Policies that affect animals need to consider which animals can experience suffering and other positive or negative feelings. Policymakers, therefore, need to determine which animals should be treated as sentient. This requires answering several questions about the definition, criteria, evidence requirements and sources, and how far the conclusions should be generalized. These should use scientific evidence where available, but the process is also full of ethical aspects that should conform to ethical principles applicable to policymakers, such as selflessness, objectivity, accountability and openness.Deciding which animals are sentient is an important precursor for decisions about the application of animal welfare legislation, and the wider assessment of the impacts of policies on animal suffering. We ascribe sentience in order to inform decisions about how animals should be treated, and how their treatment should be regulated. This ascription is both an ethical and an evidential process, and what evidence to use and require are ethical questions. Policymakers, therefore, cannot simply rely on scientific evidence in an ethically neutral way, but must be conscious of the ethical assumptions and positions underlying the process of ascription and its application in policy and law. As such, ethical principles that apply to policymaking apply to the ascription of sentience. This paper considers the implications of the Nolan principles for public service on the ascription of animals. My Octopus Teacher), and academic enquiry e.g., [Sentience. It is also an ethically relevant question insofar as the ascription of sentience effectively constitutes an “entry ticket” to being morally considered. Similarly, government and intergovernmental policies in relation to the ascription of sentience to animals are important because they affect how the treatment of animals is regulated by further policies and legislation such as the European Union Treaty of Lisbon in 2007.Sentience–the ability to experience positive and/or negative feelings–is an important question in contemporary policymaking. The ascription of sentience to animals is a matter of public interest : selflessness, integrity, objectivity, accountability, openness, honesty, and leadership. These standards were first set out in 1995 in the first report on the Committee on Standards in Public Life  and wereThis paper considers some of the questions for policymakers–conceived broadly–to answer when deciding which animals to protect as sentient, highlighting the importance of elucidating and determining the underlying ethical and conceptual concerns. This paper is primarily an argument for attention to be given to the fact that many ethical considerations are implicitly included in the ascription of sentience.In light of this, this paper is further an argument for policymakers to ensure that definitions and norms for the ascriptions of sentience are explicit and both evidentially and ethically justifiable. As ascriptions form part of the policymaking process in relation to animals, the general principles such as Nolan principles that apply to policymaking are applicable (and should be applied) to the methods of ascribing sentience to nonhuman animals. So, this paper then illustratively considers the implications of the Nolan principles on the ascription of animals, referencing the recent consideration of the sentience of cephalopods as examples. While the Nolan principles and recent debates are UK-based, the considerations are applicable to relevant policymaking more widely.While the question of which animals are sentient may seem simple, it is important to understand exactly what is being asked in the policymaking process. In fact, when the question is operationalised, it can be seen as a combination of several questions that it is useful to separate. These might be categorised as questions of definition and criteria; questions of source; questions of evidence; and questions of generalisation.A good place to start is to ask what sentience is and can be operationally assessed.An obvious question is what definition to use. In the first place, what are we referring to when we ask if an animal is sentient? As well as the basic question of what sentience ‘is’, we have secondary questions about how narrow or broad (and how vague or precise) a useful definition should be . If a definition is too narrow and precise then policies will exclude animals from needed protection a priori. If a definition is too broad, policies could unnecessarily prevent the protection of sentient animals, for example if they were to protect insentient pathogens at the expense of sentient patients. If the definition is too vague, then policies risk contention and confusion about the very task of ascription.A second obvious question is which observable criterion or criteria are relevant to an ascription of sentience. While ascriptions might be based on metaphysical or ontological assumptions , secular policymaking generally requires a systematic and scientific process for ascribing sentience. The attribution of sentience also faces background questions of whether animals’ feelings, as subjective states, are ones that we can directly observe or quantify. However, it appears to be generally assumed within the policies under discussion that we can at least infer animals’ feelings .We need justifiable ways to assess which data we should count and which we should discount. We face the most salient question of what criteria constitute evidence of sentience . Behind this question are more technical questions such as how theoretically-laden and specific to be in developing our criteria .Methods of ascription might draw analogies that compare animals to humans, assuming associations between observable features and unobservable experiences. This raises questions of which properties need to be similar, and how similar they need to be, for an animal to be deemed sentient. To answer this, we might turn to abductive reasoning that identifies best explanations of behaviour that involve experiences, but scientists and philosophers have proven highly versatile in generating explanations  that do not require experiences as part of the explanation.As a specific example, policymakers might base ascriptions partly on analogies between human and other animals’ central nervous systems. However, this leaves how we define (sufficiently) humanlike open. There is evidence that central neocortices are associated with sentience in ourselves, but this does not mean they are a necessary or a sufficient criterion. It is certainly conceivable that the very different neural structures of cephalopods might be sufficiently complex to support feelings despite their dissimilarities to humans . As anotPolicymakers might use many candidate criteria. The DEFRA assessment of cephalopod and decapod sentience used a combination of neurological and behavioural criteria adapted and improved from , see alsThe third question is how important different criteria are. While no criterion is necessary or sufficient for proof, they may be more or less convincing. For example, the DEFRA-commissioned study proposed that the criterion that animals value a putative analgesic or anaesthetic when injured in particular ways “provides particularly compelling evidence in its own right” whereas the criterion of possessing nociceptive receptors sensitive to noxious stimuli “could only ever form a small part of a wider case for sentience, due to the difference between sentience and nociception” .Rattus norvegicus), would satisfy all of them [Often, we assess the criteria with reference to how specific and sensitive they appear to be. The DEFRA-commissioned assessment notes that “Our criteria are not unreasonably demanding (they are not demands for absolute certainty). This can be seen by noting that well-researched mammals, such as lab rats  of evidence are relevant for assessing sentience. In everyday life, we use direct intuition or perceptions , and such views might be collated and assessed e.g., . HoweverHowever, the decision to use scientific evidence in making ascriptions is not inevitable: it is a decision. Indeed, it is one that is not ethically neutral insofar as it involves decisions to endorse the assumptions of a scientific approach  and insofar as it implies an endorsement of the implications of that approach (e.g. the policies that apply if sufficient scientific evidence is lacking). The inherent ethical components underlying scientific questions has been well recognised for decisions about how animal welfare scientific data should be used to decide how sentient animals should be treated ,29. It iAscribing sentience is not a simple matter of science or fact. It is a policy question. It is about what animals we treat as sentient, and it is about how we decide to make ascriptions. As a policy question it has both an evidential and a normative basis. What evidence exists, and its reliability, are evidential questions that can be addressed scientifically. However, what evidence to use and acquire, and how and how far to apply it, are ethical questions. These questions not only have ethical implications in how we treat animals, but our method of ascription is itself an ethically-loaded process on which we should decide. The methods of attribution prescribed in policies are essentially normative. Policies’ definitions and ascriptions happen (and should happen) inside an ethical framing, which occurs when scientists or policymakers create frameworks for ascription of sentience (which may be more or less conscious to the investigators).Deferring to scientific evidence requires recognition and acceptance of the consequences of that deferral as a de facto decision on how animals can be treated. Policymakers, therefore, cannot simply draw on scientific evidence in an ethically neutral way, but must be conscious of the ethical assumptions and positions underlying the process of ascription and its application in policy and law. The application of science cannot absolve policymakers of responsibility for the implications of a scientific approach.In practice, there is often varying amount of evidence to support an ascription of sentience. Science is a process, and the use of scientific data relies on the studies being conducted and researched. Evidence therefore provides support to varying degrees, without ever constituting a definitive proof against strict inclusion/exclusion criteria. This support is partly a matter of the number and power of studies, but complicated also by the frequent variety of types of evidence, for example if a species exhibits multiple different forms of associative learning in different contexts, where there might be different levels of evidence for each.In particular, policymakers often lack evidence not because of any properties of the animals themselves, but because scientific