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This study aimed to examine the relationship between serum cholesterol levels and the ratio of zinc (Zn) and copper (Cu) in the blood serum and the incidence of cardiovascular disease (CVD). In Phase I of the study, 9704 individuals between the age of 35 and 65 years were recruited. Phase II of the cohort study comprised 7561 participants who completed the 10-year follow-up. The variables which were measured at the baseline of the study included gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP); biochemical parameters including serum Cu, Zn, copper-zinc ratio (Cu/Zn), zinc-copper ratio (Zn/Cu); fasted lipid profile consisting of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) as well as fasting serum glucose, and triglycerides-glucose (TyG) index. Decision tree (DT) and logical regression (LR) models were applied to examine the relationship between the aforementioned factors and CVD. CVD was diagnosed in 837 individuals (378 males and 459 females) out of 7561 participants. According to the LR models, SBP, TC, HDL, age, Zn/Cu, and TyG index for males and SBP, age, TyG index, HDL, TC, Cu/Zn, and Cu for females had the highest correlation with CVD (p-value ≤ 0.033). Based on the DT algorithm, 88% of males with SPB < 129.66 mmHg, younger age (age < 53 years), TyG index < 9.53, 173 ≤ TC < 187 mg/dL, and HDL ≥ 32 mg/dL had the lowest risk of CVD. Also, 98% of females with SBP < 128 mmHg, TyG index < 9.68, age < 44, TC < 222 mg/dL, and HDL ≥ 63.7 mg/dL had the lowest risk of CVD. It can be concluded that the Zn/Cu for men and Cu/Zn for women, along with dyslipidemia and SBP, could significantly predict the risk of CVD in this cohort from northeastern Iran.
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Due to the increasing complexity of decision problems, many managers employ multiple experts to reach a good decision in a group decision making. Now, if there is ambiguity in the evaluation of experts, the use of fuzzy numbers can be useful for each expert. In these situations, the use of hesitant fuzzy numbers (HFNs) which consists of several fuzzy numbers with special conditions can be suggested. HFNs are as an extension of the fuzzy numbers to take a better determining the membership functions of the parameters by several experts. Because of simple and fast calculations, in this paper, we use triangular HFNs in the pairwise comparison matrix of analytic hierarchy process by opinions of a group of decision makers in a hesitant fuzzy environment. We define consistency of the hesitant fuzzy pairwise comparison matrix and use the arithmetic operations on the HFNs and a new method of comparing HFNs to get the hesitant fuzzy performance score. By using score function to hesitant fuzzy score we can get a final score for alternatives. Finally, a practical example is provided to show the the effectiveness of this study. The obtained results from this paper show that new method can get a better answer by keeping the experts' opinions in the process of solving the problem.
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OBJECTIVE: To investigate the association between cardiovascular diseases (CVDs) and haematologic factors in a cohort of Iranian adults. METHOD: For a total population of 9,704 aged 35 to 65, a prospective study was designed. Haematologic factors and demographic characteristics (such as gender, age, and smoking status) were completed for all participants. The association between haematologic factors and CVDs was assessed through logistic regression (LR) analysis, decision tree (DT), and bootstrap forest (BF). RESULTS: Almost all of the included factors were significantly associated with CVD (p<.001). Among the included factors, were: age, white blood cell (WBC), and platelet distribution width (PDW) had the strongest correlation with the development of CVD. For unit OR interpretation, WBC has been represented as the most remarkable risk factor for CVD (OR: 1.22 (CI 95% (1.18, 1.27))). Also, age is associated with an increase in the odds of CVD + occurrence (OR: 1.12 (CI 95% (1.11, 1.13))). Moreover, males are times more likely to develop CVD than females (OR: 1.39 (CI 95% (1.22, 1.58))). In DT model, age is the best classifier factor in CVD development, followed by WBC and PDW. Furthermore, based on the BF algorithm, the most crucial factors correlated with CVD are age, WBC, PDW, sex, and smoking status. CONCLUSION: The obtained result from LR, DT, and BF models confirmed that age, WBC, and PDW are the most crucial factors for the development of CVD.
