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Abstract The Pythagorean fuzzy set (PFS) which is an extension of intuitionistic fuzzy set, is more capable of expressing and handling the uncertainty under uncertain environments, so that it was broadly applied in a variety of fields. Whereas, how to measure PFSs’ distance appropriately is still an open issue. It is well known that the square root of Jensen–Shannon divergence is a true metric in the probability distribution space which is a useful measure of distance. On account of this point, a novel divergence measure between PFSs is proposed by taking advantage of the Jensen–Shannon divergence in this paper, called as PFSJS distance. This is the first work to consider the divergence of PFSs for measuring the discrepancy of data from the perspective of the relative entropy. The new PFSJS distance measure has some desirable merits, in which it meets the distance measurement axiom and can better indicate the discrimination degree of PFSs. Then, numerical examples demonstrate that the PFSJS distance can avoid generating counter-intuitive results which is more feasible, reasonable and superior than existing distance measures. Additionally, a new algorithm based on the PFSJS distance measure is designed to solve the problems of medical diagnosis. By comparing the different methods in the medical diagnosis application, it is found that the new algorithm is as efficient as the other methods. These results prove that the proposed method is practical in dealing with the medical diagnosis problems.

Dietary change presents an opportunity to meet the dual challenges of non-communicable diseases and the effects of climate change in China. Based on a food survey and reviewed data sets, we linked nutrient composition and carbon footprint data by aggregating 1950 types of foods into 28 groups. Nine dietary scenarios for both men and women were modeled based on the current diet and latest National Program for Food and Nutrition. Linear uncertainty optimization was used to produce diets meeting the Chinese Dietary Reference Intakes for adults aged 18-50years while minimizing carbon footprints. The theoretical optimal diet reduced daily footprints by 46%, but this diet was unrealistic due to limited food diversity. Constrained by acceptability, the optimal diet reduced the daily carbon footprints by 7-28%, from 3495 to 2517-3252g CO2e, for men and by 5-26%, from 3075 to 2280-2917g CO2e, for women. Dietary changes for adults are capable of benefiting China in terms of the considerable footprint reduction of 53-222Mt.CO2eyear-1, when magnified based on the Chinese population, which is the largest worldwide. Seven of eight scenarios showed that reductions in meat consumption resulted in greater reductions in greenhouse gas emissions. However, dramatic reductions in meat consumption may produce smaller reductions in emissions, as the consumption of other ingredients increases to compensate for the nutrients in meat. A trade-off between poultry and other meats (beef, pork, and lamb) is usually observed, and rice, which is a popular food in China, was the largest contributor to carbon footprint reductions. Our findings suggest that changing diets for climate change mitigation and human health is possible in China, though the per capital mitigation potential is slight lower than that in developed economies of France, Spain, Sweden, and New Zealand.

Few studies on population-specific health effects of extreme temperature on cardiovascular diseases (CVDs) deaths have been conducted in the subtropical and tropical climates of China. We examined the association between extreme temperature and CVD across four cities in China. We performed a two-stage analysis; we generated city-specific estimates using a distributed lag non-linear model (DLNM) and estimated the overall effects by conducting a meta-analysis. Heat thresholds of 29 °C, 29 °C, 29 °C, and 30 °C and cold thresholds of 6 °C, 10 °C, 14 °C, and 15 °C were observed in Hefei, Changsha, Nanning, and Haikou, respectively. The lag periods for heat-related CVD mortality were observed only for 0–2 days, while those of cold-related CVD mortality were observed for 10–15 days. The meta-analysis showed that a 1 °C increase above the city-specific heat threshold was associated with average overall CVD mortality increases of 4.6% (3.0%–6.2%), 6.4% (3.4%–9.4%), and 0.2% (−4.8%–5.2%) for all ages, ≥65 years, and <65 years over a lag period of 0–2 days, respectively. Similarly, a 1 °C decrease below the city-specific cold threshold was associated with average overall CVD mortality increases of 4.2% (3.0%–5.4%), 4.9% (3.5%–6.3%), and 3.1% (1.7%–4.5%), for all ages, ≥65 years, and <65 years over a lag period of 0–15 days, respectively. This work will help to take appropriate measures to reduce temperature-mortality risk in different populations in the subtropical and tropical climates of China.