studies have simply not been done, or have been done at an insufficient power to reject their null hypotheses. For example, there have been several studies on octopods and true crabs in comparison to other cephalopods  and decapods  and the weight of evidence is in proportion to the scientific attention devoted to each taxon or species .Policymakers need to answer three key questions in relation to how much evidence is needed:The first question is whether the policies need to be framed as binary categories of (treated as) “sentient” vs. “insentient”. This approach is tempting insofar as it tries to mirror what we may assume is the ontological reality that animals either are or are not able to experience feelings. However, it does not reflect the discreteness and complexity of the evidence, where many criteria admit of degrees . We need a way to deal with such continuous data without oversimplification.The second question for policymakers is specifying what weight and strength of evidence is sufficient–or satisfising–to ascribe sentience (or insentience) against the given criteria. For example, if it is considered that self-administration of analgesics is a criterion, how much evidence is needed to demonstrate self-administration: a single observation, a single study , a series or a meta-analysis. This is even more complicated when considering the cumulative evidence across multiple criteria. Even when there is evidence, there is the potential for disagreement over whether the available evidence is sufficient, and an unavoidable risk of some people wanting to call for more (or different) evidence (hopefully in good faith).Decisions about the threshold of what evidence is sufficient have effective and practical implications, particularly insofar that animals for which there is “insufficient” evidence can be treated in certain ways that would be considered unethical if they were deemed sentient. Under the UK’s Animal Welfare Act 2006 and Animal Health and Welfare (Scotland) Act 2006, whether ministers are satisfied that animals are of a kind capable of experiencing pain or suffering, affects whether they are then protected against unnecessary suffering and whether those responsible for them are required to adequately meet the needs of (sentient) animals in their care, whereas those that are not aere excluded from the protection afforded by that legislation.prove facts per se, it can only reach degrees of confidence in an association, theory or belief. More specifically, it is arguably impossible for there to be enough evidence to prove sentience (except in oneself at a particular time). The same logic means we cannot prove insentience either.The decision on what counts as “sufficient” cannot be a purely scientific question but one that relies on a metacognitive  assessment of the evidence. Generally, science cannot This explains why there is the potential for disagreement even in the face of similar evidence. For example, some cephalopods have been considered sentient in the UK’s Animals (Scientific Procedures) Act (Amendment) Order 1993 and the Welfare of Animals (Transport) (England) Order 2006 but were not included as (sentient) animals under the Animal Welfare Act 2006 and Animal Health and Welfare Act 2006. As the latter were subsequent or contemporaneous with the former, these differences cannot have been due to the evidence available (first-hand evidence aside), but on the use of that evidence.A third question is what the policy should be in the absence of sufficient evidence. Assuming we have a definition and evidential criteria for ascribing sentience, policymakers need to decide what default policy should be followed in the absence of enough data to the contrary. Do we assume insentience  in the absence of sufficient evidence for sentience, or do we assume sentience (and the associated degree of protection) in the absence of evidence that warrants sufficient doubt? In essence, policymakers need to choose whether to place the “burden of proof” on ascribing sentience or on refuting it. Obviously, this decision has implications for all cases where there is insufficient evidence to meet the requisite burden. For example, Cephalopods were afforded “the benefit of the doubt” by the Animals Procedures Committee proposed in 1992 , whereasIn the policymaking context, this default policy may not explicitly relate to an ascription. It might be framed entirely in terms of other policy areas, for example if animals deemed insentient are therefore outside the scope of animal welfare protection policies, this means that their protection is not an exception to wider policies of how animals are treated. In particular, it might be that humans are allowed to treat such animals in any way they like  or in ways that conserve the historic level of protection . In the case of cephalopods and decapods, this would affect whether their use would come under the relevant regulations relating to animals in scientific procedures, farming, wildlife and welfare at the time of killing. If not, the research, farming, management or slaughter may be permitted using methods that are otherwise permissible (or even subsidized in some cases).When there is relevant and sufficient evidence for some animals to be considered sentient, policymakers also need to decide how far to generalise across taxa and ages. Are ascriptions applicable only to fully mature adults, or to certain earlier developmental stages or chronological cut-off points? Are they applicable at the level of species, genera, classes, infraclasses, families, phyla or kingdoms? It seems hard to avoid arbitrary policies without valid rules of generalisation. The risks are parallels to the risks related to the choice of criteria and evidence: over-generalisation might include animals who are insentient ; under-generalisation might exclude sentient animals .The first question is about how far we can legitimately generalise in the absence of data relating to all species or development types. Very few of the millions of species and billions of animals  have been scientifically studied against recognised criteria of sentience. The fundamental issue underlying this question is that observable features, such as neuroanatomy, physiology and biochemistry are partly but incompletely conserved across taxa . The wider the generalization across more diverse animals, the lower the shared degrees of similarity and the weaker the argument for such widespread ascriptions. Before obtaining data, policymakers may decide how widely they are willing to extrapolate data across groups.The question of generalisation may be taken, at least partly, as prior to the evidence-gathering. This is firstly seen in terms of the scoping of each analysis, for example the SAWC opinion considered only cephalopods ; the DEFspecifics of observable characteristics in humans might seem “accidental” and applying them too narrowly in scope  might make them too restrictive to usefully inform ascriptions of sentience. The wider the generalisation, the greater the likelihood of similar functions with different features or vice versa, which may be the result of convergent or divergent evolution.The second question concerns how generically criteria are specified or interpreted in the face of interspecific differences. This question represents a philosophical conundrum if the model for ascribing sentience is based on generalisations from ourselves (as the one species some of which we can each confidently deem sentient). The More precisely, the extrapolation is from oneself, as the one individual we can each confidently deem sentience . HoweveAs one example, within the Animal Welfare Act 2006, policymakers specified the limits of generalisations as a single criterion–being a vertebrate–thereby excluding invertebrate cephalopods. However, this criterion is not particularly generic insofar as it relies on a specific neuroanatomical/phylogenetic criterion for ascribing sentience: the presence of a spinal column, i.e., a skeletal and neural linear structure , when it is entirely conceivable for sentience to correlate to other neural structures. As another example, invertebrates may have different neurotransmitters and so their behaviour may be modulated by different pharmacological tests . The more specific the features described, the narrower the generalization can be expected to be, and thus the narrower the ascription of sentience and protection–and, conversely, the wider the “default” policies will apply to those animals beyond the generalization.observable evidence can be expected to be found . This avoids assuming that a clade maps precisely onto an inductive rule of ascription, since it allows us to recognise where individual members of a clade do not show that evidence  and revert to more robust, individual-level methodsScientific data are important for determining observable associations and how widely they can be generalised across taxa. This implies that taxa are not sufficient or necessary criteria for absolute general ascriptions, which would mean that all or only animals in a given clade are sentient. . Taxa are practically useful in making predictive, inductive generalisations about how widely What might, or should, the implied ethical features be in a policy-making context? There are many ethical concepts that might be relevant and could be applied as relevant principles for policymaking, including normativity, cognitivism, naturalism, prescriptivity, universalizability, justice, generic consistency, categorically imperative, reflective equilibrium, equipoise, and calculus. However, to narrow the field to what is achievable within a single paper, the following analysis shall consider the Seven Principles of Public Life (aka. Nolan Principles)-selflessness, integrity, objectivity, accountability, openness, honesty, and leadership-and their application to ascribing sentience.The principle of selflessness asserts that ‘Holders of public office should act solely in terms of the public interest.’ While the Committee doubtless had in mind the personal interest of humans, it is worth considering how we might consider a wider concept of public interests in animal protection.per se a matter of perception or cognition (or language), but a matter of being able to have positive and negative experiences. For example, the SAWC defined animal sentience as: ‘the ability to have physical and emotional experiences, which matter to the animal, and which can be positive and negative’ [The principle of selflessness firstly highlights that the ascription of sentience, like other policies, is a normative matter in terms of its purpose and impact. The reason for ascribing sentience is to protect vulnerable animals who can experience suffering or other feelings, and to help society to avoid causing unjustified suffering or deprivation. This dictates an appropriate definition for sentience by relating it to experiences that matter. Sentience in this understanding is not egative’  and the egative’ .On hedonic or teleological ethical approaches, these would include experiences that matter to the animal. We might also include experiences that relate to animals’ assessments of what matters. This would suggest we are concerned with valenced affective states  or motivational states . In this, while we might see ascriptions as ultimately based on empathy, it is not necessary to be able to describe precisely “what it is like” subjectively to be a bat or how they experience “red”, but simply to recognise the evidence for valenced or motivational experiences.Selflessness is, secondly, also about ensuring our ascriptions are not ones that benefit only ourselves, and in this context “ourselves” relates to our species. Policies should aim to protect all sentient animals. Specifically, selflessness requires policymakers to avoid unduly prioritising human interests in the exploitation of animals whose sentience is under question  can also be expected to benefit humans).Put simply, assessments on whether a species is sentient should not be affected by the purely financial implications of that assessment. Even if a practice such as live boiling is widespread and lucrative or enjoyable , that should not affect whether the animals affected should be deemed sentient.One potential solution to this is to recognize these partialities as post hoc exemptions, rather than trying to retrofit our ascriptions to suit them. In other words, policies can ultimatel sentience where the evidence supports it and then transparently factor economic and other concerns into the policies about how those animals are treated. While this still might not ultimately afford animals the protection needed, it at least locates debate in the right point in the policymaking process.ceteris paribus, to be far worse to falsely deny sentience than to falsely ascribe it. So, without embracing an overly liberal ascription , policies can be expected to have a greater utility if there is a modest presumption of erring towards (rather than against) an assumption of sentience. It is selfless to give animals the benefit of the doubt, when doing so has relatively minor impacts on our own wellbeing .Indeed, we might go further and suggest that selflessness would prescribe giving animals the benefit of the doubt. There is an asymmetry in getting ascriptions wrong: it is likely, A slightly different principle is that of integrity. Integrity in this context relates to recognising and avoiding and resolving any ‘inappropriate influence’ towards oneself, one’s relatives or other people or organisations in their work. We have considered biases towards humans’ non-moral interests under selflessness, which could manifest themselves as undue pressures from those who benefit from using animals in ways that would cause sentient animals suffering. There are also other potential influences that favour humans.At its broadest, this principle suggests that we should not be unduly influenced towards ascribing sentience to ourselves above other animals. Applied to ascription, this means avoiding solipsism regarding oneself or human exceptionalism regarding one’s species and, more widely, avoiding systematic pro-human assumptions. It does not mean ignoring the plausible view that we can have greater confidence in (most) humans’ sentience than (most) other animals’, but it requires the greater confidence in human sentience should be the a posteriori result, rather than an inbuilt a priori assumption, of the methods.Some quite subtle pro-human influences risk being structurally built into ascriptions insofar as ascriptions are based on extrapolations or analogical reasoning from ourselves, either in terms of associations or of explanations. Generalising from ourselves creates a risk that we are less likely or able to ascribe feelings we have personally never experienced or based on observable criteria that we lack. For example, I have not experienced being part of a shoal, vertical migration, pleustonic variation or having decentralized control of eight legs, and might therefore be less able to identify such behaviours as relevant to experiences.per se.Ascriptions similarly need to avoid predetermining conclusions by using differing criteria or evidential thresholds for humans  versus other species, or relying on verbal reportage or other methods that cannot be applied to nonhuman species. Different ascriptions for different species can be justified if and only if there are relevant differences in the evidence relating to those animals. Ascriptions, therefore, need to extrapolate or analogise oneself in ways that avoid treating irrelevant  differences between ourselves and other animals as relevant, and ignore as irrelevant any characteristics that we do not see as having a non-chance association with and/or explanation for our experiences, such as eye colour, language, and genetic species membership Objectivity is explained as ‘act(ing) and tak(ing) decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.’ There are two complementary elements to this: recognising the best evidence available and avoiding partiality, unfairness, discrimination and bias. Basing ascriptions on the best evidence is both a positive matter of using the most relevant, informative and reliable data available, and a negative matter of avoiding biases that are based on irrelevant evidence. The use of the best evidence may help make decisions “on merit”, so long as it does not bring in (and hide) other biases.Making ascriptions fairly includes minimising undue species biases. In addition to the pro-human biases considered as matters of Selflessness and Integrity, other biases include partiality for other animal species based on metaphysical concepts, common affections for animals such as dogs and cats, and prejudices against animals such as spiders and flies . other bSuch objectivity requires us to employ the same methods of ascription to evaluate sentience in other species as we would want others to evaluate sentience in oneself in situations. We might imagine hypothetical heuristic scenarios, such as an angel or alien arriving on Earth and having to ascertain our sentience or us having to regulate under a Rawlsian/Rowlandsian veil of ignorance, where the imagined veil precludes knowledge of which species is our own. Such an approach would not logically use species as a criterion in its own right, since to be consistent, that criterion would be not “human” but “the same species as me”, which is a criterion that would be biased against us when applied by other species and nonsensical to apply behind a veil of ignorance as to one’s species.More positively, best evidence is an evaluative concept. The use of best evidence requires the evaluation of the data that support and weaken the ascription of sentience. The warrant for an ascription is a matter of the evidence’s weight , strength , reliability , and relevance  so it is more than simply quantifiable observations. It is further a matter of “triangulation” across all evidence, basing ascriptions on the cumulative and interactive effect of multiple data, insofar as our ascriptions form a “web” of interacting explanations, analogies and ascriptions. In this way, all ascriptions affect each other, insofar as the totality should aim to be cogent, internally consistent and mutually supportive. The “denser” the web of evidence, the stronger the grounds for analogy.These are matters of degree, which suggests that warrant and confidence should also be continuous variables. Degrees of confidence would range in proportion to the evidence from near-absolute (in oneself) to negligible . We might relate confidence to the strength and weight of evidence, and to the degree of relevant similarities. Recognising that there are degrees of confidence could also allow the justification of affording a lesser degree of protection to animals in whose sentience we are less certain , while still protecting species with weaker evidence from harms for trivial purposes such as live boiling of crustaceans in haut cuisine cooking or placing insects in simulated predator-prey situations for entertainment.Stronger, more reliable evidence  might be afforded more weight than weaker evidence . The principle of using the “best evidence” therefore promotes the use of scientific evidence, and the need for the best evidence creates a responsibility to invest in research to obtain, find, collect and evaluate data. This includes funding studies looking at different species and reviewing that data. It also includes research to develop better methods of ascription, the result of which constitute ever better evidence.However, the concern for using the best evidence does not mean that policymakers need perfect evidence or should limit the evidence to scientific data. It means policies should be based on the best evidence available. In some case, this may be non-scientific evidence which, if ignored, would leave animals unprotected. In the absence of robust scientific data, the best evidence may well be, in such cases, the perceptive responses of unconflicted and empathetic people. Conversely, the use of other sources of evidence and approaches does not reduce the value of better evidence; initial ascriptions should be seen as an interim protective policy until better evidence is obtained.The use of scientific evidence is also not a solution to all partiality or biases. Firstly, the use of evidence may be subject to biases: as described above, evidential requirements and interpretations are normative matters. Secondly, the scientific approach itself has built-in ethical assumptions and implications that may build in structural biases, which may be unnoticed or unremarked if they are widely held biases ,35.p-value of 0.95 could be taken to represent a 5% likelihood of a Type I error that wrongly identifies a relationship that supports sentience, but a 20% chance of a Type II error that would wrongly miss an association that would supports it [For example, ascriptions may draw on studies that observe associations between contexts and behaviours such as the placement of an acidic chemical on an antenna. Such studies often use frequentist statistical methods to distinguish chance from non-chance associations. In the wider scientific approach, this is a logical safeguard to reduce the chance of erroneous positive findings. However, such statistical methods can create asymmetrical biases: a ports it . This asThese structural biases of current scientific methods are the opposite of the bias towards ascription that might be expected to minimise suffering. In this case, the scientific approach runs counter to at least one moral approach that the Nolan Principles might be seen as prescribing. As such, we might consider that scientific data should