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Review

A review on interventions to prevent osteoporosis and improve fracture healing in osteoporotic patients

  • Received: 01 July 2020 Accepted: 24 September 2020 Published: 10 October 2020
  • Introduction Proportion of aged people has increased due to improvement in longevity. With advancing age bones loose mass, get weakened, become more prone to osteoporotic fractures. Development of osteoporosis is silent with reduction in total bone mineral content. Bone mineral density is the most important parameter which can measure gravity of OP. The T-score of −2.5 or below indicates OP leading to fractures commonly in bones of spine, hip and distal extremities.
    Objective Purpose of this review is to find out currently available as well as future approaches those could be beneficial in faster recoveries.
    Method Major databases were searched from inception to till January 2020. Relevant main articles and cross references were evaluated. In addition, findings were compared to a previously published review. Pharmacological and bio-molecule interventions decrease bone depletion by reducing bone resorption and enhancing bone formation process, and other external stimuli like strengthening muscular and skeletal tissues are employed to prevent OP and accelerate fracture healing and normal functioning.
    Results A literature review of such interventions showed that bisphosphonates and selective estrogen receptor modulator treatment reduces fracture risks in osteoporosis and increase callus formation during fracture repair but do not reduce total time of fracture healing. Parathyroid hormone (PTH) and its analogues prevent OP by promoting callus formation as well as osteogenesis, enhance coupled remodelling and amount of mineralized tissue. When PTH is combined with bone morphogenetic proteins (BMP) improve mechanical functioning by integrating new bone tissue with old bone tissue. Restraining and supportive therapies like the physical exercises could be beneficial to minimize gravity of osteoporosis. Electromagnetic field therapy and pulsed ultrasonic therapy could be useful after surgical management of fracture or delayed union.
    Conclusion To identify the quantitative effect of these therapies in isolation or in combination, clinical trials under proper experimental settings are especially important. Unlike the therapies for fracture repair in non-osteoporotic patients, the line of treatment and duration of each therapy in isolation or in combination with pharmacological agents, biomolecules, physical stimuli, exercises and lifestyles are necessary.

    Citation: Manishtha Rao, Madhvi Awasthi. A review on interventions to prevent osteoporosis and improve fracture healing in osteoporotic patients[J]. AIMS Medical Science, 2020, 7(4): 243-268. doi: 10.3934/medsci.2020015

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  • Introduction Proportion of aged people has increased due to improvement in longevity. With advancing age bones loose mass, get weakened, become more prone to osteoporotic fractures. Development of osteoporosis is silent with reduction in total bone mineral content. Bone mineral density is the most important parameter which can measure gravity of OP. The T-score of −2.5 or below indicates OP leading to fractures commonly in bones of spine, hip and distal extremities.
    Objective Purpose of this review is to find out currently available as well as future approaches those could be beneficial in faster recoveries.
    Method Major databases were searched from inception to till January 2020. Relevant main articles and cross references were evaluated. In addition, findings were compared to a previously published review. Pharmacological and bio-molecule interventions decrease bone depletion by reducing bone resorption and enhancing bone formation process, and other external stimuli like strengthening muscular and skeletal tissues are employed to prevent OP and accelerate fracture healing and normal functioning.
    Results A literature review of such interventions showed that bisphosphonates and selective estrogen receptor modulator treatment reduces fracture risks in osteoporosis and increase callus formation during fracture repair but do not reduce total time of fracture healing. Parathyroid hormone (PTH) and its analogues prevent OP by promoting callus formation as well as osteogenesis, enhance coupled remodelling and amount of mineralized tissue. When PTH is combined with bone morphogenetic proteins (BMP) improve mechanical functioning by integrating new bone tissue with old bone tissue. Restraining and supportive therapies like the physical exercises could be beneficial to minimize gravity of osteoporosis. Electromagnetic field therapy and pulsed ultrasonic therapy could be useful after surgical management of fracture or delayed union.
    Conclusion To identify the quantitative effect of these therapies in isolation or in combination, clinical trials under proper experimental settings are especially important. Unlike the therapies for fracture repair in non-osteoporotic patients, the line of treatment and duration of each therapy in isolation or in combination with pharmacological agents, biomolecules, physical stimuli, exercises and lifestyles are necessary.


