Using the DEMATEL-VIKOR Method in Dam Failure Path Identification.

Dams are important water-resisting structures prone to failure, causing huge economic and environmental losses. Traditionally, a dam failure is identified using the failure mode and effect analysis. This approach analyzes both the dam failure path (the specific effect chain of the failure mode) and the damage degree, by identifying and sorting the severity caused by the dam failure path. However, this analysis can be misleading since the relationship among the failure paths is not considered. To account for this, the DEMATEL method is used to modify the evaluation result of the severity of the failure consequence, caused by the dam failure path. Based on the fuzzy mathematics and VIKOR method, a dam failure path identification method is established, and then the dam failure paths are identified and sorted for a case study: gravity dam located at the junction of Yibin County (China). According to results, the two top initial failure paths were insufficient design of upstream anti-seepage (R6) or defective water-tight screen and corrosion (R7).

Impact of surgical margin status on the outcome of bladder cancer treated by radical cystectomy: a meta-analysis.

Data regarding the association between surgical margin status and the outcome of bladder cancer treated by radical cystectomy (RC) are conflicting. Therefore, the present meta-analysis was performed to assess the associations between the outcomes of bladder cancer, in terms of recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS), and the presence of positive surgical margins versus negative surgical margins following treatment with RC. Research articles published prior to April 2016 were identified from Pubmed, Embase and the Cochrane Library databases. A total of 36 articles were included, with a sample size of 38,384 bladder cancer patients. Of these, 4,354 patients were reported to have positive surgical margins. Significant associations were detected between positive surgical margins following RC and unfavorable RFS [summary relative risk estimate (SRRE), 1.63; 95% confidence interval (CI), 1.46-1.83; P = 0.105], CSS (SRRE, 1.82; 95% CI, 1.63-2.04; P = 0.001) and OS (SRRE, 1.68; 95% CI, 1.58-1.80; P = 0.805), by fixed or random effects models. The findings were consistent independently of age, sample size, publication year, follow-up duration, study type and geographical region. In summary, the present findings demonstrate that the presence of positive surgical margins is associated with poor survival outcomes in bladder cancer following RC, indicating that avoidance of positive surgical margins during surgery is helpful to improve the prognosis of patients with bladder cancer.