be used in ways that counter the inbuilt bias (and at least do not add to it), for example, by more “liberal” generalisations and lower thresholds of what counts as “sufficient” evidence.Overall, there is a risk of using scientifically-justified methods to make morally-unjustified decisions. This brings a risk that policymakers believe or claim they are being objective and impartial by using science, but actually have built in biases in the decisions of how to use science. If we ignore these biases, we might blindly believe policies are being objectively scientific, while inadvertently favouring particular ethical views. Policymakers “are accountable to the public for their decisions and actions and must submit themselves to the scrutiny necessary to ensure this.” This has two elements. The first is accountability in that decisions must be made. The second is that they are responsible for their decisions, including decisions to make decisions in a particular way . Policymakers are specifically accountable for a decision to rely on science or to “outsource” decisions on what animals are sentient to scientists: such decisions do not absolve policymakers of their responsibility, and policymakers need to discharge that responsibility by being aware of the implications of how they use scientific data and experts. The third is that those decisions should be considered subject to correction.Policymakers are responsible for their decisions, including their decisions not to make, or to defer making, a decision. A decision not to make an ascription is a decision. Policymakers are then accountable for any resultant suffering if the animals are, in point of fact, sentient. For example, the exclusion of decapods in UK animal welfare legislation has permitted the suffering of lobsters through inhumane killing methods during that time.Some policymaking might explicitly reject the consideration of certain animals’ sentience outright . Others might be due to industry pressure, and policymakers are also, of course, accountable for decisions to base policies on non-scientific factors such as stakeholder pressure to delay or avoid protecting certain animals.However, decisions might be more subtly avoided or deferred by policies that require scientific evidence or scientific consensus. This excludes animals that have simply not been studied yet. It also effectively brings the structural scientific biases into the policymaking. In particular, scientific approaches legitimately tolerate uncertainty, for example by presuming null hypotheses until presented with evidence that is sufficient under a statistical definition, usually in relation to confidence intervals.as well as any responsibility to ensure the evidence gaps are filled. This reinforces the recognition that policymakers have a moral imperative to assess animal sentience on the evidence available.In comparison, policymakers cannot reserve judgement without real-world implications. Policymakers need to make decisions about how to treat animals, such as cephalopods and decapods, under conditions of scientific uncertainty. An “appeal to ignorance” might sometimes be politically expedient, but it is not, in this case, a legitimate excuse for allowing unnecessary suffering. This holds even in the absence of studies, insofar as it creates a responsibility to either change the default position  or the evidential requirements  - When policymakers decide to base the policy on science, they are further accountable for their decisions on how that science is used within the policymaking framework. Firstly, policymakers need to ensure that scientific methodologies are used for the evidential questions to which they are suited–associations between observations–but that policies also use other concepts of justification for our decisions, such as ethical justification. Secondly, policymakers are responsible for where they set evidential requirements. In particular, if policymakers always require a particularly high level of scientific evidence before ascribing sentience , then they effectively decide not to protect animals until that evidence is available (if it ever can be) and therefore effectively decide to continue a default or status quo policy approach that allows humans to cause suffering.One implication of policymakers’ accountability for the implications of their decisions is that, on a consequentialist approach, policymakers have a duty to use a method of ascription which is expected to minimise overall suffering. Such an approach needs to minimise the risks of under-ascribing (when not outweighed by significant other concerns for which they are responsible). Such a policy would at least be one that ascribes evidence on the basis of a more modest level of “sufficient” evidence rather than proof, and arguably would be one that ascribes on a default assumption of animal sentience.One additional responsibility for accountable policymakers is to accept decisions might be wrong and need refinement or correction. This may feel challenging for those under lay media scrutiny. Nonetheless, this is an important aspect of ascribing sentience. We should see ascriptions as plausible views that need to be reviewed and our confidence amended subject to subsequent new evidence. These revisions should not “change our belief” in a binary way (which is a high demand on any one piece of information) but might proportionately modulate our confidence in an ascription in a proportionate way, thereby avoiding the risk of it being too easy to throw an ascription back into complete question. This is more a matter of corrigibility than defeasibility.The refinement of our ascriptions should be an iterative process as new data is obtained and considered. In Bayesian terms, this would consider  new data in light of the prior confidence in a given ascription, to generate a revised confidence in the ascription. The initial prior confidence might legitimately be based on non-scientific assessments of explanations for behaviour, see ,38, and To ascribe in an open and transparent manner, policymakers should be open and transparent about which data are used, when and how science is used, the ethical bases of the method of ascription, the implications of that approach, and of course the conclusions reached. The DEFRA-commissioned study was released, albeit after some active lobbying by non-governmental animal welfare organisations such as Crustacean Compassion. Articulating the underlying ethical and methodological aspects of the approach to ascription might help to provide a framework for discussions. This is particularly valuable to ensure ethical views do not bias policies in hidden and non-systematic ways.Articulating the underlying methods and ethics is also useful to improve the debate. Hidden ethical views appear to provoke debates between focus and lobby groups who have access to the same scientific data but reach different conclusions (which sometimes leads them to cite different subsets of those data). Without understanding how data are used, these debates are unproductive and potentially intractable. Discussing the ethical grounds on which analogical or abductive inferences are justified is a way to foster discussion, as ideas people can understand metaphorically or empathetically. This also entails guarding against assuming animals’ behaviour is explained by the “lowest” psychological mechanisms, as citizens may well find experience-based explanations of animals’ behaviour, that relate to their own behaviour and experiences, more understandable and accessible than convoluted explanations that try to avoid ascribing experiences.Our policy on ascriptions should obviously avoid conclusions that are believed to be likely to be untrue. Our ascriptions should be based on beliefs that are as well founded and as confident as possible. This means evidential requirements need to be feasible , operationalizable within the limitations of current evidence, and applicable to reality as it appears to us from all the evidence available. This means not requiring a standard of proof or degree of certainty that would necessitate a perfect ability to imagine what other animals’ experiences feel like, or data that do not exist yet.The principle of honesty does not mean that policymakers may only make statements about which they are absolutely and incontrovertibly certain. Inevitably policymakers must make statements based on the best information available and a legitimate interpretation. We must further accept that some will be justifiable errors. The principle of honesty can be understood as prescribing that policy positions and conclusions should be based on beliefs that are justifiable, with that justification being both evidential and ethical.The principle of leadership “piggybacks” on the other principles, in the sense of promoting them. Nonetheless, we might consider additional leadership qualities such as being inclusive , respectful and transformational. Policymaking in this context needs to overcome conservative inertia and biases, and avoid placing undue barriers against recognising the sentience of other species. More widely, the leadership on this issue should look to transform our relationship with sentient animals. As the United Nations Secretary General stated in the UN’s Harmony with Nature report, “A first step to recognizing the rights of Nature is the recognition that non-human animals are sentient beings, not mere property, and must be afforded respect and legal recognition” .Policymakers face an unusual challenge in determining how to ascribe sentience to nonhuman animals, and this challenge cannot be avoided or overcome by the simple naïve use of scientific methods. Scientific data are important for determining observable associations and how widely they can be generalised across taxa. However, they cannot determine how those data are used, what is done in the absence of sufficient data or how to overcome the biases that are built into the scientific methods. The ascriptionof sentience to nonhuman animals is a challenge loaded with ethical dimensions that need transparent articulation, careful examination, and open discussion. The consideration of basic ethical principles for policymaking may help to avoid the more extreme errors and, one hopes to minimise suffering for sentient animals.


