Search Results (37)

Background and Aim: The therapeutic landscape for ulcerative colitis (UC) is rapidly evolving, with an increasing number of biologic agents available. This systematic review and meta-analysis synthesized randomized controlled trials (RCTs) data on biologic therapies for achieving key endoscopic and histologic endpoints in moderate to severe UC. Methods: A systematic search of MEDLINE, EMBASE, Cochrane Library, Web of Science and grey literature was conducted through November 2024. Separate meta-analyses were performed for induction and maintenance. A random-effects model was used to estimate relative risks (RR), with 95% confidence intervals (CI), and confidence in estimates was evaluated with the GRADE approach (Grading of Recommendation Assessment, Development and Evaluation). Results: We included 40 RCTs (13 therapies, 14,369 patients). Thirty-two trials provided data in induction and twenty-eight in maintenance. During induction, all biologic therapies, except mirikizumab and filgotinib 100 mg, demonstrated superiority over placebo (RR 2.02, 95% CI: 1.76–2.31, I² = 72%) for endoscopic improvement. Upadacitinib showed the highest efficacy (RR 5.53, 95% CI: 3.78–8.09). For mucosal healing, all interventions were superior to placebo (RR 2.95, 95% CI: 2.11–4.13, I² = 61%), except filgotinib 100 mg. Risankizumab showed the highest efficacy (RR 10.25, 95% CI: 2.49–42.11). In maintenance, all therapies showed superiority over placebo for endoscopic improvement. For mucosal healing all therapies were superior to placebo, except risankizumab. Upadacitinib 30 mg showed the highest efficacy (RR 4.01, 95% CI: 1.81–8.87). Conclusions: Biologic and small-molecule therapies demonstrated substantial efficacy in achieving key endpoints. Standardized outcome definitions and further head-to-head RCTs are essential to strengthen confidence in our findings. Full article

Background/Objectives: Although the Robin Hood Index (RHI) is increasingly used to quantify geographic health inequality and guide resource redistribution, empirical evidence on whether higher physician density reduces RHI-measured inequality remains limited. This study systematically reviews and meta-analyzes RHI-based research to assess the association between physician distribution and health inequalities. Methods: We conducted a systematic review and meta-analysis of studies using the RHI to evaluate health inequalities, without restrictions on country or publication date. Following PRISMA 2020 guidelines and registered in PROSPERO (CRD42024496486), we searched PubMed, Scopus, and OpenGrey literature, extracted data on physician density and RHI outcomes, and conducted a meta-analysis. Odds ratios (ORs), ln(OR), and 95% confidence intervals (CIs) were calculated, and risk of bias was assessed using the Robvis tool. Results: Seventeen studies covering 720 regions and 1.07 billion individuals were included. Three clusters emerged: physician redistribution (10 studies), poverty–mortality associations (six studies), and systematic reviews (one study). Physician redistribution was strongly associated with increased inequality and policy attention (r = 0.73; p = 0.0038). Meta-analysis of eight redistribution studies yielded a pooled OR of 1.24 (95% CI: 0.54–2.86), consistent in sensitivity analysis (OR = 1.26; 95% CI: 0.56–2.89). Poverty–mortality studies also showed a correlation with the number of variables considered (r = 0.59; p = 0.022). Conclusions: A greater physician supply is associated with increased health inequalities, with statistical support but limited certainty. Methodological heterogeneity in RHI-based studies constrains comparability. Standardized methodologies and broader analytic models are needed to inform research and guide health policy. Full article

The EVM method is an essential project management technique that compares the work done to the planned values (PVs) to identify project variances. However, the inherent uncertainties and possibilities in the project introduce uncertainty in the input data. Despite this importance, the input data for this method is often considered deterministic in most research, and several researchers have modeled it under fuzzy information. In this research, we developed a novel approach using a combined model of fuzzy numbers and grey numbers called interval grey triangular fuzzy (IGTF) numbers. This model is designed to manage the project’s fuzzy grey value, addressing the two pillars of fuzzy and grey uncertainty. The findings of the study indicate that by combining the grey degree of confidence with the triangular fuzzy number (TFN), the results are closer to the real world and more lenient. Finally, based on the estimation of the actual final cost of the project, managers are encouraged to use certainty in lowering costs concerning the value obtained by using the Z-number for the phases of the project. This research provides practical insights and a new model for managing sustainable project uncertainties using fuzzy and grey theories, offering a potential solution to this challenge. Full article

