Improved cosine and cotangent function-based similarity measures for q-rung orthopair fuzzy sets and TOPSIS method

Despite the importance of cosine and cotangent function- based similarity measures, the literature has not provided a satisfactory formulation for the case of q-rung orthopair fuzzy set (qROFS). This paper criticizes the existing attempts in terms of respect of the basic axioms of a similarity measure and strict inclusion relation. In addition, the maximum operator-based similarity measures are criticized. Then, new improved, axiomatically supported cosine and cotangent function-based similarity measures for qROFSs are proposed. Additional properties of the new similarity measures are discussed to guarantee their good performance. Two algorithmic procedures of TOPSIS method that based on fixed and relative ideal solutions are discussed. The numerical examples are provided to support the findings

Building Peace through Sports Projects: A Scoping Review

The term peacebuilding has gained traction in academic works since introduction in the 1960s. In recent decades, sport for development and peace (SDP) has also captured the interest of the academic community, with a growing field of work. This scoping review identifies and considers the academic literature on SDP projects deployed as peacebuilding tools in post-conflict communities, to gain a greater understanding of those projects and draw inferences from them collectively. Using strict inclusion criteria, results of database searches were narrowed down to 30 publications, which the review explored through comparing the publications and their findings, to reveal the range of disciplines this research is emerging from, the countries projects are operating in, the demographics targeted, and other key data. The resulting conclusion is that there is scope for more targeted studies to clarify specific demographics to include, whether there is an ideal age to engage with youth, or an optimal timeframe for involvement. Many of the publications reference the importance of being part of broader initiatives, but the best context in which to utilise sport, and how much of an impact is being made on the wider communities, is yet to be determined.

MDR1 gene polymorphisms and imatinib response in chronic myeloid leukemia: A meta-analysis

Background Our study aimed to investigate the association between multidrug resistance (MDR1) C1236T, C3435T and G2677T/A polymorphisms and the response to imatinib (IM) in chronic myeloid leukemia (CML). Materials and methods An electronic databases in PubMed, Embase, Web of Knowledge, Scopus and Cochrane were searched using combinations of keywords relating to MDR1 polymorphisms and the response to IM in CML. Studies retrieved from database searches were screened using strict inclusion and exclusion criteria. Results In total, 37 studies were initially identified, and 17 studies, involving 4494 CML patients, were eventually included in this meta-analysis. Results of our study revealed significant association between MDR1 G2677T/A and C3435T polymorphisms and response to IM in Caucasian population under recessive model (T or A vs G; OR = 1.43,95%CI [1;06-1.93]; T vs C;OR = 1.13; 95%IC [0.79; 1.63]), dominant (T or A vs G; OR = 0.94; 95%CI [0.74–1.21]; T vs C; OR = 1.49; 95%CI [1.02–2.17]) and heterozygous models (T or A vs G; OR = 0.83; 95%CI [0.64; 1.09]; T vs C; OR = 1.52; 95%CI [1.01–2.28]); respectively. However, never significative association was found between IM response and the MDR1 C1236T polymorphism (OR = 1.25; 95%CI [0.46; 3.33]). Conclusion The MDR1 G2677T/A and C3435T polymorphisms might be a risk factor for resistance to IM in Caucasian CML patients.

A Laboratory for Human Animals

The Phase I clinic can be seen as a type of laboratory for human animals. Chapter 5 further develops the concept of the healthy volunteer as a model organism, and it explores how standardization and control are imposed on healthy volunteers who are confined for studies. In Phase I clinics, what happens, and how often, to participants differs dramatically from later-phase clinical trials. Additionally, the strict inclusion-exclusion criteria for studies define “healthy” in terms of narrow physiological markers that volunteers must meet in order to participate. In the process, the healthy volunteer becomes a type of model organism that is maximally suited to Phase I research. The chapter also illustrates how research staff’s practices in selecting and managing healthy volunteers define who can enroll at their clinics and normalize those participants to the demands of Phase I trials.

Key Barriers to Clinical Trial Enrolment: A Survey of Clinical Trial Staff at an NCI Designated Cancer Center

Background: Clinical trials, key elements of the processes that account for many of the recent advances in cancer care, are becoming more complex and challenging to conduct. The Stephenson Cancer Center (SCC) has been the lead accruer to NCI-LAP trials over the past three years, and in addition, fields investigator initiated and industry sponsored trials. To identify opportunities for continued improvement in clinical trial enrolment, we sought to identify the obstacles encountered by our clinical trial staff in these activities. Method: We conducted a survey of our research staff including all research nurses and disease site coordinators who participate in recruitment, screening, consenting, data collection and compliance. The survey, sent by email to the clinical trial list-serve at SCC (90 staff member), invited respondents to enumerate obstacles to patient participation in clinical trials. We then performed a follow up meeting with our research coordinators to clarify responses. A total of 26 responses from 90 respondents were received and tabulated by disease site. Results: The most commonly reported obstacles to enrolment were, in descending order: communication/language barriers, cultural bias, time/procedure commitment, and complexity of the trial protocol, financial logistics, comorbidities, and stringent trial criteria. Respondents identified 83 obstacles as frequently encountered obstacles to enrolment. The 83 reported obstacles were classified into 9 categories and organized by disease site as presented in tabular format (below). The most commonly identified obstacles to patient enrolment were communication and language barriers. In patients for whom Spanish is the primary language this was a universal obstacle, as there is a lack of consistent Spanish consents across the clinical trial portfolio. Cultural bias, as an obstacle was manifested as a general mistrust by prospective trial participants of experimental therapies and clinical trials. After communication and cultural bias as barriers, travel requirements and the associated expenses playing a role in patients from rural areas were identified as the most commonly encountered barrier. The complexity of trial protocols and the associated large number of clinic visits, frequent laboratory and imaging tests were also identified as common obstacles. Clinical trial complexity with strict inclusion and exclusion criteria and trial-specified biopsies were frequently cited. Implications: In this descriptive study, common barriers to patient enrolment in clinical trials were identified by clinical trial staff. Assessing barriers encountered by clinical trial staff is infrequently used as a metric for improving clinical trial enrolment, but provides important perspective. In our study, some obstacles are inherent in our patient populations, others appear to be actionable. Development of Spanish language consents and specific programs to overcome negative bias regarding clinical trials are potential areas for improvement. The complexity of clinical trial protocols and the increasingly strict inclusion/exclusion criteria, are issues that will require consideration and action at the level of the cooperative groups and industry. Disclosures No relevant conflicts of interest to declare.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients With Myelomeningocele: Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development