    Abbreviations: H-H inequalities: Hermite-Hadamard inequalities; i-v-ms: Interval-valued mappings; UD order: Up and down order; LR order: Left and Right order; H-H Fejér inequality: Hermite-Hadamard Fejér inequality; IA-integrable: Aumann integrable; FA-integrable: Fuzzy Aumann integrable

    Numerous academics have been working to generalize and extend the classical convexity in various ways recently, and they have found new integral inequalities for this convexity that has been generalized and extended; for examples, see [1,2,3,4,5,6]. Invex functions, a helpful extension of convex functions, were first presented by Hanson [7] in 1981. The class of invex functions is identical to the class of functions whose stationary points are global minima, as demonstrated by Craven and Glover [8]. Ben-Israel and Mond [9] established the idea of preinvex functions. Preinvex functions are nonconvex functions, as is common knowledge. The study and applications of this newly defined nonconvex function in optimization theory and related domains were the subject of several research articles that were motivated by this idea, see [10,11,12].

    Hermite-Hadamard (H-H) inequality, an extension of the traditional H-H inequality, was derived by Noor [13] for the preinvex functions. The idea of classical convex functions on coordinates was developed by Dragomir [14], who also illustrated H-H type inequalities for these functions. Additionally, Latif and Dragomir [15] discovered several H-H type inequalities for functions whose second-order partial derivatives in absolute value are preinvex on the coordinates and defined preinvex functions on the coordinates. Using the symmetry of the positive function, Matoka [16] proposed the class of (h1, h2)-preinvex functions on the coordinates and proved H-H and Fej'er type inequalities. See [17,18,19,20,21] for further information on preinvex functions and associated inequalities.

    Moore was the first person to think about interval analysis [22]. Moore [23] conducted research on interval techniques for finding upper and lower limits on the precise values of integrals of interval-valued mappings (i-v-ms) in 1979. He also explored the integration of interval-valued mappings. In order to find effective solutions, Bhurjee and Panda [24] established a generic multi-objective fractional programming problem whose parameters in the objective functions and constraints are intervals. In order to develop KKT optimality requirements for LU-prinvex and invex optimization problems with an interval-valued objective function, Zhang et al. [25] expanded the notions of invexity and preinvexity to interval-valued mappings. For interval-valued mappings, Zhao et al. [26] established the interval double integral and provided Chebyshev type inequalities. Areas of economics, chemical engineering, beam physics, control circuitry design, global optimization, robotics, error analysis, signal processing, and computer graphics are among the practical uses of interval analysis (see [27,28,29,30,31]).

    Remember that fuzzy interval-valued functions are fuzzy number valued mappings. On the other hand, Nanda and Kar [32] were the first to introduce the idea of convex fuzzy number valued mappings. In order to offer new versions of H-H and fractional type of inequalities, Khan et al. [33,34] presented h-convex fuzzy number valued mappings and (h1, h 2)-convex fuzzy number valued functions and got some by utilizing fuzzy Riemann Liouville Fractional Integrals and fuzzy Riemannian integrals, respectively. Similarly, using fuzzy order relations and fuzzy Riemann Liouville Fractional Integrals, Sana and Khan et al. [35] developed new iterations of fuzzy fractional H-H inequalities for harmonically convex fuzzy number valued mappings. We direct the readers to [36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67] and the references therein for further information on extended convex functions, fuzzy intervals, and fuzzy integrals.

    Zhao et al. [5,26] and Zhang et al. [49] serve as major sources of inspiration for the work in this study report. As an extension of classical convex functions, we introduce the concept of up and down λ-convex fuzzy-number valued mapping via up and down fuzzy relation and provide new H-H type fuzzy inclusions for these functions. For the result of two up and down λ-convex fuzzy-number valued mappings, we additionally give H-H type fuzzy inclusions. Moreover, we use some appropriate cases to highlight our findings. As a specific situation, the results for up and down λ-convex fuzzy-number valued mapping are included in the conclusions drawn in this study. Using fuzzy Riemann integrals, we can look at H-H type inclusions for up and down λ-convex fuzzy-number valued mapping that have fuzzy number values.