AbstractThirty‐four alcoholics were treated with acupuncture to the ear and the body in a randomized single‐blind placebo‐controlled design over 14 days. Orthodox points and placebo needles to orthodox points were used daily for a total of 10 treatments starting on the first day of admission as add‐on therapy to standard medication with carbamazepine. The primary outcome was the Clinical Institute Withdrawal Assessment (CIWA‐Ar‐scale) assessed on days 1‐6, 9 and 14. No initial differences were found regarding sociodemographic data, drinking history and alcohol‐related data, indicating successful randomization. Longitudinal analysis of the Clinical Institute Withdrawal Assessment (CIWA‐Ar‐scale) data showed that patients assigned to acupuncture had a general tendency towards better outcome results and significantly fewer withdrawal symptoms on day 14 (Wilcoxon‐W=177.500, Z=‐2.009, p = 0.045). No significant differences were found in the Beck Depression Inventory (BDI), State‐Trait Anxiety Inventory (STAI X1 and X2) and Eigenschaftswoerterliste (EWL S60). We conclude that acupuncture as an adjunctive treatment to carbamazepine medication shows promise for the treatment of alcohol withdrawal symptoms. Further investigation of this treatment modality appears to be warranted.

Beijing-Tianjin-Hebei (BTH) region in China is affected seriously by the hazy weather that has a large impact on human health. PM2.5 is one of the most important reasons for hazy weather. Understanding the PM2.5 emission characteristics from different types of heavy-duty trucks (HDTs) is valuable in policies and regulations to improve urban air quality and mitigate vehicle emission in China. The investigation and analysis on HDT population and PM2.5 emission in BTH region are carried out. The results show that the population and PM2.5 emission of HDTs in BTH has risen for the last four consecutive years, from 404 thousand and 1795 tons in 2012 to 551 thousand and 2303 tons in 2015. The PM2.5 emission from HDTs in Hebei is about 10 times more than that of Beijing and 9 times more than that of Tianjin. The proportion of natural gas HDTs is about 5%; however, its PM2.5 emission only accounts for 0.94% in 2015, which indicates the utilization of HDTs powered by natural gas facilitate PM2.5 mitigation more than diesel in BTH. The tractor and pickup trucks are the main source of PM2.5 emission from different types of HDT, while special and dump trucks are relatively clean. This study has provided insights for management method and policy-making of vehicle in terms of environmental demand.

To determine the safety and effectiveness of transarterial embolization ablation (TEA) of hepatocellular carcinoma (HCC) with a lipiodol-ethanol mixture.Between January 1 and December 31, 2009, 15 patients with HCC (13 men/two women, aged 38-75 years) accepted TEA treatment and were enrolled in this study, including five newly diagnosed patients and 10 with refractory disease. Two months after TEA, angiography and contrast computed tomography (CT) were performed, and responses were assessed using a modified version of Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). The follow-up period was to June 30, 2010.Every new case was treated once. Angiography was performed immediately after TEA, and showed that the tumor-feeding vessels were completely embolized and that lipiodol was densely deposited inside tumors. Two months after treatment, contrast CT showed no enhanced lesions. Alpha fetoprotein levels returned to normal in four patients and markedly decreased in another. mean ± SD survival after treatment was 10.8 ± 4.5 mo. All five patients survived during the follow-up period. Ten patients with refractory disease were treated a total of 14 times. Angiography immediately after TEA showed that blood flow to the tumors was obviously decreased in all cases, and contrast CT showed obvious depositions of lipiodol. Two months after treatment, the tumors had shrunk (6/10) or were stable (3/10). One had progressed after 2 mo and died of tumor rupture 3 mo after TEA. mean ± SD survival after treatment was 8.6 ± 4.3 mo; two patients survived during the follow-up period. Adverse effects included reversible hepatic decompensation, upper abdominal pain, and fever.TEA is an effective therapy for patients with HCC and might be more effective than transcather arterial chemoembolization for treating refractory disease.

The science of statistics contributes to the development and application of tools for the design, analysis, and interpretation of empirical medical studies [...]

In a world with climate change and environmental pollution, modern Biology is concerned with organismic susceptibility. At the same time, policy and decision makers seek information about organismic susceptibility. Therefore, information about organismic susceptibility may have far-reaching implications to the entire biosphere that can extend to several forthcoming generations. Here, we review a sample of approximately 200 published peer-reviewed articles dealing with plant response to ground-level ozone to understand how the information about susceptibility is communicated. A fuzzy and often incorrect terminology was used to describe the responsiveness of plants to ozone. Susceptibility was classified too arbitrarily and this was reflected to the approximately 50 descriptive words that were used to characterize susceptibility. The classification of susceptibility was commonly based on calculated probability (p) value. This practice is inappropriate as p values do not provide any basis for effect or susceptibility magnitude. To bridge the gap between science and policy decision making, classification of susceptibility should be done using alternative approaches, such as effect size estimates in conjunction with multivariate ordination statistics.