BACKGROUND Myelomeningocele (MM) is the most common congenital anomaly to affect the nervous system and affects 1500-2000 newborn infants per year in the United States. It is accompanied by symptomatic hydrocephalus in approximately 70%-80% of patients. Different treatment strategies for hydrocephalus characteristically result in different effects on the size of the ventricles. OBJECTIVE The objective of this systematic review was to determine whether persistent ventricular enlargement adversely impacts neurocognitive development in patients with MM. METHODS The PubMed National Library of Medicine Medline database and Embase were queried using MeSH headings and keywords relevant to neurocognitive or intellectual development and ventricular size or morphology. Abstracts were reviewed by the authors to identify which studies met strict inclusion criteria. An evidence table was constructed that summarized the included studies and reflected the quality of evidence (Classes I–III) that each represented. A recommendation was made that is based on the quality of the evidence. RESULTS An initial abstract review utilizing strict inclusion/exclusion criteria yielded 48 studies, 9 of which underwent full-text review. There is limited and conflicting Class III evidence from 2 studies. CONCLUSION Currently, there is insufficient data to conclude that ventricular size and morphology impact neurocognitive development. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-5.

Microlobectomy: A Novel Form of Endoscopic Lobectomy

Objective Microlobectomy is a novel form of videoscopic-assisted thoracic surgery lobectomy. Strict inclusion criteria consist of the following: no intercostal incisions greater than 5 mm, 12 mm subxiphoid port, subxiphoid removal of the specimen, total endoscopic technique with CO2 insufflation, vision through a 5-mm camera, stapling via the subxiphoid port, or with 5-mm stapling devices. Methods The combined early experiences of six hospitals from three countries were combined from September 2014 to May 2016. During that time, the study represents a consecutive cohort study of this technique. Results Seventy-two patients underwent microlobectomy. The median (range) age was 66 (27–82). Half of the patients were female. There were 48 right-sided resections and 24 on the left. There were four segmental resections and there was one right pneumonectomy. Four operations were performed robotically (with 8-mm intercostal incisions). The median (range) operative time was 180 (94–285) minutes and the blood loss was 118 (5–800) mL. There were three conversions to thoracotomy and two conversions to videoscopic-assisted thoracic surgery by means of an intercostal utility incision to complete the operation. The median (range)length of stay was 3(1–44) days and 30 patients (42%) when home by day 2 and 16 patients (22%) were discharged on day 1. There were no deaths. Five patients (7%) had a prolonged airleak. There were no wound infections and there was one incisional hernia. Conclusions We believe that microlobectomy is an interesting novel form of videoscopic-assisted thoracic surgery lobectomy and has several theoretical advantages. We have presented our early results and hope that this will stimulate others to investigate this type of videoscopic-assisted thoracic surgery lobectomy further.

The real-life experience with cardiovascular complications in the first dose of fingolimod for multiple sclerosis

Fingolimod is a new and efficient treatment for multiple sclerosis (MS). The drug administration requires special attention to the first dose, since cardiovascular adverse events can be observed during the initial six hours of fingolimod ingestion. The present study consisted of a review of cardiovascular data on 180 patients with MS receiving the first dose of fingolimod. The rate of bradycardia in these patients was higher than that observed in clinical trials with very strict inclusion criteria for patients. There were less than 10% of cases requiring special attention, but no fatal cases. All but one patient continued the treatment after this initial dose. This is the first report on real-life administration of fingolimod to Brazilian patients with MS, and one of the few studies with these characteristics in the world.

Strong and Extremely Strong Ditkin sets for the Banach Algebras Apr(G) = Ap ⋂ Lr(G)

Let Ap(G) be the Figa-Talamanca, Herz Banach Algebra on G; thus A2(G) is the Fourier algebra. Strong Ditkin (SD) and Extremely Strong Ditkin (ESD) sets for the Banach algebras Apr (G) are investigated for abelian and nonabelian locally compact groups G. It is shown that SD and ESD sets for Ap(G) remain SD and ESD sets for Apr(G), with strict inclusion for ESD sets. The case for the strict inclusion of SD sets is left open.A result on the weak sequential completeness of A2(F) for ESD sets F is proved and used to show that Varopoulos, Helson, and Sidon sets are not ESD sets for A2r(G), yet they are such for A2(G) for discrete groups G, for any 1 ≤ r ≤ 2.A result is given on the equivalence of the sequential and the net definitions of SD or ESD sets for σ-compact groups.The above results are new even if G is abelian.