Grey target decision making is a useful tool to solve multiple-criteria decision-making problems. Decision makers’ expected information can reflect their preferences and play an important role in decision process. In this paper, a new grey target group decision-making method considering decision makers’ expected information is proposed. First, based on the decision makers’ expected information, a novel method to obtain synthetical criteria weights combining subjective weights and objective weights is presented. Furthermore, a new way to determine decision makers’ weights is put forward. Moreover, on the basis of the decision matrix, criteria weights, and decision makers’ weights, a ranking method for all alternatives is proposed. Finally, a case for maintaining a precise instrument in a nursing home is used to illustrate the effectiveness of our proposed method. Full article

Chronic venous disease (CVD) is among the most common diseases in industrialized countries and has a significant socioeconomic impact. The diversity of clinical symptoms and manifestations of CVD pose major challenges in routine diagnosis and treatment. Despite the high prevalence and the huge number of venous surgical interventions performed every day, a substantial proportion of the etiopathogenesis remains unclear. There are several widely advocated and generally valid theories of “peri-capillary fibrin cuffs” and “white cell trapping hypothesis”, which consider the role of venous reflux/obstruction, inflammation, vascular remodeling, hemodynamic changes, genetic and social risk factors. There are several specific provoking factors for the development of venous reflux: incompetence of the valve system, inflammation of the vascular wall, and venous hypertension. Over the past few years, increasing scientific data has demonstrated the link between oxidative stress, endothelial dysfunction, and vascular inflammation. High levels of oxidants and persistent inflammation can cause cumulative changes in hemodynamics, resulting in permanent and irreversible damage to the microcirculation and endothelial cells. Production of reactive oxygen species and expression of inflammatory cytokines and adhesion molecules are involved in a vicious cycle of venous wall remodeling. The interaction of ROS, and in particular, the superoxide anion radical, with nitric oxide leads to a decrease in NO bioavailability, followed by the initiation of prolonged vasoconstriction and hypoxia and impairment of vascular tone. This review addresses the role of ED, oxidative, and hemodynamic stress in the CVD mediation. Based on predefined inclusion and exclusion criteria, we conducted a systematic review of published scientific articles using PubMed, PMC Europe, Scopus, WoS, MEDLINE, and Google Scholar databases in the interval from 24 April 2002 to 1 April 2025. The current review included studies (n = 197) scientific articles, including new reviews, updates, and grey literature, which were evaluated according to eligibility criteria. The selection process was performed using a standardized form according to PRISMA rules, the manual search of the databases, and a double-check to ensure transparent and complete reporting of reviews. Studies had to report quantitative assessments of the relationship between vascular endothelial dysfunction, inflammation, oxidative stress, and shear stress in a chronic venous disease. Full article

Grey systems theory, through the special mathematics and methods offered, such as through seeing numbers as intervals rather than fixed values, provides a bridge between the two extreme cases in which a system under investigation might find, namely, a white system, easy to read and understand, and a black system, completely unknown to the investigator. Since its appearance in 1982, the theory has contributed to solving various challenges traditionally addressed through complex means. The paper provides a comprehensive perspective on the evolution of the grey systems domain over the 42-year period analysed, spanning from 1982 to 2024. Utilizing a dataset extracted from the Clarivate Analytics’ Web of Science Core Collection database, the paper conducts a bibliometric analysis that includes the identification of key journals, affiliations, authors, and countries, as well as the collaboration networks among authors and countries. It also analyses the most frequently used keywords and authors’ keywords. The annual growth rate of 12.99% indicates a sustained interest among researchers. Using the Biblioshiny 4.2.3 library in R version 4.4.1, a variety of visualisations have been created, including thematic maps and WordClouds. A detailed review of the most cited papers has been performed to highlight the role of grey systems in advancing intelligent decision-making techniques. In terms of results, it has been observed that the university with the highest contribution to the field is the Nanjing University of Aeronautics and Astronautics while the most influential figure in the area of grey systems in terms of the number of published papers is Sifeng Liu. As expected, China, the home of grey systems theory, is the country with the most notable contribution in terms of published papers and international collaboration networks. Full article

