Multiple criteria decision analytic methods in management with T-spherical fuzzy information.

With a focus on T-spherical fuzzy (T-SF) sets, the aim of this paper is to create a split-new appraisal mechanism and an innovative decision analytic method for use with multiple-criteria assessment and selection in uncertain situations. The T-SF frame is the latest recent advancement in fuzzy settings and uses four facets (consisting of membership grades of positivity, neutrality, negativity, and refusal) to elucidate complex uncertainties, thereby evidently reducing information loss, in anticipation of fully manifesting indistinct and equivocal information. This paper adds to the body of knowledge regarding multiple criteria choice modeling by raising T-SF correlation-oriented measurements connected to the fixed and displaced ideal/anti-ideal benchmarks and by creating an approachable appraisal mechanism for advancing a T-SF decision analytic methodology. Consider, in particular, the performance ratings of available options in terms of judging criteria under the T-SF type of uncertainties. This research gives correlation-oriented measurements focusing on two varieties of maximum and square root functions in T-SF situations, which serve as a solid foundation for an efficacious appraisal mechanism from two views of anchored judgments corresponding to the fixed and displaced benchmarks. The T-SF Minkowski distance index is generated to integrate the outranking and outranked identifiers relying on correlation-oriented measurements for figuring out the local outranking and outranked indices. The T-SF decision analytic procedures are constructed using a new appraisal significance index that is founded on certain valuable insights of correlation-oriented maximizing and minimizing indices as well as global outranking and outranked indices. Additionally, a concrete location selection dilemma is dealt with in this research to showcase the applicability and efficiency of the suggested T-SF decision analytic methodology. Sensitivity analyses and comparative studies are carried out to investigate substantial modifications in pertinent parameters and to confirm the robustness of the predominance relationships among the available options. The suggested approaches are adaptable, flexible, and reliable, according to the application outcomes and comparison findings. This research provides four scientific contributions: (1) the utilization of T-SF correlation coefficients as the basis for prioritization analysis involving multiple criteria assessments, (2) the evolution of the T-SF Minkowski distance index to model outranking decision-making processes, (3) the creation of a reliable appraisal mechanism based on T-SF correlation-oriented measurements for intelligent decision support, and (4) the advancement of computational tools and procedures (e.g., correlation-oriented maximizing and minimizing indices, global outranking and outranked indices, and appraisal significance indices) to perform the decision analytic procedure in T-SF settings. In terms of managerial implications, the solution findings support the employment of the fixed ideal/anti-ideal benchmarking mechanism, as its measurements and indices are easy to operate and suitably sensitive. Next, in practical implementations of the T-SF decision analytic procedure, it is advised to utilize the T-SF Manhattan distance index for calculating convenience. Finally, the T-SF decision analytic techniques offer fundamental ideas and measurements appropriate for manipulating T-SF information in complex decision situations, thereby increasing the application potential in the area of decision-making with information uncertainty.

Timing is everything: The importance of patient-reported outcome assessment frequency when characterizing symptomatic adverse events.

OBJECTIVE: Although patient-reported symptoms and side effects are increasingly measured in cancer clinical trials, an appropriate assessment frequency has not yet been established. To determine whether differences in assessment frequency affect the apparent incidence and severity of patient-reported symptoms using two well-established patient-reported outcome measures used within the same clinical trial. METHODS: We examined patient-reported outcome results from AURA3 (NCT02151981), a randomized open-label study comparing Tagrisso (osimertinib) with platinum-based chemotherapy in patients with previously treated estimated glomerular filtration rate/T790M mutation-positive metastatic non-small cell lung cancer. The outcome of interest was the proportion of patients in each arm that reported worsening of nausea, vomiting, fatigue, diarrhea, constipation, and appetite loss from baseline measured using the patient-reported outcome-common terminology criteria for adverse event (weekly) or European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (every 6 weeks). RESULTS: Similar trends were observed for all six symptoms investigated. Using nausea in the chemotherapy arm as an example, 76% of patients reported any worsening from baseline based on weekly patient-reported outcome-common terminology criteria for adverse event assessments. When using an every 6-week assessment of Quality of Life Questionnaire Core 30 nausea and restricting analysis to an every 6-week assessment for patient-reported outcome-common terminology criteria for adverse event nausea, the proportion of chemotherapy arm patients reporting any worsening of nausea was 40% for both measures. Across the six patient-reported symptomatic adverse events, we observed differential proportions when comparing frequent versus sparse assessment. CONCLUSION: This analysis demonstrates that more frequent assessment of patient-reported symptomatic adverse events will lead to improved detection, and therefore a more complete understanding of the tolerability of experimental anti-cancer therapies.