    The following is how this paper is organized: We provide a few important introductions in Section 2. Moreover, Section 2 also provides the definition of up and down λ-convex fuzzy-number valued mapping and some related basic concepts. Section 3 provides an analysis of H-H type fuzzy inclusions. In addition, we provide H-H type fuzzy inclusions for the product of two up and down λ-convex fuzzy-number valued mappings. Moreover, we have proved the weighted H-H type fuzzy inclusions for up and down λ-convex fuzzy-number valued mapping. In Section 3, certain unique instances of these results are also examined. We examine the study's findings and potential directions in Section 4.

    Let XI be the space of all closed and bounded intervals of R and wXI be defined by

    w=[w,w]={ϰR|wϰw},(w,wR). (1)

    If w=w, then w is said to be degenerate. In this article, all intervals will be non-degenerate intervals. If w0, then [w,w] is called a positive interval. The set of all positive intervals is denoted by X+I and defined as X+I={[w,w]:[w,w]XIandw0}.

    Let ςR and ςw be defined by

    ςw={[ςw,ςw]ifς>0,{0}ifς=0,[ςw,ςw]ifς<0.. (2)

    Then the Minkowski difference xw, addition w+x and w×x for w,xXI are defined by

    [x,x]+[w,w]=[x+w,x+w], (3)
    [x,x]×[w,w]=[min{xw,xw,xw,xw},max{xw,xw,xw,xw}], (4)
    [x,x][w,w]=[xw,xw], (5)

    Remark 1. (ⅰ) For given [x,x],[w,w]XI, the relation "I" defined on XI by

    [w,w]I[x,x]ifandonlyif,wx,xw, (6)

    for all [x,x],[w,w]XI, it is a partial interval inclusion relation. The relation [w,w]I[x,x] coincident to [w,w][x,x] on XI. It can be easily seen that "I" looks like "up and down" on the real line R, so we call "I" is "up and down" (or "UD" order, in short) [49].

    (ⅱ) For given [x,x],[w,w]XI, we say that [x,x]I[w,w] if and only if xw,xw or xw,x<w, it is an partial interval order relation. The relation [x,x]I[w,w] coincident to [x,x][w,w] on XI. It can be easily seen that "I" looks like "left and right" on the real line R, so we call "I" is "left and right" (or "LR" order, in short) [48,49].

    For [x,x],[w,w]XI, the Hausdorff-Pompeiu distance between intervals [x,x] and [w,w] is defined by

    dH([x,x],[w,w])=max{|xw|,|xw|}. (7)

    It is familiar fact that (XI,dH) is a complete metric space [40,46,47].

    Definition 1. [39,40] A fuzzy subset L of R is distinguished by a mapping ˜w:R[0,1] called the membership mapping of L. That is, a fuzzy subset L of R is a mapping ˜w:R[0,1]. So for further study we have choosed this notation. We appoint E to denote the set of all fuzzy subsets of R.

    Definition 2. [39,40] Given ˜wEC, the level sets or cut sets are given by [˜w]i={ϰR|˜w(ϰ)>i} for all i[0,1] and by [˜w]0={ϰR|˜w(ϰ)>0}. These sets are known as i-level sets or i-cut sets of ˜w.

    Definition 3. [41] Let ˜wE. Then, ˜w is known as fuzzy number or fuzzy number if following properties are satisfied by ˜w:

    (1) ˜w should be normal if there exists ϰR and ˜w(ϰ)=1;

    (2) ˜w should be upper semi continuous on R if for given ϰR, there exist ϵ>0 there exist δ>0 such that ˜w(ϰ)˜w(s)<ϵ for all ϰ,sR with |ϰs|<δ;

    (3) ˜w should be fuzzy convex that is ˜w((1ς)ϰ+ςs)min(˜w(ϰ),˜w(s)), for all ϰ,sR and ς[0,1];

    (4) ˜w should be compactly supported that is cl{ςR|˜w(ϰ)>0} is compact.

    We appoint EC to denote the set of all fuzzy numbers of R.

    Proposition 1. [42] Let ˜w,˜xEC. Then relation "F" given on EC by

    ˜wF˜xifandonlyif,[˜w]iI[˜x]i,foreveryi[0,1], (8)

    it is left and right order relation.

