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Distance measures are among the most studied phenomena for deciding the degree of belongingness between the two distinct objects. This paper presents a new distance measure among intuitionistic fuzzy sets (IFSs) using the generalized difference sequence spaces within p-summable intuitionistic fuzzy bounded variation (IFBV). The IFBV is a procedure used to approximate the arc-length of an intuitionistic fuzzy-valued function (IFVF) over the IFS, i.e. distance function of all data points of IFS distributed over the geometrical structure of IFBV with power p. The topological uniqueness in the proposed distance measure made it distinguishable, independent from the reflective relationship, and free from the reflective symmetry. All distance measure characteristics are satisfied, and various situations showing the inclusive relations within distance metrics are drawn. Moreover, the proposed distance measure is applied for multi-attribute decision-making approaches, namely the TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) and GRA (Grey Relational Analysis) techniques. An improved Intuitionistic Fuzzy TOPSIS (IFTOPSIS) and Trapezoidal Intuitionistic Fuzzy GRA (TrIFGRA) techniques are developed to demonstrate the superiority of proposed distance measure with several established ones. With suitable examples, we thoroughly illustrate the functioning of the IFTOPSIS and TrIFGRA decision-making procedures. Extensive comparisons with other popular distance measures are performed to check the effectiveness of our proposed distance measure. [ABSTRACT FROM AUTHOR]

Benzocaine is a widely used topical oropharyngeal anesthetic and has been reported to cause methemoglobinemia. We discuss benzocaine-induced methemoglobinemia and review the causes, presentation, and management of this serious complication. Treatment with methylene blue will result in reversal of methemoglobinemia and clinical recovery in most cases but needs to be used at appropriate doses in carefully selected individuals. Physicians who perform procedures involving the application of benzocaine for topical anesthesia need to rapidly identify and treat methemoglobinemia to avoid significant associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

The relentless drive toward miniaturization in microelectronic devices has sparked an urgent need for materials that offer both high thermal conductivity (TC) and excellent electrical insulation. Thermal interface materials (TIMs) possessing these dual attributes are highly sought after for modern electronics, but achieving such a combination has proven to be a formidable challenge. In this study, a cutting‐edge solution is presented by developing boron nitride (BN) and graphite films layered silicone rubber composites with exceptional TC and electrical insulation properties. Through a carefully devised stacking‐cutting method, the high orientation degree of both BN and graphite films is successfully preserved, resulting in an unprecedented through‐plane TC of 23.7 Wm−1 K−1 and a remarkably low compressive modulus of 4.85 MPa. Furthermore, the exceptional properties of composites, including low thermal resistance and high resilience rate, make them a reliable and durable option for various applications. Practical tests demonstrate their outstanding heat dissipation performance, significantly reducing CPU temperatures in a computer cooling system. This research work unveils the possible upper limit of TC in BN‐based TIMs and paves the way for their large‐scale practical implementation, particularly in the thermal management of next‐generation electronic devices. [ABSTRACT FROM AUTHOR]

Background: The accurate and timely completion of patient admission notes is crucial for high-quality patient care and effective communication among healthcare providers. In the Pulmonology ward, where patients with respiratory conditions receive specialized treatment, comprehensive and prompt documentation of admission information is paramount. The complexity of these conditions and potential for acute exacerbations make accurate and timely documentation even more critical for guiding appropriate interventions and ensuring patient safety. Methodology: This uni-disciplinary audit reviewed prospective admission records and associated data for each patient over one month, with a sample size of 75 patients. The initial audit was conducted from June to July 2023 in the Pulmonology ward of Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur. Following initial audit recommendations, a proforma on patient admission notes with pre-written variables was created and explained to house officers and postgraduate residents. A subsequent re-audit was conducted from September to October 2023 to compare results with the initial audit. Results: The audit findings indicated a need for improvement in the timeliness of patient attendance and the documentation of initial assessments, vital signs, and treatment plans. The re-audit suggested improvements in patient attendance timeliness and initial assessment with vital sign recordings. However, the treatment chart signatures, and postgraduate resident stamps still needed improvement. Conclusion: Implementing the suggested recommendations can enhance patient care and ensure compliance with established protocols. Regular monitoring and follow-up audits are recommended to evaluate the effectiveness of the changes. [ABSTRACT FROM AUTHOR]