Developing Physical Assessment Skills in Pharmacy Students through Participation in a Creative Movement Workshop: An Interdisciplinary Study between Pharmacy and Dance.

The role a pharmacist plays in the care of patients is continually changing and expanding. Most recently, there is movement towards including pharmacists in the physical assessment of patients. We developed a creative movement workshop with the purpose of increasing students' levels of comfort with touch, ability to interpret non-verbal mannerisms, to increase empathy for the patient, and to increase student comfort in conducting physical exams. In this interventional study, surveys were administered to third year pharmacy students, before and after the creative movement workshop, in order to assess participant's change in level of comfort with a variety of behaviors needed to conduct effective physical assessment. The two hour workshop involved: partner stretching, mirroring, and creative spatial exploration between bodies. The 11-item survey evaluated students' perceptions on touch, nonverbal communication, and sharing personal space. Our results showed that the level of comfort improved for the ability to give touch (p = 0.001), the ability to receive touch (p = 0.002), and the ability to share personal space (p = 0.001). Participants commented that the workshop increased their understanding of how important confidence is when performing physical assessment and reported an increased appreciation for how much non-verbal mannerisms can communicate to another. This study explores how an interdisciplinary workshop between pharmacy and dance has the potential to increase student effectiveness as future healthcare professionals, by targeting skills not often focused on within traditional pharmacy curriculums, including: sharing personal space, displaying empathy, and providing a comforting and confident touch.

Cost-efficient and Custom Electrode-holder Assembly Infrastructure for EEG Recordings.

Mobile electroencephalogram (EEG)-sensing technologies have rapidly progressed and made the access of neuroelectrical brain activity outside the laboratory in everyday life more realistic. However, most existing EEG headsets exhibit a fixed design, whereby its immobile montage in terms of electrode density and coverage inevitably poses a great challenge with applicability and generalizability to the fundamental study and application of the brain-computer interface (BCI). In this study, a cost-efficient, custom EEG-electrode holder infrastructure was designed through the assembly of primary components, including the sensor-positioning ring, inter-ring bridge, and bridge shield. It allows a user to (re)assemble a compact holder grid to accommodate a desired number of electrodes only to the regions of interest of the brain and iteratively adapt it to a given head size for optimal electrode-scalp contact and signal quality. This study empirically demonstrated its easy-to-fabricate nature by a low-end fused deposition modeling (FDM) 3D printer and proved its practicability of capturing event-related potential (ERP) and steady-state visual-evoked potential (SSVEP) signatures over 15 subjects. This paper highlights the possibilities for a cost-efficient electrode-holder assembly infrastructure with replaceable montage, flexibly retrofitted in an unlimited fashion, for an individual for distinctive fundamental EEG studies and BCI applications.

Insomnia Increases Symptom Severity and Health Care Utilization in Patients With Fibromyalgia: A Population-based Study.

OBJECTIVE: This study aimed to determine whether comorbid insomnia is associated with increased use of fibromyalgia-related medications and health resources in fibromyalgia (FM) patients. MATERIALS AND METHODS: We analyzed data retrieved from the Longitudinal Health Insurance Database 2010, which contains claims data of 1 million beneficiaries randomly selected from Taiwan's National Health Insurance program. Patients treated for FM (n=17,920) on 2 separate visits between 2000 and 2001 were selected and subsequently divided into 2 groups: patients with and without comorbid insomnia (n=5466 and 12,454, respectively). Insomnia was identified through diagnosis on 2 separate visits after the index FM date. FM-related pharmacotherapies and ambulatory care visits were tracked from the index date to the end of 2013. RESULTS: Insomnia was associated with increased likelihood of future use of antidepressants (adjusted odds ratio [OR]=3.84, P<0.001), gabapentin (adjusted OR=1.67, P<0.001), pregabalin (adjusted OR=1.79, P=0.046), muscle relaxants (adjusted OR=3.05, P<0.001), and opioids and tramadol (adjusted OR=1.59, P<0.001) among FM patients compared with FM patients without insomnia. In addition, a diagnosis of insomnia was associated with an increased frequency of visits to ambulatory care services for both FM (ß=1.79; 95% confidence interval, 1.57-2.02; P<0.001) and other conditions (ß=108.51; 95% confidence interval, 103.14-113.89; P<0.001). DISCUSSION: This study demonstrates the substantial burden of comorbid insomnia in patients with FM.