    Proposition 2. [57] Let ˜w,˜xEC. Then relation "F" given on EC by

    ˜wF˜xifandonlyif,[˜w]iI[˜x]i,foreveryi[0,1], (9)

    it is up and down order relation on EC.

    Remember the approaching notions, which are offered in literature. If ˜w,˜xEC and iR, then, for every i[0,1], the arithmetic operations are defined by

    [ς˜w]i=ς.[˜w]i. (10)
    [˜w˜x]i=[˜w]i+[˜x]i, (11)
    [˜w˜x]i=[˜w]i×[˜x]i. (12)

    These operations follow directly from the Eqs. (2)–(4), respectively.

    Theorem 1. [40] The space EC dealing with a supremum metric i.e., for ˜w,˜xEC

    d(˜w,˜x)=sup0i1dH([˜w]i,[˜x]i), (13)

    is a complete metric space, where H denote the well-known Hausdorff metric on space of intervals.

    Now we define and discuss some properties fractional integral operators of interval and fuzzy-number valued mappings.

    Theorem 2. [40,41] If Υ:[τ,ϑ]RXI is an interval-valued mapping (i-v-m) satisfying that Υ(ϰ)=[Υ(ϰ),Υ(ϰ)], then Υ is Aumann integrable (IA-integrable) over [τ,ϑ] if and only if, Υ(ϰ) and Υ(ϰ) both are integrable over [τ,ϑ] such that

    (IA)ϑτΥ(ϰ)dϰ=[ϑτΥ(ϰ)dϰ,ϑτΥ(ϰ)dϰ]. (14)

    Definition 4. [48] Let ˜Υ:IREC is called fuzzy-number valued mapping. Then, for every i[0,1], as well as i-levels define the family of i-v-ms Υi:IRXI satisfying that Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)] for every ϰI. Here, for every i[0,1], the endpoint real-valued mappings Υ(,i),Υ(,i):IR are called lower and upper mappings of Υ.

    Definition 5. [48] Let ˜Υ:IREC be a fuzzy-number valued mapping. Then ˜Υ(ϰ) is said to be continuous at ϰI, if for every i[0,1], Υi(ϰ) is continuous if and only if, both endpoint mappings Υ(ϰ,i) and Υ(ϰ,i) are continuous at ϰI.

    Definition 6. [41] Let ˜Υ:[τ,ϑ]REC is fuzzy-number valued mapping. The fuzzy Aumann integral ((FA)-integral) of ˜Υ over [τ,ϑ], denoted by (FA)ϑτ˜Υ(ϰ)dϰ, is defined level-wise by

    [(FA)ϑτ˜Υ(ϰ)dϰ]i=(IA)ϑτΥi(ϰ)dϰ={ϑτΥ(ϰ,i)dϰ:Υ(ϰ,i)S(Υi)}, (15)

    where S(Υi)={Υ(.,i)R:Υ(.,i)isintegrableandΥ(ϰ,i)Υi(ϰ)}, for every i[0,1]. ˜Υ is (FA)-integrable over [τ,ϑ] if (FA)ϑτ˜Υ(ϰ)dϰEC.

    Theorem 3. [42] Let ˜Υ:[τ,ϑ]REC be a fuzzy-number valued mapping, as well as i-levels, define the family of i-v-ms Υi:[τ,ϑ]RXI satisfying that Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)] for every ϰ[τ,ϑ] and for every i[0,1]. Then ˜Υ is (FA)-integrable over [τ,ϑ] if and only if, Υ(ϰ,i) and Υ(ϰ,i) both are integrable over [τ,ϑ]. Moreover, if ˜Υ is (FA)-integrable over [τ,ϑ], then

    [(FA)ϑτ˜Υ(ϰ)dϰ]i=[ϑτΥ(ϰ,i)dϰ,ϑτΥ(ϰ,i)dϰ]=(IA)ϑτΥi(ϰ)dϰ, (16)

    for every i[0,1].

    The family of all (FA)-integrable fuzzy-number valued mappings over [τ,ϑ] are denoted by FA([τ,ϑ],i).

    Breckner discussed the coming emerging idea of interval-valued convexity in [43].

