Fuzzy Logic Preanesthetic Risk Evaluation of Laparoscopic Cholecystectomy Operations

2021 ◽  
pp. 000313482110298
Author(s):  
Baris Sandal ◽  
Yuksel Hacioglu ◽  
Ziya Salihoglu ◽  
Nurkan Yagiz
Keyword(s):  
Fuzzy Logic ◽  
Laparoscopic Cholecystectomy ◽  
Evaluation Model ◽  
Risk Groups ◽  
Risk Classification ◽  
The Other ◽  
Classification Model ◽  
Complication Rates ◽  
Fuzzy Logic Algorithm ◽  
Other Hand

Background and Objective Pre-operative risk classification of patients undergoing anesthesia is an essential interest and has been the focus of many research and categorizations. On the other hand, the ideal categorization system, based on medical doctors’ clinical experience and cooperation with other disciplines, has not been developed yet. Methods In this study, 218 consecutive patient undergoing laparoscopic cholecystectomy operations were included. A novel fuzzy logic evaluation model consisting of 270 rules was constructed. Five major (pulmonary, cardiac, diabetes mellitus and renal or liver disease) and three minor criteria (patientsʼ age, cigarette smoking and body mass index) were chosen to be used during high-risk groups determination. Results The verification of the success of risk value decision with the proposed novel fuzzy logic algorithm is the main goal of this study. On the other hand, though not essential aim, a statistical consistency check was also included to have a deeper understanding and evaluation of the graphical results. During the statistical analysis the 0-30%, 30-60% and 60-90% risk ranges were found to be in a very strong positive relationship with complication occurrence. In this study, 172, 31, 15 patients were in 0-30, 30-60 and 60-90% risk ranges, respectively. Complication rates were 7/172 (4.07%) in 0-30% range, 3/31 (9.68%) in 30-60% range; and 2/15 (13.33%) in 60-90% range. Conclusions Fuzzy based risk classification model was successfully used to predict medical results for patients undergoing laparoscopic cholecystectomy operations and reliable deductions were reached.

A Novel Risk Classification Model Predicts Overall Survival and Locoregional Surgery Benefit in Colorectal Patients with Distant Metastasis at the Initial Diagnosis

2020 ◽  
Author(s):  
Mo Chen ◽  
Tian-en Li ◽  
Pei-zhun Du ◽  
Junjie Pan ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Risk Group ◽  
Risk Groups ◽  
Risk Classification ◽  
Low Risk ◽  
Classification Model ◽  
Intermediate Risk

Abstract Background and aims: In this research, we aimed to construct a risk classification model to predict overall survival (OS) and locoregional surgery benefit in colorectal cancer (CRC) patients with distant metastasis.Methods: We selected a cohort consisting of 12741 CRC patients diagnosed with distant metastasis between 2010 and 2014, from the Surveillance, Epidemiology and End Results (SEER) database. Patients were randomly assigned into training group and validation group at the ratio of 2:1. Univariable and multivariable Cox regression models were applied to screen independent prognostic factors. A nomogram was constructed and assessed by the Harrell’s concordance index (C-index) and calibration plots. A novel risk classification model was further established based on the nomogram.Results: Ultimately 12 independent risk factors including race, age, marriage, tumor site, tumor size, grade, T stage, N stage, bone metastasis, brain metastasis, lung metastasis and liver metastasis were identified and adopted in the nomogram. The C-indexes of training and validation groups were 0.77 (95% confidence interval [CI] 0.73-0.81) and 0.75 (95% CI 0.72-0.78), respectively. The risk classification model stratified patients into three risk groups (low-, intermediate- and high-risk) with divergent median OS (low-risk: 36.0 months, 95% CI 34.1-37.9; intermediate-risk: 18.0 months, 95% CI 17.4-18.6; high-risk: 6.0 months, 95% CI 5.3-6.7). Locoregional therapies including surgery and radiotherapy could prognostically benefit patients in the low-risk group (surgery: hazard ratio [HR] 0.59, 95% CI 0.50-0.71; radiotherapy: HR 0.84, 95% CI 0.72-0.98) and intermediate risk group (surgery: HR 0.61, 95% CI 0.54-0.68; radiotherapy: HR 0.86, 95% CI 0.77-0.95), but not in the high-risk group (surgery: HR 1.03, 95% CI 0.82-1.29; radiotherapy: HR 1.03, 95% CI 0.81-1.31). And all risk groups could benefit from systemic therapy (low-risk: HR 0.68, 95% CI 0.58-0.80; intermediate-risk: HR 0.50, 95% CI 0.47-0.54; high-risk: HR 0.46, 95% CI 0.40-0.53).Conclusion: A novel risk classification model predicting prognosis and locoregional surgery benefit of CRC patients with distant metastasis was established and validated. This predictive model could be further utilized by physicians and be of great significance for medical practice.