Obesity, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD) are characterized by the concepts of lipo- and glucotoxicity. NAFLD is characterized by the accumulation of different lipidic species within the hepatocytes. Bile acids (BA), derived from cholesterol, and conjugated and stored in the gallbladder, help the absorption/processing of lipids, and modulate host inflammatory responses and gut microbiota (GM) composition. The latter is the new “actor” that links the GI tract and liver in NAFLD pathogenesis. In fact, the discovery and mechanistic characterization of hepatic and intestinal farnesoid X receptor (FXR) shed new light on the gut–liver axis. We conducted a search on the main medical databases for original articles, reviews, meta-analyses of randomized clinical trials, and case series using the following keywords, their acronyms, and their associations: farnesoid X receptor, bile acids metabolism, gut microbiota, dysbiosis, and liver steatosis. Findings on the synthesis, metabolism, and conjugation processes of BAs, and their action on FXR, change the understanding of NAFLD physiopathology. In detail, BAs act as ligands to several FXRs with GM modulation. On the other hand, the BAs pool is modulated by GM, thus, regulating FXRs functioning in the frame of liver fat deposition and fibrosis development. In conclusion, BAs passed from their role of simple lipid absorption and metabolism agents to messengers between the gut and liver, modulated by GM. Obesity, type 2 diabetes, and dyslipidemia are features of our Westernized lifestyle. Non-alcoholic fatty liver disease (NAFLD) follows the same epidemiological trends as these disorders, and has a global prevalence of 25% among the general population . NAFLD iNAFLD is characterized by the accumulation of different lipidic species within the hepatocytes—a process regarded as “lipotoxicity” ,4. In adThe gut is linked to the liver through the gut–liver axis , and gutThis review of the scientific literature aims to describe the metabolism of bile acids and their “vital” cycle, and their role in lipogenesis and lipotoxicity in the liver and NAFLD, with a special focus on the role of the farnesoid X receptor in the pathogenesis and potential treatment of liver steatosis. BAs are derived from cholesterol to form primary BAs  and chenodeoxycholic acid, or CDCA . SubsequThe conjugation process has several functions: it minimizes the passive absorption of BAs, modulates host inflammatory responses and gut microbiota composition, and maintains the gut “eubiosis”, limiting small intestinal bacterial overgrowth (SIBO) incidence within our small bowel as a feature of “dysbiosis” ,12. Postprandially, BAs are released from the gallbladder into the small bowel, following the secretion of GI cholecystokinin (CCK). BAs are crucial for the emulsification of dietary fat, and enhance the absorption of lipids, sterols, and vitamins ,13. ApprIleal BA transport is highly efficient, but a small proportion (1–2%) of BA escapes the enterohepatic circulation, and enters the large intestine . As theyIn detail, BAs deconjugation by gut microbiota is crucial for bile bio-transformation : this smLactobacillus, Bifidobacterium [Clostridium spp., and Enterococcus [Bacteroides spp [Bile salt hydrolases belong to the Ntn-hydrolase superfamily of proteins . In partacterium ,17,18, Crococcus ,20. Howeides spp ,12,21,22Listeria monocytogenes has BSH activity, an adaptive quality guaranteeing its gut persistence [Xanthomonas maltophilia is present in soil [Brevibacillus sp in hot springs [BSH presence is also detected in pathogens. For example, the gastrointestinal sistence ,23,24. F in soil ,26, and  springs ,28. This adaptive quality has a horizontal transmission amongst gut bacteria, suggestive of a strong evolutionary selection for this activity ,29. Description of functioning, distribution, and abundance of BSH within the human gut microbiome is possible through a metagenomics approach, enabling researchers to reconstruct entire genomic libraries starting from small genomic sequences . More inFrom a functional point of view, we can briefly describe the BSH activity as a protective shield for some bacterial species  to colonize the human gut ,32,33. TThe concept of the gut–liver axis helps explain the complex interplay between systemic metabolism, gut hormone release, and the immune response . Over thFor example, the strong antimicrobial properties of BAs, and the maintenance of the eubiosis of gut microbiota, are mediated by a multifaceted mechanism of activation of FXR ,39. NAFLMore interestingly, the activation of FXR localized in the intestinal cells can start a crucial endocrine feedback mechanism ,44. In fConsequently, evidence of a FXR-mediated decrease in hepatic lipid accumulation and improved insulin sensitivity is the basis for the use of its agonists in NAFLD treatment. For example, a dose of 25 mg/day of the semisynthetic BA obeticholic acid (OA) in patients with non-cirrhotic, non-alcoholic steatohepatitis was compared to placebo for 72 weeks of treatment . As a prThe use of FGF-19 and -15 agonists is discouraged because of their correlation with hepatocyte proliferation, potentially leading to hepatocellular carcinoma (HCC) development in mice. Accordingly, human HCC cells and cirrhotic livers show increased expression of FGF19 ,49. These data remark the need for a better understanding of the pathways induced by FXR activation, before their clinical use.BAs can also “ sense “ the G-protein-coupled membrane receptor, TGR5, expressed in the gallbladder, the liver, specifically Kupffer cells and endothelial cells, not in hepatocytes, the intestine, adipose tissue, spleen, and the kidneys. TGR5 regulates the composition of BAs acid pool, and modulates the immune system and metabolism ,50,51. IIn addition, INT-767, an FXR/TGR5 dual agonist, shows lowered lipid accumulation, inflammation, and fibrosis in various in vitro models ,55,56, wFirmicutes and Bacteroidetes represent the most abundant phyla of the microbiota. Their ratio is a fundamental factor in the host’s health [Fusobacteria, Actinobacteria, Proteobacteria, and Verrucomicrobia [The intestinal microbiota represents one of the most complex ecosystems present in nature. It accounts for over 100 trillion microorganisms . Firmicus health . Among tmicrobia . Gut micmicrobia . Eubiosis defines the balanced qualitative and quantitative condition of the intestinal microflora, and is essential to preserving the host’s health. On the contrary, its qualitative/quantitative perturbation, namely, dysbiosis, is associated with the development of various diseases such as NAFLD, NASH until HCC ,60, diabAs BAs are metabolized by gut microbiota, changes in their composition influence the pathways mediated by BAs, such as FXR signaling . Thus, wOne cutting edge research, unraveling the circular interaction of gut microbiota and BAs via FXR, was led by Friedman et al. , throughFirmicutes in the small bowel, as compared to control mice [Firmicutes, there is an increase in the representation of microbial genomic pathways involved in DNA synthesis and amino acid metabolism, such as after OA treatment of healthy subjects. There are currently no data showing how BA composition and concentration affect the gut microbiota in the pathogenesis of various diseases, but it is noteworthy that the manipulation of the gut microbiota from BAs may be considered in the future to develop clinical approaches aimed at disease prevention and treatment.Interestingly, OA suppresses endogenous BA synthesis with a reversible induction of Gram-positive bacteria in the small intestine, mainly derived from diet and the oral microbiota. These strains of bacteria are normally down-regulated by the BAs pool. At a molecular level, OA treatment determines an increased activity of microbial genomic pathways involved in DNA synthesis and amino acid metabolism. Accordingly, mice treated with OA show reduced endogenous BA levels, and an increased proportion of rol mice . OppositFurthermore, the modulation of intestinal FXR by BAs unravels some interesting consequences for the development of obesity and liver steatosis. Indeed, experimental models of NAFLD show microbiota from obese subjects lowering the levels of BAs with higher activity of FXR. This results in the synthesis of ceramides that alter lipid metabolism at the liver level, leading to the accumulation of fatty acids ,67. AccoIn addition, gut microbiota from obese mice has a promotional activity in favor of diet-induced obesity through FXR. Subsequently, FXR may contribute to increased adiposity through action on microbiota composition .Summarizing all these pieces of evidence, we hypothesize that inhibition of FXR within the gut might protect against the development of a fatty liver. However, this hypothesis is in contrast with the assumption of FXR activation being beneficial during NAFLD . Thus, iIn conclusion, we assume that FXR regulation by BAs and gut microbiota is very complex, as is strongly influenced by the organ in which such receptors are activated. We conducted a search on PubMed and Medline for original articles, reviews, meta-analyses, and case series using the following keywords, their acronyms, and their associations: farnesoid X receptor, bile acids metabolism, gut microbiota, dysbiosis, and liver steatosis. When appropriate, preliminary evidence from abstracts belonging to main national and international gastroenterological meetings  was also included. The papers found from the above-mentioned sources were reviewed by two of the authors (E.S. and G.S.B.), according to PRISMA guidelines . The lasIn total, we found 249 manuscripts matching our search: 69 were clinical trials/original articles, of these 47 randomized clinical trials (RCT)s; 95 reviews of the scientific literature, 1 of those a systematic review; 3 meta-analyses. We included data from 41 original articles , 5 RCTs, 26 reviews of the scientific literature, excluding those not updated, and from 1 meta-analysis.This review of the scientific literature conveys a novel concept of BAs beyond the classic concept of simple regulators of lipid absorption. They have a sophisticated mechanism of networking with cells not only in the liver, but also in the intestine. This multi-faceted net of chatting is possible through nuclear receptors such as FXR that have at least a bi-valent role in liver fat deposition and metabolism. Moreover, the gut microbiota is crucial for BAs metabolic transformation within the gut. More interesting, gut microbiota composition is modulated by BAs pool and, vice versa; it affects their forms and composition. Thus, this unconventional connection is crucial for the host’s health and survival, as BAs avoid the emergence of pathogenic microbial strains from our intestinal tract. Several factors affecting gut microbiota  influence its composition, and bring BAs and their interactions with cells towards a dysmetabolic state , favoring gluco- and lipotoxicity.Indeed, BAs pool modulation is as crucial as microbial eubiosis for our survival and health. All these pieces of evidence explain the interest of researchers in nuclear receptors modulation with agonists/antagonists according to different tissue targeted in our fight against an obesity-driven Westernized world. Moreover, pre-, pro-, and post-biotics can be powerful and promising weapons to correct and heal a “fattening” BAs pool, through microbial modulation.