    A i-v-m Υ:I=[τ,ϑ]XI is called convex i-v-m if

    Υ(ςϰ+(1ς)s)ςΥ(ϰ)+(1ς)Υ(s), (17)

    for all ϰ,y[τ,ϑ],ς[0,1], where XI is the collection of all real valued intervals. If (17) is reversed, then Υ is called concave.

    Definition 7. [32] The fuzzy-number valued mapping Υ:[τ,ϑ]EC is called convex fuzzy-number valued mapping on [τ,ϑ] if

    ˜Υ(ςϰ+(1ς)s)Fς˜Υ(ϰ)(1ς)˜Υ(s), (18)

    for all ϰ,s[τ,ϑ],ς[0,1], where ˜Υ(ϰ)F˜0 for all ϰ[τ,ϑ]. If (18) is reversed then, ˜Υ is called concave fuzzy-number valued mapping on [τ,ϑ]. ˜Υ is affine if and only if it is both convex and concave fuzzy-number valued mapping.

    Definition 8. [49] The fuzzy-number valued mapping ˜Υ:[τ,ϑ]EC is called up and down convex fuzzy-number valued mapping on [τ,ϑ] if

    ˜Υ(ςϰ+(1ς)s)Fς˜Υ(ϰ)(1ς)˜Υ(s), (19)

    for all ϰ,s[τ,ϑ],ς[0,1], where ˜Υ(ϰ)F˜0 for all ϰ[τ,ϑ]. If (19) is reversed then, ˜Υ is called up and down concave fuzzy-number valued mapping on [τ,ϑ]. ˜Υ is up and down affine fuzzy-number valued mapping if and only if it is both up and down convex and, up and down concave fuzzy-number valued mapping.

    Definition 9. [62] Let K be convex set and λ:[0,1]KR+ such that λ0. Then fuzzy-number valued mapping ˜Υ:KEC is said to be up and down λ-convex on K if

    ˜Υ(ςϰ+(1ς)s)Fλ(ς)˜Υ(ϰ)λ(1ς)˜Υ(s), (20)

    for all ϰ,sK,ς[0,1], where ˜Υ(ϰ)˜0. The fuzzy-number valued mapping ˜Υ:KEC is said to be up and down λ-concave on K if inequality (20) is reversed. Moreover, ˜Υ is known as affine up and down λ-convex fuzzy-number valued mapping on K if

    ˜Υ(ςϰ+(1ς)s)=λ(ς)˜Υ(ϰ)λ(1ς)˜Υ(s), (21)

    for all ϰ,sK,ς[0,1], where ˜Υ(ϰ)˜0.

    Remark 2. The up and down λ-convex fuzzy-number valued mappings have some very nice properties similar to convex fuzzy-number valued mapping,

    1) if ˜Υ is up and down λ-convex fuzzy-number valued mapping, then α˜Υ is also up and down λ-convex for α0.

    2) if ˜Υ and ˜T both are up and down λ-convex fuzzy-number valued mappings, then max(˜Υ(ϰ),˜T(ϰ)) is also up and down λ-convex fuzzy-number valued mapping.

    Here, we will go through a few unique exceptional cases of up- and down-convex fuzzy-number valued mappings:

    (ⅰ) If λ(ς)=ςs, then up and down λ-convex fuzzy-number valued mapping becomes up and down s-convex fuzzy-number valued mapping, that is

    ˜Υ(ςϰ+(1ς)s)Fςs˜Υ(ϰ)(1ς)s˜Υ(s),ϰ,sK,ς[0,1].

    (ⅱ) If λ(ς)=ς, then up and down λ-convex fuzzy-number valued mapping becomes up and down convex fuzzy-number valued mapping, see [49], that is

    ˜Υ(ςϰ+(1ς)s)Fς˜Υ(ϰ)(1ς)˜Υ(s),ϰ,sK,ς[0,1].

    (ⅲ) If λ(ς)1, then up and down λ-convex fuzzy-number valued mapping becomes up and down P-convex fuzzy-number valued mapping, that is

    ˜Υ(ςϰ+(1ς)s)F˜Υ(ϰ)˜Υ(s),ϰ,sK,ς[0,1].

    Note that, there are also new special cases (ⅰ) and (ⅲ) as well.