The reliability growth of electromechanical products is a continuous process of addressing reliability defects, which is very important for manufacturing enterprises. At present, research on the reliability growth of electromechanical products mostly focuses on the reliability defects of the products themselves, ignoring the fact that manufacturing enterprises are the executors of product reliability related work. Improving the organizational reliability capability of manufacturing enterprises can enhance the reliability of electromechanical products. In order to understand the current situation of organizational reliability capability (ORC) in electromechanical product manufacturing enterprises and make improvements, this paper establishes an ORC evaluation indicator framework for electromechanical product manufacturing enterprises and evaluates it using the grey evaluation method. Firstly, an evaluation indicator framework for ORC is established based on enterprise research. Secondly, the ORC of electromechanical product manufacturing enterprises is evaluated by combining the three-parameter interval grey number and projection index function. Then, the evaluation results are analyzed from multiple perspectives to understand the current situation and shortcomings of ORC and guide its improvement. Finally, the evaluation indicator framework and method are explained through practical application in CNC machine tool manufacturing enterprises, and the effectiveness of the framework and method is demonstrated through the MTBF growth of CNC machine tools. Full article

Grey sedge (Lepironia articulata Retz. Domin) is a plant endemic to tropical peatlands and is widely used as a handicraft and biodegradable product that brings income to local farmers. However, its habitat has been decreasing due to peatland degradation, which has forced local farmers to harvest L. articulata repeatedly in the same habitat. To examine the effects of repeated shoot cutting at different time intervals on L. articulata growth and biomass yield, a mesocosm experiment was conducted from June 2019 to March 2020 in a tropical peatland in Perigi village, Ogan Ilir District, South Sumatra, Indonesia, using a randomized block design with four treatments and three replicates. The treatments were as follows: P1 (cutting every 1 month), P2 (cutting every 2 months), P3 (cutting every 3 months), and P4 (cutting at 6-months). The results showed that P1 significantly reduced monthly shoot height, shoot diameter, shoot number, dry biomass, cumulative shoot number, and cumulative dry biomass. In contrast, considering L. articulata‘s regenerative growth, the growth and cumulative biomass yield of P3 (1453.5 ± 518.4 g m⁻²) were as good as those of P4. These results indicate that the harvesting interval should be longer than 3 months for the sustainable use of L. articulata in tropical peatlands without damaging its regenerative ability. Full article

Product Identity (PI) is a strategic instrument for enterprises to forge brand strength through New Product Development (NPD). Concurrently, facing increasingly fierce market competition, the NPD for consumer emotional requirements (CRs) has become a significant objective in enterprise research and development (R&D). The design of new product forms must ensure the continuity of PI and concurrently address the emotional needs of users. It demands a high level of experience from designers and significant investment in R&D. To solve this problem, a generative and quantitative design method powered by AI, based on Shape Grammar (SG) and Kansei Engineering (KE), is proposed. The specific method is as follows: Firstly, representative products for Morphological Analysis (MA) are selected, SG is applied to establish initial shapes and transformation rules, and prompts are input into Midjourney. This process generates conceptual sketches and iteratively refines them, resulting in a set of conceptual sketches that preserve the PI. Secondly, a web crawler mines online reviews to extract Kansei words. Factor Analysis (FA) clusters them into Kansei factors, and the Grey Analytic Hierarchy Process (G-AHP) calculates their grey weights. Thirdly, after analyzing the PI conceptual sketches for feature extraction, the features are integrated with CRs into the Quality Function Deployment (QFD) matrix. Experts evaluate the relationships using interval grey numbers, calculating the optimal ranking of PI Engineering Characteristics (PIECs). Finally, professional designers refine the selected sketches into 3D models and detailed designs. Using a Chinese brand as a case study, we have designed a female electric moped (E-moped) to fit the PI and users’ emotional needs. Through a questionnaire survey on the design scheme, we argue that the proposed innovative method is efficient, applicable, and effective in balancing the product form design of PI and user emotions. Full article