As one of the severe natural disasters, typhoon hazard brings tremendous tragedy to human beings. The foreland in the southeast of China is one of the most typhoon prone areas in the world. There are amount of damage of civil engineering structures induced by typhoon every year. Especially for the spacious villages, the low-rise buildings are vulnerable to typhoon so that many of them are destroyed regionally. The typhoon vulnerability assessment of civil engineering structures is a classical multiple attribute group decision making (MAGDM) issues. In this paper, the 2-tuple linguistic neutrosophic number grey relational analysis (2TLNN-GRA) method is built based on the grey relational analysis (GRA) and 2-tuple linguistic neutrosophic sets (2TLNSs) with incomplete weight information. For deriving the weight information of the attribute, an optimization model is built on the basis of the GRA, by which the attribute weights can be decided. Then, the optimal alternative is chosen through calculating largest relative relational degree from the 2-tuple linguistic neutrosophic number positive ideal solution (2TLNNPIS) which considers both the largest grey relational coefficient (GRC) from the 2TLNNPIS and the smallest GRC form 2-tuple linguistic neutrosophic number negative ideal solution (2TLNN NIS). Then, combine the traditional fuzzy GRA model with 2TLNNSs information, the 2TLNN-GRA method is established and the computing steps for MAGDM are built. Finally, a numerical example for typhoon vulnerability assessment of civil engineering structures has been given and some comparisons is used to illustrate advantages of 2TLNN-GRA method. The multiple attribute group decision-making (MAGDM) refers to integrating and ranking the criterion values of multiple schemes under multiple criteria –3. Due tThere are three shortcomings in disposing of the MAGDM problems under 2TLNSs environment that to form our incentives in the following:The existing decision methods just consider distance-based similarity degree . How to The existing weight determining methods just consider completely known weight information , 14. HowThe concept of vulnerability was first proposed in the military field to describe the vulnerability of an aircraft or ship’s hull to physical collisions. It was not until 1968 that the concept of structural fragility was first proposed in the Ronan Point apartment collapse to express the ability of a structure to withstand disproportionate collapse. Therefore, it is urgent for researchers in related disciplines to conduct exploratory research in this field to enrich the research content of typhoon disasters in Chinese. The typhoon disaster assessment of civil engineering structures in Chinese is still in a blank state. Therefore, it is urgent for researchers in related disciplines to conduct exploratory research in this field to enrich the research content of typhoon disasters in my country. The typhoon vulnerability assessment study of civil engineering structures has two meanings: (a) according to the typhoon disaster prediction, designers can improve the structure’s typhoon resistance ability according to the different typhoon vulnerability of the structure; (b) according to the typhoon disaster Loss assessment research, decision-making departments can provide a basis for government and enterprise typhoon disaster loss estimates. The typhoon vulnerability assessment of civil engineering structures is a classical MAGDM issues. Thus, the third incentive of this paper is to build new decision methods for typhoon vulnerability assessment of civil engineering structures.On this basis, combined with the characteristics of typhoon vulnerability assessment of civil engineering structures, a new MAGDM method for typhoon vulnerability assessment of civil engineering structures in 2TLNSs environment is proposed. Specific research points are listed as follows:In this paper, the 2-tuple linguistic neutrosophic number grey relational analysis (2TLNN-GRA) method is built based on the GRA and 2TLNSs with incomplete weight information. The 2TLNN-GRA investigate the decision methods consider the shape-based similarity degree.For deriving the incompletely known weight information of the attribute, an optimization model is built on the basis of the 2TLNN-GRA, by which the attribute weights can be decided. Then, the optimal alternative is chosen through calculating largest relative relational degree from the 2-tuple linguistic neutrosophic number positive ideal solution (2TLNNPIS) which considers both the largest grey relational coefficient (GRC) from the 2TLNNPIS and the smallest GRC form 2-tuple linguistic neutrosophic number negative ideal solution (2TLNN NIS). Then, combine the traditional fuzzy GRA model with 2TLNNSs information, the 2TLNN-GRA method is established and the computing steps for MAGDM are built.Finally, a numerical example for typhoon vulnerability assessment of civil engineering structures has been given and some comparisons is used to illustrate advantages of 2TLNN-GRA method. This paper mainly provides method guidance and technical support for the realization of typhoon damage assessment and prediction of low-rise building structures in the southeastern coastal villages and towns of my country through the preliminary research on the typhoon vulnerability assessment of civil engineering structures. This has far-reaching significance for the decision-making of typhoon prevention and disaster mitigation in the public sector, infrastructure construction in villages and towns, and even national security and stability.In order to do so, the reminder structure of such built paper proceeds. The related literature review is introduced in Sec. 2. The 2TLNNSs is introduced in Sec. 3. The 2TLNN-GRA method is built for MAGDM in Sec. 4. A numerical example for typhoon vulnerability assessment of civil engineering structures is given and some comparisons are also done in Sec. 5. Sec. 6 gives some the conclusions.Due to the complexity of the decision-making environment and the limited cognition of decision-makers, it is difficult for decision-makers to give accurate evaluation information in actual decision-making. In this case, how to effectively solve the above problems and make more reasonable decisions, the research on relevant decision-making methods is particularly important. In 1986, Atanassov  studied As a serious natural disaster, typhoon disaster has brought huge disasters to human beings. The southeastern coastal area of my country is one of the areas where typhoons land most frequently in the world. Affected by typhoons, a large number of civil engineering structures are damaged by wind disasters every year. Especially in the vast villages and towns, low-rise buildings have poor wind resistance and often regional damage collapse phenomenon. In order to evaluate and predict the typhoon disaster losses of civil engineering structures, so as to provide a basis for the decision-making of typhoon prevention and disaster reduction in the public sector. The concept of vulnerability was first proposed in the military field to describe the vulnerability of an aircraft or ship’s hull to physical collisions. It was not until 1968 that the concept of structural fragility was first proposed in the Ronan Point apartment collapse to express the ability of a structure to withstand disproportionate collapse. Successively, Lind  defined Herrera and Martinez  defined lδ = {lsi | i = 0,1,2,⋯, M} be the linguistic term sets (LTSs). Any label, lsi represents a possible value through the given linguistic variable.Let Definition 1 . Let β be the fused result of labels assessed in the given lδ, i.e., the result of a symbolic fused operation, β ∈ , being M the cardinality of lδ. Let i = round(β) and α = β − i be two values, i ∈  and α ∈  is the value representing the fused result of defined linguistic symbolic. Then the function Δ used to obtain the 2-tuple linguistic information equivalent to β is:lsi has the closest label to β and α is the symbolic translation value.Definition 3 . Let lδ = {lsi | i = 0,1,2,⋯, M} be the LTSs and  be a 2-tuple. There is the function Δ−1, such that, from a 2-tuple  it returns the corresponding numerical value β ∈  ⊂ R.X be a fix set, the SVNSs η is depicted as  represent the truth-membership, indeterminacy membership and falsity-membership, and meets the condition 0 ≤ ϕη(x) + φη(x) + γη(x) ≤ 3.Let icted as :η=x,ϕηWang et al.  devised Definition 4 . Let lδ = {lsi | i = 0,1,2,⋯, M} be the LTSs. Any label lsi depicts a possible linguistic information, and lδ = {ls0 = exceedingly terrible, ls1 = very terrible, ls2 = terrible, ls3 = medium, ls4 = well, ls5 = very well, ls6 = exceedingly well.}, then the 2TLNSs is described as:−1, Δ−1, Δ−1 ∈  represent the truth-membership, indeterminacy-membership and the falsity-membership which are expressed by 2-tuple linguistic variables and meets the condition:Definition 5 . Let According to Definition 2, the operation laws are defined.Definition 6 . Let lδ = 〈, , 〉 be a 2TLNN, the score and accuracy functions of lδ is expressed:lδ1 and lδ2, based on Definition 3, thenFor Definition 7 . Let Definition 8 . Let wj is weight of lδj, which meets m defined decision alternatives {ϕ1, ϕ2, …ϕm}, n devised attributes {o1, o2, … on} and t given experts {d1, d2, … dt}, let expert’s weight be {a1, a2, … at}, w =  is weight of attributes oj, wj ∈ , H is a sort of partially known weight, which has the following forms, for i ≠ j m×n:VR = [vϕij]m×n is:Based on 2TLNNWG operator, the Step 3. Normalize the VR = [vϕij]m×n into NR = [nϕij]m×n.For benefit attributes:For cost attributes:Step 4. Determine the 2TLNN positive ideal solution (2TLNNPIS) and 2TLNN negative ideal solution (2TLNNNIS) through Eqs (ough Eqs –22):2:2Step Step 5. Compute the grey rational coefficients (GRC) from the 2TLNNPIS and 2TLNNNIS as:ED and ED is 2TLNN Euclidean distances.Step 6. Compute the grey relation degree (GRD) of defined alternatives from 2TLNNPIS and 2TLNNNIS:TLNNPISGRD(ξi) along with smaller 2TLNNNISGRD(ξi), the better alternative ϕi is. But the attribute weights’ information is incompletely known. So, to derive the PLPIS(ξi), PLNIS(ξi), we can build the multiple objective optimization models (MOOM-1):The fundamental idea of GRA method is that the optimal alternative is supposed to possess the “largest degree of GRC” from 2TLNNPIS and “smallest degree of GRC” from 2TLNNNIS. Evidently, the larger 2Due to each decision alternative is non-inferior, there is no preference relation for all the decision alternatives. Besides, the multiple objective optimization (MOOM-1) might be fused into the single objective optimization (SOOM-1) with equal weights:w =  is regarded as the attributes weight. Then, the 2TLNNPISGRD(ξi) and 2TLNNNISGRD(ξi) is obtained through Eqs (By solving the (SOOM-1), the solution ough Eqs  and 26)w =  from 2TLNNPIS:Step 8. According to 2TLNNRRD(ξi). The highest information value of 2TLNNRRD(ξi) is, the optimal alternative is