    Theorem 4. [62] Let K be convex set, non-negative real valued function λ:[0,1]KR such that λ0 and let ˜Υ:KEC be a fuzzy-number valued mapping, whose i-levels define the family of i-v-ms Υi:KRX+IXI are given by

    Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)], (22)

    for all ϰK and for all i[0,1]. Then ˜Υ is up and down λ-convex on K, if and only if, for all i[0,1], Υ(ϰ,i) is λ-convex and Υ(ϰ,i) is λ-concave.

    Remark 3. If Υ(ϰ,i)=Υ(ϰ,i) with i=1, then up and down λ-convex fuzzy number valued function reduces to the λ-convex function.

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)=ςs with s(0,1), then up and down λ-convex fuzzy number valued function reduces to the s-convex function.

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)=ς with s(0,1), then up and down λ-convex fuzzy number valued function reduces to the convex function.

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)=1, then up and down λ-convex fuzzy number valued function reduces to the P-convex function.

    Example 1. We consider λ(ς)=ς, for ς[0,1] and the fuzzy-number valued mapping ˜Υ:[0,1]EC defined by

    ˜Υ(ϰ)(σ)={σ2ϰ2σ[0,2ϰ2]4ϰ2σ2ϰ2σ(2ϰ2,4ϰ2]0otherwise.

    Then, for each i[0,1], we have Υi(ϰ)=[2iϰ2,(42i)ϰ2]. Since end point functions Υ(ϰ,i), Υ(ϰ,i) are λ-convex and λ-concave functions for each i[0,1], respectively. Hence ˜Υ(ϰ) is up and down λ-convex fuzzy-number valued mapping.

    Definition 10. [62] Let ˜Υ:[τ,ϑ]EC be a fuzzy-number valued mapping, whose i-levels define the family of i-v-ms Υi:[τ,ϑ]X+CXC are given by

    Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)], (23)

    for all ϰ[τ,ϑ] and for all i[0,1]. Then, ˜Υ is lower up and down λ-convex (λ-concave) fuzzy-number valued mapping on [τ,ϑ], if and only if, for all i[0,1], Υ(ϰ,i) is a λ-convex (λ-concave) mapping and Υ(ϰ,λ) is a λ-affine mapping.

    Definition 11. [62] Let ˜Υ:[τ,ϑ]EC be a fuzzy-number valued mapping, whose i-levels define the family of i-v-ms Υi:[τ,ϑ]X+CXC are given by

    Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)], (24)

    for all ϰ[τ,ϑ] and for all i[0,1]. Then, ˜Υ is an upper up and down λ-convex (λ-concave) fuzzy-number valued mapping on [τ,ϑ], if and only if, for all i[0,1], Υ(ϰ,i) is an λ-affine mapping and Υ(ϰ,i) is a λ-convex (λ-concave) mapping.

    Remark 4. If λ(ς)=ς, then both concepts "up and down λ-convex fuzzy-number valued mapping" and classical "convex fuzzy-number valued mapping, see [32]" behave alike when ˜Υ is lower up and down convex fuzzy-number valued mapping.

    Both concepts "convex interval-valued mapping, see [43]" and "left and right λ-convex interval-valued mapping, see [49]" are coincident when Υ is lower up and down λ-convex fuzzy-number valued mapping with i=1.

    The fuzzy Hermite-Hadamard inequalities for up and down λ-convex fuzzy-number valued mappings are established in this section. Additionally, several instances are provided to support the theory produced in this study's application.

    Theorem 5. Let ˜Υ:[τ,ϑ]EC be an up and down λ-convex fuzzy-number valued mapping with non-negative real valued function λ:[0,1]R+ and λ(12)0, whose i-levels define the family of i-v-ms Υi:[τ,ϑ]RX+I are given by Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)] for all ϰ[τ,ϑ] and for all i[0,1]. If ˜ΥFA([τ,ϑ],i), then

    12λ(12)˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF[˜Υ(τ)˜Υ(ϑ)]10λ(ς)dς. (25)

    If ˜Υ is up and down λ-concave fuzzy-number valued mapping, then (25) is reversed.

    12λ(12)˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF[˜Υ(τ)˜Υ(ϑ)]10λ(ς)dς. (26)

    Proof. Let ˜Υ:[τ,ϑ]EC be an up and down λ-convex fuzzy-number valued mapping. Then, for a,b[τ,ϑ], we have

    ˜Υ(ςa+(1ς)b)Fλ(ς)˜Υ(a)λ(1ς)˜Υ(b),

    If ς=12, then we have

    1λ(12)˜Υ(a+b2)F˜Υ(a)˜Υ(b).