Earthquakes pose significant risks to national stability, endangering lives and causing substantial economic damage. This study tackles the urgent need for efficient post-earthquake relief in search and rescue (SAR) scenarios by proposing a multi-UAV cooperative rescue task allocation model. With consideration the unique requirements of post-earthquake rescue missions, the model aims to minimize the number of UAVs deployed, reduce rescue costs, and shorten the duration of rescue operations. We propose an innovative hybrid algorithm combining particle swarm optimization (PSO) and grey wolf optimizer (GWO), called the PSOGWO algorithm, to achieve the objectives of the model. This algorithm is enhanced by various strategies, including interval transformation, nonlinear convergence factor, individual update strategy, and dynamic weighting rules. A practical case study illustrates the use of our model and algorithm in reality and validates its effectiveness by comparing it to PSO and GWO. Moreover, a sensitivity analysis on UAV capacity highlights its impact on the overall rescue time and cost. The research results contribute to the advancement of vehicle-routing problem (VRP) models and algorithms for post-earthquake relief in SAR. Furthermore, it provides optimized relief distribution strategies for rescue decision-makers, thereby improving the efficiency and effectiveness of SAR operations. Full article

This study proposes a novel fuzzy programming optimization model for tugboat scheduling, directly considering multiple berthing bases, time windows, and operational uncertainties. The uncertainties in the required number of tugboats, the earliest start time, the latest start time, the processing time, and the start and end locations of each task are directly captured in the proposed fuzzy optimization model. The objective of the presented formulation is to minimize the total cost of fuel and delays. According to the characteristics of the problem, a Grey Wolf Optimization algorithm based on random probability encoding and custom genetic operators is proposed. The proposed algorithm, LINGO, the canonical Grey Wolf Optimization algorithm, and particle swarm optimization were used to compare and analyze the results of several examples. The results validate the efficiency of the proposed algorithm against the alternative exact and metaheuristics methods. Moreover, the findings from the conducted sensitivity analysis show the applicability of the developed fuzzy programming model for different confidence interval levels. Full article

Due to sensor characteristics, geographical environment, electromagnetic interference, electromagnetic silence, information countermeasures, and other reasons, there may be significant system errors in sensors in multi-sensor tracking systems, resulting in poor track-to-track association (TTTA) effect of the system. In order to solve the problem of TTTA under large system errors, this paper proposes an asynchronous anti-bias TTTA algorithm that utilizes the average distance between the nearest neighbor intervals between tracks. This algorithm proposes a systematic error interval processing method to track coordinates, and then defines the nearest neighbor interval average distance between interval coordinate datasets and interval coordinate points, and then uses grey theory to calculate the correlation degree between tracks. Finally, the Jonker–Volgenant algorithm is combined to use the canonical allocation method for TTTA judgment. The algorithm requires less prior information and does not require error registration. The simulation results show that the algorithm can ensure a high average correct association rate (over 98%) of asynchronous unequal rate tracks under large system errors, and achieve stable association, with good association and anti-bias performance. Compared with other algorithms, the algorithm maintains good performance for different target numbers and processing cycles, and has good superiority and robustness. Full article

