http://hdl.handle.net/10498/6722 Thu, 05 Nov 2026 04:25:40 GMT 2026-11-05T04:25:40Z http://hdl.handle.net/10498/40498 Multicompartmental prolapse: A comparative study between clinical examination and ultrasound García-Mejido, José Antonio; Salas Álvarez, Olaya; Bugatto González, Fernando; Fernández-Palacín, A.; Fernández Palacín, Fernando; Sainz Bueno, José Antonio Objective: The accurate diagnosis of multicompartment pelvic organ prolapse (POP) is fundamental to surgical success. This study aims to compare the diagnostic performance of transperineal ultrasound against clinical examination (pelvic organ prolapse quantification, POP-Q) for the detection of compartmental defects in patients with multicompartment POP, using assessment under spinal anesthesia as the reference standard. Method: A prospective randomized diagnostic accuracy study was designed, including 129 patients scheduled for multicompartment POP surgery. Patients were randomly assigned to undergo either a preoperative POP-Q two-dimensional transperineal ultrasound assessment. The reference standard for all patients was the intraoperative POP-Q assessment, conducted under spinal anesthesia immediately before surgery. Sensitivity, specificity, and likelihood ratios (LR) were calculated for each method and compartment. Results: Both techniques demonstrated high sensitivity for the diagnosis of cystocele (100% vs 98.3%). However, their performance varied across the other compartments. Ultrasound showed superior specificity for uterine prolapse (73.4% vs 45.4%) and rectocele (86.3% vs 66.0%) and was particularly robust in confirming enterocele (LR+ of 10.5). In turn, clinical examination had a higher sensitivity for detecting rectocele (61.5% vs 21.4%) and was highly reliable for ruling out cystocele and uterine prolapse (LR− of 0). Conclusion: Clinical examination and ultrasound are complementary in the diagnosis of prolapse. Their combined use is key to accurate surgical planning. Thu, 01 Jan 2026 00:00:00 GMT http://hdl.handle.net/10498/40498 2026-01-01T00:00:00Z http://hdl.handle.net/10498/40417 Robust penalty function method for an uncertain multi-time control optimization problems Jayswal, Anurag; Preeti; Arana Jiménez, Manuel This paper gives some new results on multi-time first-order PDE constrained control optimization problem in the face of data uncertainty (MCOPU). We obtain the robust sufficient optimality conditions for (MCOPU). Further, we construct an unconstrained multi-time control optimization problem (MCOPU) corresponding to (MCOPU) via absolute value penalty function method. Then, we show that the robust optimal solution to the constrained problem and a robust minimizer to the unconstrained problem are equivalent under suitable hypotheses. Moreover, we give some non-trivial examples to validate the results established in this paper Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10498/40417 2022-01-01T00:00:00Z http://hdl.handle.net/10498/40378 Fréchet and Gateaux gH-differentiability for interval valued functions of multiple variables Stefanini, Luciano; Arana Jiménez, Manuel; Sorini, Laerte In this work we extend concepts of differentiability for Interval-Valued functions (IVfunctions) of multiple variables, based on generalized Hukuhara gH-difference. In this context, we introduce a new concept of gH-linearity and characterize the class of gHlinear IV-functions, which are fundamental for a general approach to Fréchet-type and Gateaux-type gH-differentiability of the first order. We moreover consider vector IVfunctions and outline the definition of the gH-Jacobian; by representing intervals and IV-functions in midpoint-radius notation, we establish properties and relations between pointwise, Fréchet and Gateaux gH-differentiability. Finally, higher-order differentiability and gH-Hessian matrix are considered. These intuitive concepts are mathematically and computationally easy to work with. Sat, 01 Feb 2025 00:00:00 GMT http://hdl.handle.net/10498/40378 2025-02-01T00:00:00Z http://hdl.handle.net/10498/40371 An enhanced interval slacks-based model to solve inverse DEA for estimating outputs Arana Jiménez, Manuel; Lotfi, Farhad Hosseinzadeh; Younesi, Atefeh This study proposes a non-radial slacks-based Inverse Data Envelopment Analysis (Inverse DEA) framework for decision-making units under interval data. To address uncertainty in both inputs and outputs, the methodology integrates interval arithmetic with partial ordering, enabling robust efficiency evaluation. The research investigates how output levels should be adjusted when inputs increase, and the inefficiency score of a unit decreases by a specified proportion. An enhanced inverse DEA model is developed, and necessary and sufficient conditions for output estimation are derived through the Pareto optimal solutions of a multi-objective nonlinear program. Two illustrative examples are provided to illustrate the applicability of the proposed approach under interval data scenarios. Mon, 27 Apr 2026 00:00:00 GMT http://hdl.handle.net/10498/40371 2026-04-27T00:00:00Z