designed.CESi  to be chosen and four attributes to be assessed these civil engineering structures: ①PQ is the product quality; ②DC is the delivery capacity; ③SL is the service level; ④EP is the enterprise performance. The five possible civil engineering structures CESi  are to be evaluated by 2TLNNs under the four given attributes by three experts dt  and known attribute’s weight is H = {0.17 ≤ ω1 ≤ 0.25, 0.16 ≤ ω2 ≤ 0.25, 0.28 ≤ ω3 ≤ 0.35, ω3 − ω4 ≥ 0.10}.The construction industry is a pillar industry of China’s economy, and plays an important supporting role in my country’s national economy and social development. With the implementation of the "One Belt, One Road" policy, the construction industry will also reach a new stage of development. Of course, opportunities and challenges coexist. How to better combine the characteristics of contemporary enterprise development, achieve higher economic benefits, and then improve international competitiveness is a topic worthy of in-depth study and consideration by Chinese construction enterprises. Under the new situation, construction enterprises should actively carry out reforms, adopt advanced management methods, improve corresponding management systems, and improve management efficiency and social influence. In the process of construction enterprises implementing engineering projects, the choice of material suppliers is very important, and its pros and cons will directly affect the quality, progress and cost of engineering construction. Choosing a suitable building material supplier can, on the one hand, meet the index requirements of all aspects of the project and meet the owner’s need for product excellence, thereby improving customer satisfaction; win. Therefore, it is of great significance to investigate the building materials supplier selection and improve the structure of the entire supply chain. At present, with the changes in the market situation, the requirements of the owners continue to increase, the development environment of construction enterprises has become more diverse, complex and unpredictable, and the competition has become more intense. What used to be simple competition between companies in the same industry has now developed into a complex competition model involving the entire supply chain. With the continuous improvement of customers’ requirements for product quality, after-sales service, corporate image, corporate reputation and other aspects of enterprises, the pressure of enterprises’ survival and competition is also increasing. The development of information technology has also reduced the internal transaction costs of enterprises, which in turn makes the product life cycle is shorter. Therefore, a high-quality supply chain structure is particularly important in the brutal market competition. The typhoon vulnerability assessment of civil engineering structures is a classical MAGDM issues. In this given section, we provide a real numerical example for typhoon vulnerability assessment of civil engineering structures through 2TLNN-GRA method. Assume that five possible civil engineering structures The 2TLNN-GRA method is used to solve the typhoon vulnerability assessment of civil engineering structures.Step 1. Build the 2TLNN matrix Step 2. Normalize the Step 3. According to Step 4. Determine the 2TLNNPIS and 2TLNNNIS (See NNIS See .Step 5. Compute the 2TLNNNISGRC(ξij) and 2TLNNNISGRC(ξij) (See Tables Step 6. The model (SOOM-1) is utilized to set up the single-objective programming model:w = T.The weight of attributes is obtained: Step 7. Compute the 2TLNNPISGRD(ξi) and 2TLNNNISGRD(ξi) (See (ξi) See :Step 8. Compute each alternative’s 2TLNNRRD(ξi) (See (ξi) See .Step 9. According to 2TLNNRRD(ξi), the order is CES2 > CES1 > CES5 > CES4 > CES3 and CES2 is the best one.In such section, the 2TLNN-GRA method is compared with 2TLNWHM and 2TLNWDHM operator . The fusAccording to score of 2TLNNs, the score for alternative is listed in The order by 2TLNNs operators is obtained in Comparing the results of the 2TLNN-GRA method with 2TLNWHM & 2TLNWDHM fused operators, the obtained results are slightly different and the chosen best alternative is same. However, the 2TLNN-GRA has the precious characteristics: (1) the basic idea of 2TLNN-GRA is to judge whether the relationship between the sequences is close according to the similarity of the shape of the sequence curves; if the curves between the sequences are closer, the greater the degree of correlation between the corresponding sequences, and vice versa; (2) 2TLNN-GRA is based on the development trend, so there are no too many requirements for the size of the sample, nor does it need a typical distribution law, and the amount of calculation is relatively small, the results will be more consistent with the qualitative analysis results. Therefore, the GRA is a relatively simple and reliable analysis method in system analysis.In recent years, some researchers in the field of civil engineering disaster science have gone deep into the typhoon-stricken areas to investigate the typhoon damage of civil engineering structures, and analyze and summarize the experience of structural typhoon disasters based on the damage degree and damage characteristics of various engineering structures. These experiences truly reflect the impact of typhoons on engineering structures, and comprehensively reveal the actual wind resistance performance of various engineering structures. It can be seen that using the existing structural typhoon disaster data to evaluate the wind resistance performance of various existing engineering structures is an important aspect of wind engineering research. In the past five years, the typhoon disaster of low-rise buildings in the southeast coastal villages and towns of my country has been particularly serious, which has seriously affected the goal of building a harmonious society for the coordinated development of urban and rural areas in my country. Therefore, we must quickly strengthen the regional typhoon disaster investigation of low-rise buildings to obtain more abundant structural typhoon disaster data, and to achieve structural typhoon vulnerability assessment and loss estimation. Therefore, it is very important to use scientific and effective methods for typhoon vulnerability assessment of civil engineering structures. The typhoon vulnerability assessment of civil engineering structures is the MAGDM. In this paper, we build the 2TLNN-GRA method for MAGDM based on the traditional GRA method. Finally, a numerical example for typhoon vulnerability assessment of civil engineering structures has been given to illustrate the 2TLNN-GRA method. Thus, the main research contribution of this study is: (1) the 2TLNN-GRA method is used to deal with the MAGDM problems under 2TLNNs with incomplete weight information; (2) an empirical example for typhoon vulnerability assessment of civil engineering structures has been given. (3) some comparative algorithms are given to show the rationality of 2TLNN-GRA method. In the future, the 2TLNN-GRA method could be applied to the risk analysis issues, selection issues, other MAGDM issues and many other uncertain environments.According to the current research status in this field and its own research progress, research and exploration of decision-making and evaluation methods will be continued in the following aspects in the future. (1) Consensus and consistency improvement may conflict with each other in group decision-making –50, so i


While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting the focus statement, “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time”. The panelists’ assessment was also compared to findings from a national survey of practicing physicians, psychiatrists, and sleep specialists. Survey respondents revealed a wide range of opinions regarding the appropriateness of using the US Food and Drug Administration (FDA)-approved medications for the treatment of insomnia lasting more than 3 weeks. After discussion of the literature, the panel unanimously agreed that some classes of insomnia medications, such as non-benzodiazepines hypnotics, have been shown to be effective and safe for long-term use in the appropriate clinical setting. For eszopiclone, doxepin, ramelteon and the newer class of dual orexin receptor antagonists, the FDA label does not specify that their use should be of a limited duration. Thus, an evaluation of evidence supporting the long-term safety and efficacy of newer non-benzodiazepine hypnotics is timely and should be considered in practice recommendations for the duration of pharmacologic treatment of chronic insomnia. Insomnia is among the most common medical conditions worldwide, affecting 15–30% of the general population ,3. The cWhile cognitive behavioral therapy for insomnia (CBT-I) is recommended as first-line therapy, pharmacologic therapy is commonly used in the management strategy for treating insomnia . Data frThe recommendation by the ACP Clinical Practice Guideline on the Management of Chronic Insomnia Disorder in Adults that medication use should be limited to 4–5 weeks  derives In view of the important ongoing dialogue regarding the appropriate duration of treatment, the availability of long-term efficacy and safety data of the newer classes of medications and the fact that insomnia is often chronic, lasting months to even years, a clinical appraisal regarding the long-term use of insomnia medications is timely. The objective of this appraisal was to evaluate the evidence for the focus statement: “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time”. The appraisal consisted of three parts: a national survey to understand healthcare professionals’ perspectives regarding the long-term use of insomnia medications; a review of current clinical and pre-clinical literature related to the safety profile of insomnia medications; and a meeting of an insomnia expert panel to assess the evidence and implications for the practice, and to identify future needs. The literature review assessed the evidence regarding the class and mechanism of action of the insomnia medication, safety profiles and availability of short-term and long-term data.n = 508 eligible responses to the statement were obtained and of the 508 total the breakdown subspecialty was as follows: MDs (74%), nurse practitioners (14%), physician assistants (11%) and PhDs (1%).To gauge perceptions on a number of distinct but related issues regarding the management of insomnia that are the subject of current debate in the U.S. medical community, an electronic survey was distributed nationally to healthcare professionals (HCPs)  across the United States. Responses were collected in two waves: in December 2021 and in April 2022. In wave 1: the online survey was sent to 97,000 HCPs procured from a variety of collector lists and all emails used were General Data Protection Regulation compliant. 