    Let a=ςτ+(1ς)ϑ and b=(1ς)τ+ςϑ. Then, above inequality we have

    1λ(12)˜Υ(τ+ϑ2)F˜Υ(ςτ+(1ς)ϑ)˜Υ((1ς)τ+ςϑ).

    Therefore, for every i[0,1], we have

    1λ(12)Υ(τ+ϑ2,i)Υ(ςτ+(1ς)ϑ,i)+Υ((1ς)τ+ςϑ,i),1λ(12)Υ(τ+ϑ2,i)Υ(ςτ+(1ς)ϑ,i)+Υ((1ς)τ+ςϑ,i).

    Then

    1λ(12)10Υ(τ+ϑ2,i)dς10Υ(ςτ+(1ς)ϑ,i)dς+10Υ((1ς)τ+ςϑ,i)dς,1λ(12)10Υ(τ+ϑ2,i)dς10Υ(ςτ+(1ς)ϑ,i)dς+10Υ((1ς)τ+ςϑ,i)dς.

    It follows that

    1λ(12)Υ(τ+ϑ2,i)2ϑτϑτΥ(ϰ,i)dϰ,1λ(12)Υ(τ+ϑ2,i)2ϑτϑτΥ(ϰ,i)dϰ.

    That is

    1λ(12)[Υ(τ+ϑ2,i),Υ(τ+ϑ2,i)]I2ϑτ[ϑτΥ(ϰ,i)dϰ,ϑτΥ(ϰ,i)dϰ].

    Thus,

    12λ(12)˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰ. (27)

    In a similar way as above, we have

    1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF[˜Υ(τ)˜Υ(ϑ)]10λ(ς)dς. (28)

    Combining (27) and (28), we have

    12λ(12)˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF[˜Υ(τ)˜Υ(ϑ)]10λ(ς)dς.

    Hence, the required result.

    Note that, by using same steps, the formula (26) can be proved with the help of up and down λ-concave fuzzy-number valued mapping.

    Remark 5. If λ(ς)=ςs, then Theorem 5 reduces to the result for up and down s-convex fuzzy-number valued mapping which is also new one:

    2s1˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF1s+1[˜Υ(τ)˜Υ(ϑ)]. (29)

    If λ(ς)=ς, then Theorem 5 reduces to the result for up and down convex fuzzy-number valued mapping which is also new one:

    ˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF˜Υ(τ)˜Υ(ϑ)2. (30)

    If λ(ς)1 then Theorem 5 reduces to the result for up and down P-convex fuzzy-number valued mapping which is also new one:

    12˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF˜Υ(τ)˜Υ(ϑ). (31)

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1, then Theorem 5 reduces to the result for classical λ-convex function, see [5]:

    12λ(12)Υ(τ+ϑ2)1ϑτ(IA)ϑτΥ(ϰ)dϰ[Υ(τ)+Υ(ϑ)]10λ(ς)dς. (32)

    If Υ(ϰ,i)Υ(ϰ,i) with i=1 and λ(ς)=ς, then Theorem 5 reduces to the result for classical convex function, see [5]:

    Υ(τ+ϑ2)1ϑτ(IA)ϑτΥ(ϰ)dϰΥ(τ)+Υ(ϑ)2. (33)

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1, then Theorem 5 reduces to the result for classical λ-convex function, see [64]:

    12λ(12)Υ(τ+ϑ2)1ϑτϑτΥ(ϰ)dϰ[Υ(τ)+Υ(ϑ)]10λ(ς)dς. (34)

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)=ςs, then Theorem 5 reduces to the result for classical s-convex function, see [64]:

    2s1Υ(τ+ϑ2)1ϑτϑτΥ(ϰ)dϰ1s+1[Υ(τ)+Υ(ϑ)]. (35)

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)=ς, then Theorem 5 reduces to the result for classical convex function:

    Υ(τ+ϑ2)1ϑτϑτΥ(ϰ)dϰΥ(τ)+Υ(ϑ)2. (36)