scholarly journals RISK CLASSIFICATION AS AN ESSENTIAL TOOL IN BANKING RISK MANAGAMENT

2004 ◽  
Vol 10 (2) ◽  
pp. 47-56
Author(s):  
Galina Ševčenko ◽  
Leonas Ustinovičius ◽  
Robert Balcevič
Keyword(s):  
Risk Classification ◽  
The Other ◽  
Risk Level ◽  
Other Hand ◽  
Essential Tool ◽  
Banking Risk ◽  
High Benefit ◽  
Level Of Risk

The word “risk” usually has a negative meaning ‐ this notion usually contains some meanings about danger, injuries and wastes. It can be understood as a possibility to suffer injuries, to lose salary or that the main aim would require more funds and abilities than usually. Although risk is not acceptable in the bank activities it can not be avoided. Risk is usually found as a negative, hazardous process or condition that causes injuries, loss of funds, when the credits are not paid back, decreasing of resources, payments out of time, and so on. But on the other hand, as the level of risk is lower, chances to get high benefit are also low. So, usually manufacturers try to avoid risks and choose one of several alternative ways that is less risky, although the proportion of the risk level and the incoming funds should be settled.

scholarly journals Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs

1990 ◽  
Vol 104 (2) ◽  
pp. 275-287 ◽  
Author(s):  
B. P. Marmion ◽  
R. A. Ormsbee ◽  
M. Kyrkou ◽  
J. Wright ◽  
D. A. Worswick ◽  
...  
Keyword(s):  
Q Fever ◽  
Protective Efficacy ◽  
Phase 1 ◽  
South Australia ◽  
Risk Groups ◽  
The Other ◽  
Cell Mediated Immunity ◽  
Igg Antibody ◽  
Inoculation Site ◽  
Other Hand

SUMMARYDuring the period 1981–8 a clinical trial of a Q fever vaccine (Q-vax; Commonwealth Serum Laboratories, Melbourne) has been conducted in abattoir workers and other at-risk groups in South Australia. Volunteers in four abattoirs and visitors to the abattoirs were given one subcutaneous dose of 30 μg of a formalin-inactivated, highly-purifiedCoxiella burnetiicells, Henzerling strain, Phase 1 antigenic state, in a volume of 0·5 ml.During the period, over 4000 subjects have been vaccinated and the programme continues in the abattoirs and related groups. ‘Common’ reactions to the vaccine comprised tenderness and erythema, rarely oedema at the inoculation site and sometimes transient headache. Two more serious ‘uncommon’ reactions, immune abscess at the inoculation site, were observed in two subjects, and two others developed small subcutaneous lumps which gradually dispersed without intervention.Protective efficacy of the vaccine appeared to be absolute and to last for 5 years at least. Eight Q fever cases were observed in vaccinees, but all were in persons vaccinated during the incubation period of a natural attack of Q fever before vaccine-induced immunity had had time (≥ 13 days after vaccination) to develop. On the other hand, 97 Q fever cases were detected in persons working in, or visiting the same abattoir environments.Assays for antibody and cellular immunity showed an 80–82% seroconversion after vaccination, mostly IgM antibody to Phase 2 antigen, in the 3 months after vaccination. This fell to about 60%, mostly IgG antibody to Phase 1 antigen, after 20 months. On the other hand, 85–95% of vaccinees developed markers of cell mediated immunity as judged by lymphoproliferative responses withC. burnetiiantigens; these rates remained elevated for at least 5 years.The Q fever vaccine, unlike other killed rickettsial vaccines, has the property of stimulating long-lasting T lymphocyte memory and this may account for its unusual protective efficacy as a killed vaccine.

scholarly journals Implication of pigtail catheter vs chest tube drainage

2018 ◽  
Vol 5 (9) ◽  
pp. 3686
Author(s):  
Alaa Elsayed ◽  
Rayan Alkhalifa ◽  
Muhannad Alodayni ◽  
Rakan Alanazi ◽  
Lara Alkhelaiwy ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
The Other ◽  
Chest Tube Drainage ◽  
Complication Rates ◽  
Pigtail Catheter ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Other Hand ◽  
Lower Complication