Perinatal brain injury is a major contributor to long-term adverse neurodevelopment. There is mounting preclinical evidence for use of umbilical cord blood (UCB)-derived cell therapy as potential treatment. To systematically review and analyse effects of UCB-derived cell therapy on brain outcomes in preclinical models of perinatal brain injury. MEDLINE and Embase databases were searched for relevant studies. Brain injury outcomes were extracted for meta-analysis to calculate standard mean difference (SMD) with 95% confidence interval (CI), using an inverse variance, random effects model. Outcomes were separated based on grey matter (GM) and white matter (WM) regions where applicable. Risk of bias was assessed using SYRCLE, and GRADE was used to summarise certainty of evidence. Fifty-five eligible studies were included (7 large, 48 small animal models). UCB-derived cell therapy significantly improved outcomes across multiple domains, including decreased infarct size (SMD 0.53; 95% CI (0.32, 0.74), p < 0.00001), apoptosis (WM, SMD 1.59; 95%CI (0.86, 2.32), p < 0.0001), astrogliosis (GM, SMD 0.56; 95% CI (0.12, 1.01), p = 0.01), microglial activation (WM, SMD 1.03; 95% CI (0.40, 1.66), p = 0.001), neuroinflammation (TNF-α, SMD 0.84; 95%CI (0.44, 1.25), p < 0.0001); as well as improved neuron number (SMD 0.86; 95% CI (0.39, 1.33), p = 0.0003), oligodendrocyte number (GM, SMD 3.35; 95 %CI (1.00, 5.69), p = 0.005) and motor function (cylinder test, SMD 0.49; 95 %CI (0.23, 0.76), p = 0.0003). Risk of bias was determined as serious, and overall certainty of evidence was low. UCB-derived cell therapy is an efficacious treatment in pre-clinical models of perinatal brain injury, however findings are limited by low certainty of evidence. Full article

Systemic immune-inflammation index (SII), which is a good predictive marker for coronary artery disease, can be calculated by using platelet, neutrophil, and lymphocyte counts. The no-reflow occurrence can also be predicted using the SII. The aim of this study is to reveal the uncertainty of SII for diagnosing ST-elevation myocardial infarction (STEMI) patients who were admitted for primary percutaneous coronary intervention (PCI) for the no-reflow phenomenon. A total of 510 consecutive acute (STEMI) patients with primary PCI were reviewed and included retrospectively. For diagnostic tests which are not a gold standard, there is always an overlap between the results of patients with and without a certain disease. In the literature, for quantitative diagnostic tests where the diagnosis is not certain, two approaches have been proposed, named “grey zone” and “uncertain interval”. The uncertain area of the SII, which is given the general term “gray zone” in this article, was constructed and its results were compared with the “grey zone” and “uncertain interval” approaches. The lower and upper limits of the gray zone were found to be 611.504–1790.827 and 1186.576–1565.088 for the grey zone and uncertain interval approaches, respectively. A higher number of patients inside the gray zone and higher performance outside the gray zone were found for the grey zone approach. One should be aware of the differences between the two approaches when making a decision. The patients who were in this gray zone should be observed carefully for detection of the no-reflow phenomenon. Full article

Sustainable water resources management assessment frameworks (SWRM-AF) with associated indicators and benchmarks have appeared widely during the last decades to improve or maintain water resources. Examination or evaluation of their appropriateness and refinement for particular arid and semi-arid regions is a relatively unexplored area. To fill this gap in knowledge, a systematic review of relevant 21st century studies identified within two extensive databases, Scopus and Engineering Village, and in grey literature, is undertaken in this study. Therein, 17 studies are identified and thoroughly explored to identify their focus, application, and framework construction. The results of the comparative analysis among these frameworks show that the average numbers of components and indicators are 4.5 and 17.6, respectively. Meanwhile, categorical rescaling (47.1%), equal weighting (47.1%), arithmetic technique (82.35%), local scale (52.8%), and interval of the final index value of [0–100] (41.2%) are the most commonly used normalization methods and elements. The paper concludes that none of the existing tools reviewed is 100% applicable for arid and semi-arid regions, and therefore the case is made for developing a new bespoke SWRM-AF. The outcomes of this paper provide some useful insights into what should be included therein (e.g., stakeholder engagement and specific indicators to fit the context). Full article