sessions of Safety Planning (enhanced usual care; EUC) only or an updated version of PST (emotion-centered PST [EC-PST]) + EUC to determine the added clinical benefit of EC-PST for reducing severity of suicidal ideation and for increasing reasons for living, a critical protective factor. Participants randomized to EC-PST + EUC or EUC only will be 150 Veterans (75 each) with active suicidal ideation who are aged 60 or older; have a current DSM-5 anxiety, depressive, and/or trauma-related disorder; and without significant cognitive impairment. Primary outcomes (Geriatric Suicide Ideation Scale and Reasons for Living-Older Adults scale) will be assessed at 11 timepoints: baseline, after each of 6 treatment sessions, posttreatment, and at follow-up at 1, 3, and 6 months posttreatment, and analyzed using mixed effects modeling. Additionally, moderators and mediators of primary outcomes will be examined—functional disability, executive dysfunction, and problem-solving ability. Qualitative feedback from participants will identify potential Veteran-centric changes to the EC-PST protocol and to EUC. Ultimately, the goal of this study is to inform the evidence-based clinical practice guidelines for treatments to reduce suicide risk in older Veterans and specifically to inform clinical decision-making regarding the merit of adding EC-PST to EUC.

Blind Spot in the Radar of MEST-C Score: Type and Severity of Tubulointerstitial Nephritis in IgA Nephropathy.

The updated version of predictive classification for immunoglobulin A nephropathy (IgAN) prognosis "The Oxford Classification" identifies five histopathological features including mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), tubular atrophy/interstitial fibrosis (T) and crescents (C), the MEST-C. However, few studies suggest that tubulointerstitial inflammation, which is not included in the MEST-C, is also linked to disease progression and is, consequently, a neglected determinant of prognosis among others. Therefore, there is a need to evaluate this histopathological parameter in patients with IgA nephropathy. This cross-sectional descriptive study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan. Data of histopathological and immunofluorescence proven renal biopsies (300) of IgA nephropathy patients from January 2016 through May 2022 were extracted using a convenient sampling technique. Biopsies were histologically reviewed for type and severity of tubulointerstitial inflammation, in addition to the MEST-C score. Renal biopsies of patients who had a history of transplant, autolyzed tissue, no glomeruli on histological examination, and/or a tubular atrophy/interstitial fibrosis score of 2 (T2) in MEST-C scoring were excluded. Data were analyzed using SPSS 20. An association between the variables was analyzed using the chi-square and Fischer exact tests. A p value less than 0.05 was considered statistically significant. A total of 247/300 biopsies were eligible for inclusion. The mean age at the time of biopsy was 31.90 ± 12.48 with 63.6% in the age group between 21 and 40 years, and 69.6% were male. Tubulointerstitial inflammation was observed in 90.2% cases with 49.4% showing moderate while 4.5% showing severe degree of inflammation. A strong association of both the type and severity of tubulointerstitial inflammation was found with M, E, T, and C scores (p value < 0.05). The high-frequency and strong statistical association of tubulointerstitial inflammation with the M, E, T, and C scores in our study elucidate its prognostic role in the progression and management of IgA nephropathy.

A risk-organised model for clinically significant prostate cancer early detection.

A risk-organised model for clinically significant prostate cancer early detection.

Aczel–Alsina Power Aggregation Operators for Complex Picture Fuzzy (CPF) Sets with Application in CPF Multi-Attribute Decision Making

Complex picture fuzzy sets are the updated version of the complex intuitionistic fuzzy sets. A complex picture fuzzy set covers three major grades such as membership, abstinence, and falsity with a prominent characteristic in which the sum of the triplet will be contained in the unit interval. In this scenario, we derive the power aggregation operators based on the Aczel–Alsina operational laws for managing the complex picture of fuzzy values. These complex picture fuzzy power aggregation operators are complex picture fuzzy Aczel–Alsina power averaging, complex picture fuzzy Aczel–Alsina weighted power averaging, complex picture fuzzy Aczel–Alsina power geometric, and complex picture fuzzy Aczel–Alsina weighted power geometric operators. We also investigate their theoretical properties. To justify these complex picture fuzzy power aggregation operators, we illustrate a procedure of a decision-making technique in the presence of complex picture fuzzy values and derive an algorithm to evaluate some multi-attribute decision-making problems. Finally, a practical example is examined to illustrate the decision-making procedure under the consideration of derived operators, and their performance is compared with that of various operators to show the supremacy and validity of the proposed approaches.