Fuzzy goal programming (FGP) is applied to solve fuzzy multi-objective optimization problems. In FGP, the weights are associated with fuzzy goals for the preference among them. However, the hierarchy within the fuzzy goals depends on several uncertain criteria, decided by experts, so the preference relations are not always easy to associate with weight. Therefore, the preference relations are provided by the decision-makers in terms of linguistic relationships, i.e., goal A is slightly or moderately or significantly more important than goal B. Due to the vagueness and ambiguity associated with the linguistic preference relations, intuitionistic fuzzy sets (IFSs) are most efficient and suitable to handle them. Thus, in this paper, a new fuzzy goal programming with intuitionistic fuzzy preference relations (FGP-IFPR) approach is proposed. In the proposed FGP-IFPR model, an achievement function has been developed via the convex combination of the sum of individual grades of fuzzy objectives and amount of the score function of IFPRs among the fuzzy goals. As an extension, we presented the linear and non-linear, namely, exponential and hyperbolic functions for the intuitionistic fuzzy preference relations (IFPRs). A study has been made to compare and analyze the three FGP-IFPR models with intuitionistic fuzzy linear, exponential, and hyperbolic membership and non-membership functions. For solving all three FGP-IFPR models, the solution approach is developed that established the corresponding crisp formulations, and the optimal solution are obtained. The validations of the proposed FGP-IFPR models have been presented with an experimental investigation of a numerical problem and a banking financial statement problem. A newly developed distance measure is applied to compare the efficiency of proposed models. The minimum value of the distance function represents a better and efficient model. Finally, it has been found that for the first illustrative problem considered, the exponential FGP-IFPR model performs best, whereas for the second problem, the hyperbolic FGP-IFPR model performs best and the linear FGP-IFPR model shows worst in both cases. [ABSTRACT FROM AUTHOR]

Introduction: Lung resection surgery is a challenge to thoracic surgeons. The outcome of this surgery depends on patients' tolerance for reduced lung volume and hemodynamic alterations. The present study aimed to investigate the changes in blood gases and hemodynamic parameters in patients undergoing lung resection surgery and the associated clinical implications. Material and Methods: This study included 25 candidates for lung resection surgery. After thoracotomy, the isolation of pulmonary artery (PA) and veins was performed as usual. Blood samples were taken from the PA and radial artery simultaneously before PA clamping, as well as 5 and 20 min after clamping the PA. The systemic and PA pressure was also measured. All patients were followed up, and arterial blood gas and pulmonary function tests were performed 3-6 months after the surgery. Results: Cough (56%) and hemoptysis (56%) were the most common symptoms. Squamous cell carcinoma (56%) was identified as the most prevalent pathology. Lobectomy was the most common procedure performed on the patients. No change was observed in blood gases before and after the clamping of the PA. There was a significant increase in the mean PA pressure (P<0.001), while the mean arterial pressure showed no significant change (P=0.457). The pulmonary function tests showed a significant decrease in vital capacity, forced vital capacity, and forced expiratory volume in 1 sec at the postoperative follow-up. The patients with a pre-operative partial pressure of carbon dioxide (PCO2) of > 45 mmHg had more postoperative complications than those with a PCO2 of = 45 mmHg (P=0.047). Conclusion: Given the lack of any significant changes in the PCO2 and oxygen saturation following the lung resection surgery, it seems that this parameter is not a limiting factor for deciding on operability in patients with lung lesions having an acceptable preoperative partial pressure of oxygen. However, the patients with a PCO2 of > 45 mmHg should be categorized as a high-risk group since they have significantly higher postoperative complications/morbidity. [ABSTRACT FROM AUTHOR]