155 responses were collected, and 47 respondents were removed as not qualified via demographic questions such as “what is your area of specialty?” and “what percentage of your time is spent managing insomnia?” The datapoint of 100 respondents was agreed to be the threshold for legitimacy for publications of this type, but given the low response rate of 0.2%, a second wave was launched in April 2022. The dataset requirements for wave 2 were the same as wave 1 and the survey was sent to an additional set of 70,319 HCPs. With a response rate of 0.6%, a further 400 eligible respondents were collected. In total, Strongly agree;Mostly agree, but with minor reservations;Slightly agree, but with major reservations;Slightly disagree, due to minor reservations;Mostly disagree, due to major reservations;Strongly disagree.Healthcare professionals involved in the management and treatment of patients with insomnia  were asked to indicate their level of agreement with the survey statements by grading on a Likert scale from 1 to 6, with the following descriptions:Respondents were also given the opportunity to comment on reasons for their rating of the survey statements.The statement “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time” was evaluated during a meeting of the expert panelists in December 2021. The statement leader presented a review of the current literature pertaining to their statement, presenting both statement-supporting and statement-refuting studies to stimulate a balanced discussion of the evidence. Further, the panelists discussed the evidence in the context of current healthcare professionals’ perceptions, as indicated by the national survey results and comments, as well as current practice.Literature searches were performed in October 2021 for the statement “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time” using the following electronic database: PubMed. Searches were limited to human and English and to the last 10 years. To identify relevant clinical studies, the search terms “insomnia medication daily treatment AND short term” “insomnia AND hypnotic AND continuous” and “insomnia medication prn” and “insomnia medication AND intermittent” were used, yielding 35, 46, 11 and 10 articles, respectively. Of the 102 articles retrieved, 35 articles were selected for a detailed review based on the goal of the literature search which was to identify studies that represented evidence supporting the statement and studies that provided evidence to refute the statement. Exclusions such as references presented with the criteria of US FDA-approved insomnia medication, and exclusions based on external/internal validity criteria such as study populations including a control group were applied and 20 articles were subsequently selected for presentation.Evidence obtained from meta-analysis, including at least one large, randomized control trial (RCT);Evidence obtained from either meta-analysis, including at least one small RCT, or from at least one well-designed large RCT;Evidence obtained from well-designed cohort or case–control studies;Evidence obtained from case series, case reports, or flawed clinical trials;Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees;Insufficient evidence to form an opinion.Prior to presentation of the selected studies, the panel anonymously indicated their level of agreement with the appraisal statement, using the same six-point scale used in the national survey. Following the presentation, the panel rated the quality of the literary evidence as follows:The panel subsequently indicated their level of agreement with the appraisal statement a second time, noting whether the data impacted their assessment, and discussed how the evidence relates to current peri-operative practice.For the statement “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time” there was a wide range of responses among the survey respondents, with 50% agreeing and 50% disagreeing to some extent with the statement . The meaIn contrast with the survey respondents, all panelists expressed a prominent level of disagreement with the statement pre-presentation, and 86% strongly disagreed following the literature review  with theThe statement’s lead discussant presented a summary of the evidence in support of the focus statement and the review focused primarily on FDA-approved medications for insomnia. The majority of the evidence against the use of insomnia medications for longer than 3 weeks originated primarily from experience with BZDs and several non-BZDs. For BZDs, data on efficacy and safety were limited to short-term randomized controlled trials of 4 weeks or less ,26,27,28Results from a meta-analysis of 24 studies (7–28 days duration and one study with triazolam for 9 weeks) on the effect of BZDs and non-BZDs in older adults with insomnia showed that while the effect on sleep improvement was very small (effect size 1.07–1.17), there was a statistically significant increase in the risk of adverse effects, such as the risk of falls and cognitive impairment , raisingThere were a limited number of studies supporting the relationship between the long-term use of BZDs and non-BZDs, cognitive impairment and/or risk of dementia in adults, and most were retrospective and lacked a control group. In a retrospective longitudinal (28 days) study of 260,502 older adult beneficiaries of a national health registry, an increase of all-cause dementia was reported with use of BZD hypnotic medications, particularly in patients taking a short-acting BZD or multiple BZDs . The lacWithdrawal symptoms were examined in an open-label study of 123 patients (20–64 years of age) with insomnia disorder enrolled in a clinical trial  of eszopFollowing the presentation of evidence supporting the focus statement, a representative excerpt of the clinical evidence against the statement  was presented to the appraisal panel. Evidence supporting the long-term efficacy and safety of insomnia medications came from more recent studies with some of the non-benzodiazepine GABA-A modulators and newer medications with different mechanisms of action, such as ramelteon, doxepin and the dual orexin receptor antagonists.Unlike the studies of the older class of BZDs, there is evidence of the efficacy and safety of some of the non-BZDs. In a small study  using obA 6-month randomized controlled clinical trial studied the effects of long-term eszopiclone . The stuEfficacy and safety for longer-term use have also been studied in medications other than the GABA-A modulators. For example, a 12-week randomized, parallel, placebo-controlled study  was conducted on the safety and efficacy of doxepin treatment in older adults (65 years and older) with insomnia . OutcomeEfficacy and safety of 6-month nightly ramelteon administration in adults with chronic primary insomnia were assessed in a randomized clinical trial . Over thThe newest class of medications, the dual orexin receptor antagonist (DORA) drug studies have often included data on the efficacy and safety of 3 months or longer medication use. The DORA drugs are a novel class of insomnia medications that work through a different mechanism of action compared to earlier insomnia medications. They bind to orexin receptors and inhibit the action of the wakefulness-promoting neuropeptide orexin. Suvorexant was the first DORA drug approved for treating insomnia. Long-term (1 year) suvorexant treatment was evaluated in a multi-site randomized, placebo-controlled, parallel-group clinical trial . SuvorexIn clinical practice, insomnia is a common chronic disorder ,45, withThe purpose of this clinical appraisal exercise, therefore, was to assess the strength of the evidence supporting the views and practices of prescribing healthcare professionals (HCPs) in the field and obtain the perspectives of a panel of insomnia experts reviewing the available relevant research literature. Similar clinical appraisals  have serThe focus statement for this appraisal, “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time” contains the key caveat “No insomnia medication”. While there is no clear consensus among practitioners on how long is safe to use insomnia medications, the 3-week duration was chosen because the 1983 NIH Consensus Development Conference on Drugs and Insomnia: The Use of Medications to Promote Sleep, recommended using insomnia medications for a treatment period usually of no more than 3 weeks . This waThe primary argument for the short-term use recommendation is based on the conclusion that there is insufficient evidence to weigh the benefits vs. harms of the long-term use of pharmacologic therapies for chronic insomnia ,23,24. IHowever, there have been long-term (6 months of longer) placebo-controlled trials of non-BZD, antihistamine, melatonin agonist, and DORA hypnotic medications that have demonstrated sustained efficacy and safety, including in older adults ,35,36. RIn view of the more recent long-term studies and new classes of medications, this clinical appraisal provides an opportunity to evaluate current recommendations concerning limitations on the duration of use.In There was a notable difference in agreement between the survey respondents and the expert panel with the focus statement, “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time”. Exactly half of the field survey respondents agreed to some extent with the focus statement—most commonly due to concerns of abuse, tolerance and rebound of the BZ hypnotics. Half of the survey respondents reported having some reservations, but ultimately disagreed with the statement. Some respondents indicated that they had success with prescribing DORA medications long-term.The expert panel also shared some concerns regarding adverse effects of the BZDs and non-BZDs and the limited evidence for long-term use, particularly for the BZD class of hypnotics. Despite these reservations, and after weighing the evidence, all panel members disagreed with the focus statement. Much of the basis for this disagreement was based on the fact that several clinical studies on the use of some non-BZD GABA-A modulators (zolpidem and eszopiclone) and the newer medications, such as low-dose doxepin and the DORA drugs , support their long-term efficacy and safety.The conclusion of the expert panel after reviewing the clinical evidence was that the appropriate duration of pharmacologic therapy for chronic insomnia needs to be individualized based on the balance of benefits and harms—especially in older adults and patients with medical and/or psychiatric comorbidities and the use of concomitant medications. The panel also agreed that the sparsity of long-term use data prevents truly evidence-informed decision-making for the BZD drug class. Within the context of long-term use, shared decision making is therefore important, and it is recommended that patients are re-evaluated on a regular basis to assess the balance of risk-to-benefit, and that, in addition, patients are counseled on the potential utility of cognitive behavioral therapies as well as a discussion of deprescribing hypnotics.