Pigtail catheters and chest tubes have long been used for drainage of pleural collections for many years. In thoracic surgery, each technique is preferred in certain conditions. Pigtail catheters have the advantages of being smaller in size, more flexible, less traumatic, easier in insertion, and are associated with lower complication rates. They are particularly effective in draining non-viscid and non-coagulable fluids. The main disadvantages are their ineffectiveness in draining thick fluids, their higher liability to clogging, kinking, and obstruction. Chest tubes, on the other hand, have larger diameters allowing faster and more efficacious drainage of thick fluids and hemothorax. However, they are more painful, more distorting to tissues, and have higher complications rates. The aim of this article is to provide a review on both systems, and to compare the reported safety, efficacy, and complications of each.

scholarly journals The Impact of Social Investment Reforms on Income and Activation in the Netherlands

2017 ◽  
Author(s):  
Menno Soentken ◽  
Franca van Hooren ◽  
Deborah Rice
Keyword(s):  
The Netherlands ◽  
Local Level ◽  
Risk Groups ◽  
The Other ◽  
Flow Function ◽  
Social Investment ◽  
Lone Parents ◽  
Other Hand ◽  
Early School ◽  
The Impact

In this chapter we assess the buffer and flow dimension of the social investment state for early school leavers and lone parents in the Netherlands. By applying an ‘at-risk household-type model’, we show that the buffer function of the welfare state for the two risk groups out of work has declined in the last decade, particularly for early school leavers. On the other hand, the buffer function, in terms of minimum income protection, for those risk groups that have acquired paid employment has significantly improved. In terms of labour-market flow, we show that capacitation of risk groups is an explicit aim of service delivery at the local level in the Netherlands. On the other hand, capacitation was brought in jeopardy by recent budget, which undermined the flow function for precarious risk groups. Both the buffer and flow function of the Dutch social investment state point to an ambivalent reform path.

Propositional logic

2004 ◽  
Author(s):  
Shawn Hedman
Keyword(s):  
Fuzzy Logic ◽  
Propositional Logic ◽  
Building Blocks ◽  
English Word ◽  
The Other ◽  
American Women ◽  
Truth Values ◽  
Other Hand ◽  
Truth Value ◽  
The Relationship

In propositional logic, atomic formulas are propositions. Any assertion will do. For example, . . . A = “Aristotle is dead,” B = “Barcelona is on the Seine,” and C = “Courtney Love is tall” . . . are atomic formulas. Atomic formulas are the building blocks used to construct sentences. In any logic, a sentence is regarded as a particular type of formula. In propositional logic, there is no distinction between these two terms. We use “formula” and “sentence” interchangeably. In propositional logic, as with all logics we study, each sentence is either true or false. A truth value of 1 or 0 is assigned to the sentence accordingly. In the above example, we may assign truth value 1 to formula A and truth value 0 to formula B. If we take proposition C literally, then its truth is debatable. Perhaps it would make more sense to allow truth values between 0 and 1. We could assign 0.75 to statement C if Miss Love is taller than 75% of American women. Fuzzy logic allows such truth values, but the classical logics we study do not. In fact, the content of the propositions is not relevant to propositional logic. Henceforth, atomic formulas are denoted only by the capital letters A, B, C,. . . (possibly with subscripts) without referring to what these propositions actually say. The veracity of these formulas does not concern us. Propositional logic is not the study of truth, but of the relationship between the truth of one statement and that of another. The language of propositional logic contains words for “not,” “and,” “or,” “implies,” and “if and only if.” These words are represented by symbols: . . . ￢ for “not,” ∧ for “and,” ∨ for “or,” → for “implies,” and ↔ for “if and only if.” . . . As is always the case when translating one language into another, this correspondence is not exact. Unlike their English counterparts, these symbols represent concepts that are precise and invariable. The meaning of an English word, on the other hand, always depends on the context.

The Distributivity Equations of Semi-Uninorms

2019 ◽  
Vol 27 (02) ◽  
pp. 329-349 ◽  
Author(s):  
Yong Su ◽  
Hua-Wen Liu ◽  
Witold Pedrycz
Keyword(s):  
Fuzzy Logic ◽  
Approximate Reasoning ◽  
The Other ◽  
Other Hand ◽  
Logical Connectives ◽  
Special Classes

Distributivity between two operations is a property posed many years ago — that is especially interesting in the framework of logical connectives because of its applications to fuzzy logic and approximate reasoning as their applications. Since semi-uninorms have been used in these topics, the study of the distributivity between two semi-uninorms becomes of particular interest that calls for thorough studies. The distributivity between two semi-uninorms, which are non-commutative and non-associative uninorms, has been developed only in the cases when both semi-uninorms are examples of very special classes of semi-uninorms. On the other hand, in general, the distributivity does not rely on the commutativity and associativity. The objective of this work is twofold. The first one is to show new solutions to distributivity equations for semi-uninorms. The second one is to check whether the results concerning the distributivity between two uninorms are valid for semi-uninorms. We investigate the distributivity involving two semi-uninorms when only one semi-uninrom lies in the most studied classes of semi-uninorms, achieving the above two objectives simultaneously.