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Background: Healthcare-associated infections are a major cause of mortality worldwide, especially in intensive care units where severely ill patients have limited physical space. Aims: To investigate the incidence, microbial aetiology, antimicrobial resistance profile, and mortality rate of healthcare-associated infections in intensive care units in the Islamic Republic of Iran. Methods: This observational study retrospectively reviewed the medical records of 1722 intensive care units patients with confirmed healthcare-associated infections at hospitals affiliated with Mashhad University of Medical Sciences in 2017-2019. Data was analysed using SPSS for Windows version 11. Categorical variables were described using frequency and percentage, whereas continuous variables were defined using mean (standard deviation) with 95% confidence interval (CI) for precision. Logistic regression analysis was used to estimate crude odds ratio (OR) and adjusted OR (AOR) with 95% CI, and to identify univariate and multivariate predictors of healthcare-associated infection mortality. Results: In total, 4077 pathogens were isolated, yielding a healthcare-associated infection incidence rate of 22.1%. The most common microorganisms were Acinetobacter spp. (25.0%), Klebsiella spp. (15.1%), Staphylococcus spp. (14.0%), and Candida spp. (12.3%). Ventilator-associated events (39.5%), urinary tract infections (22.7%), and bloodstream infections (14.8%) were the main types of infection. Comorbidities, skin and soft tissue infections, and infections with Acinetobacter spp., Klebsiella spp., Pseudomonas spp., and Candida spp. were significantly associated with higher mortality among intensive care unit patients. Gram-positive bacteria were most resistant to ciprofloxacin (49.2%), clindamycin (38.0%), and erythromycin (37.1%). Gram-negative bacteria were most resistant to ceftazidime (71.0%), ciprofloxacin (65.2%), and cefotaxime (60.5%). The overall mortality rate was 45.2%. Conclusion: Healthcare-associated infections in nearly half of intensive care unit patients were fatal, especially when caused by Acinetobacter spp., Klebsiella spp., Pseudomonas spp., or Candida spp. Therefore, effective strategies must be implemented to combat antibiotic-resistant bacteria, along with stricter adherence to infection control programmes.
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Antibacterianos , Infección Hospitalaria , Humanos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Irán/epidemiología , Estudios Retrospectivos , Farmacorresistencia Bacteriana , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Unidades de Cuidados Intensivos , Ciprofloxacina , Atención a la Salud , Pruebas de Sensibilidad MicrobianaRESUMEN
Type 2 Diabetes Mellitus (T2DM) is a significant public health problem globally. The diagnosis and management of diabetes are critical to reduce the diabetes complications including cardiovascular disease and cancer. This study was designed to assess the potential association between T2DM and routinely measured hematological parameters. This study was a subsample of 9000 adults aged 35-65 years recruited as part of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. Machine learning techniques including logistic regression (LR), decision tree (DT) and bootstrap forest (BF) algorithms were applied to analyze data. All data analyses were performed using SPSS version 22 and SAS JMP Pro version 13 at a significant level of 0.05. Based on the performance indices, the BF model gave high accuracy, precision, specificity, and AUC. Previous studies suggested the positive relationship of triglyceride-glucose (TyG) index with T2DM, so we considered the association of TyG index with hematological factors. We found this association was aligned with their results regarding T2DM, except MCHC. The most effective factors in the BF model were age and WBC (white blood cell). The BF model represented a better performance to predict T2DM. Our model provides valuable information to predict T2DM like age and WBC.
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Diabetes Mellitus Tipo 2 , Cardiopatías , Adulto , Humanos , Estudios de Cohortes , Glucosa , Algoritmos , Aprendizaje Automático , Cardiopatías/complicaciones , Triglicéridos , Factores de Riesgo , Glucemia/análisisRESUMEN
This paper aims to investigate the fuzzy constrained matrix game (MG) problems using the concepts of recurrent neural networks (RNNs). To the best of our knowledge, this paper is the first in attempting to find a solution for fuzzy game problems using RNN models. For this purpose, a fuzzy game problem is reformulated into a weighting problem. Then, the Karush-Kuhn-Tucker (KKT) optimality conditions are provided for the weighting problem. The KKT conditions are used to propose the RNN model. Moreover, the Lyapunov stability and the global convergence of the RNN model are also confirmed. Finally, three illustrative examples are presented to demonstrate the effectiveness of this approach. The obtained results are compared with the results obtained by the previous approaches for solving fuzzy constrained MG.
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In this paper, a neurodynamic model is given to solve nonlinear pseudo-monotone projection equation. Under pseudo-monotonicity condition and Lipschitz continuous condition, the projection neurodynamic model is proved to be stable in the sense of Lyapunov, globally convergent, globally asymptotically stable, and globally exponentially stable. Also, we show that, our new neurodynamic model is effective to solve the nonconvex optimization problems. Moreover, since monotonicity is a special case of pseudo-monotonicity and also since a co-coercive mapping is Lipschitz continuous and monotone, and a strongly pseudo-monotone mapping is pseudo-monotone, the neurodynamic model can be applied to solve a broader classes of constrained optimization problems related to variational inequalities, pseudo-convex optimization problem, linear and nonlinear complementarity problems, and linear and convex quadratic programming problems. Finally, several illustrative examples are stated to demonstrate the effectiveness and efficiency of our new neurodynamic model.