scholarly journals Thyroidectomy as Treatment of Choice for Differentiated Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Dario Giuffrida ◽  
Raffaella Giuffrida ◽  
Ivana Puliafito ◽  
Veronica Vella ◽  
Lorenzo Memeo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Differentiated Thyroid Cancer ◽  
The Other ◽  
Subtotal Resection ◽  
Complication Rates ◽  
Pathological Features ◽  
Other Hand ◽  
Cancer Aggressiveness ◽  
First Choice

Background. Despite a large amount of data, the optimal surgical management of differentiated thyroid cancer remains controversial. Current guidelines recommend total thyroidectomy if primary thyroid cancer is >4 cm, while for tumors that are between 1 and 4 cm in size, either a bilateral or a unilateral thyroidectomy may be appropriate as surgical treatment. In general, total thyroidectomy would seem to be preferable because subtotal resection can be correlated with a higher risk of local recurrences and cervical lymph node metastases; on the other hand, total thyroidectomy is associated with more complications. Methods. This is a retrospective study conducted on 359 patients with differentiated thyroid cancer, subjected to total thyroidectomy. Our aim was to correlate clinical and pathological features (extrathyroid tumor growth, bilaterality, nodal and distant metastasis) with patient (gender and age) and tumor (size and histotype) characteristics. Moreover, we recorded postoperative complications, including hypoparathyroidism and laryngeal nerve damage. Results. In our study, we found a high occurrence of pathological features indicating cancer aggressiveness (bilaterality, nodal metastases, and extrathyroid invasion). On the other hand, total thyroidectomy was associated with relatively low postsurgical complication rates. Conclusions. Our data support the view that total thyroidectomy remains the first choice for the routine treatment of differentiated thyroid cancer.

scholarly journals Outlier Recognition via Linguistic Aggregation of Graph Databases

2021 ◽  
Vol 11 (16) ◽  
pp. 7434
Author(s):  
Adam Niewiadomski ◽  
Agnieszka Duraj ◽  
Monika Bartczak
Keyword(s):  
Fuzzy Logic ◽  
Fuzzy Sets ◽  
Uncertain Data ◽  
The Other ◽  
Graph Databases ◽  
Information Analysis ◽  
Imperfect Data ◽  
Other Hand ◽  
Recognition Algorithms ◽  
First Time

Datasets frequently contain uncertain data that, if not interpreted with care, may affect information analysis negatively. Such rare, strange, or imperfect data, here called “outliers” or “exceptions” can be ignored in further processing or, on the other hand, handled by dedicated algorithms to decide if they contain valuable, though very rare, information. There are different definitions and methods for handling outliers, and here, we are interested, in particular, in those based on linguistic quantification and fuzzy logic. In this paper, for the first time, we apply definitions of outliers and methods for recognizing them based on fuzzy sets and linguistically quantified statements to find outliers in non-relational, here graph-oriented, databases. These methods are proposed and exemplified to identify objects being outliers (e.g., to exclude them from processing). The novelty of this paper are the definitions and recognition algorithms for outliers using fuzzy logic and linguistic quantification, if traditional quantitative and/or measurable information is inaccessible, that frequently takes place in the graph nature of considered datasets.

Properties of Interval Truth Values with Certainty Factor

2003 ◽  
Vol 7 (2) ◽  
pp. 229-234
Author(s):  
Masashi Emoto ◽  
◽  
Masao Mukaidono
Keyword(s):  
Fuzzy Logic ◽  
The Other ◽  
Certainty Factor ◽  
Truth Values ◽  
Other Hand ◽  
Generalized Truth Values ◽  
Truth Value

Until now some truth values in fuzzy logic were suggested such as numerical truth value, interval truth value, fuzzy truth value and etc. Fuzzy truth value is considered as the most generalized truth values in fuzzy logic. Truth values except fuzzy truth value were suggested to clarify the properties of fuzzy truth values. However it is not sufficient to clarify the properties of fuzzy truth values from the properties of other truth values, because fuzzy truth value may not be convex or normal. On the other hand, the other truth values do have to be convex and normal. In this paper, we consider subnormal truth value and propose interval truth value with certainty factor. Then, we clarify the properties of interval truth value with certainty factor.

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