    If Υ(ϰ,i)=Υ(ϰ,i) with i=1 and λ(ς)1 then Theorem 5 reduces to the result for classical P-convex function:

    12Υ(τ+ϑ2)1ϑτϑτΥ(ϰ)dϰΥ(τ)+Υ(ϑ). (37)

    Example 2. We consider λ(ς)=ς, for ς[0,1], and the fuzzy-number valued mapping ˜Υ:[τ,ϑ]=[2,3]EC defined by,

    ˜Υ(ϰ)(θ)={θ2+ϰ121ϰ12θ[2ϰ12,3]2+ϰ12θϰ121θ(3,2+ϰ12]0otherwise.

    Then, for each i[0,1], we have Υi(ϰ)=[(1i)(2ϰ12)+3i,(1i)(2+ϰ12)+3i]. Since left and right end point mappings Υ(ϰ,i)=(1i)(2ϰ12)+3i, Υ(ϰ,i)=(1i)(2+ϰ12)+3i, are convex mappings for each i[0,1], then ˜Υ(ϰ) is up and down convex fuzzy-number valued mapping. We clearly see that ΥL([τ,ϑ],EC). Now computing the following

    12λ(12)Υ(τ+ϑ2,i)1ϑτϑτΥ(ϰ,i)dϰ[Υ(τ,i)+Υ(ϑ,i)]10λ(ς)dς.
    12λ(12)Υ(τ+ϑ2,i)=Υ(52,i)=4102(1i)+3i,
    1ϑτϑτΥ(ϰ,i)dϰ=32((1i)(2ϰ12)+3i)dϰ=(6+4263)3(1i)+3i,
    [Υ(τ,i)+Υ(ϑ,i)]10λ(ς)dς=(423)2(1i)+3i,

    for all i[0,1]. That means

    4102(1i)+3i(6+4263)3(1i)+3i(423)2(1i)+3i.

    Similarly, it can be easily show that

    12λ(12)Υ(τ+ϑ2,i)1ϑτϑτΥ(ϰ,i)dϰ[Υ(τ,i)+Υ(ϑ,i)]10λ(ς)dς.

    for all i[0,1], such that

    12λ(12)Υ(τ+ϑ2,i)=Υ(52,i)=4+102(1i)+3i,
    1ϑτϑτΥ(ϰ,i)dϰ=32((1i)(2+ϰ12)+3i)dϰ=(642+63)3(1i)+3i,
    [Υ(τ,i)+Υ(ϑ,i)]10λ(ς)dς=(4+2+3)2(1i)+3i.

    From which, we have

    4+102(1i)+3i(642+63)3(1i)+3i(4+2+3)2(1i)+3i,

    that is

    [4102(1i)+3i,4+102(1i)+3i]I[(6+4263)3(1i)+3i,(642+63)3(1i)+3i]I[(423)2(1i),(4+2+3)2(1i)+3i],

    for all i[0,1].

    Hence,

    12λ(12)˜Υ(τ+ϑ2)F1ϑτ(FA)ϑτ˜Υ(ϰ)dϰF[˜Υ(τ)˜Υ(ϑ)]10λ(ς)dς.

    Theorem 6. Let ˜Υ:[τ,ϑ]EC be an up and down λ-convex fuzzy-number valued mapping with non-negative real valued function λ:[0,1]R+ and λ(12)0, whose i-levels define the family of i-v-ms Υi:[τ,ϑ]RX+I are given by Υi(ϰ)=[Υ(ϰ,i),Υ(ϰ,i)] for all ϰ[τ,ϑ] and for all i[0,1]. If ˜ΥFA([τ,ϑ],i), then

    (38)

    where

    and ,

    Proof. Take we have

    Therefore, for every , we have

    In consequence, we obtain

    That is

    It follows that

    (39)

    In a similar way as above, we have

    (40)

    Combining (39) and (40), we have

    By using Theorem 5, we have

    Therefore, for every , we have

    that is

    hence, the result follows.

    Example 3. We consider for , and the fuzzy-number valued mapping defined by, as in Example 2, then is -convex fuzzy-number valued mapping and satisfying (25). We have and . We now compute the following:

    Then we obtain that

    Hence, Theorem 6 is verified.

    The novel fuzzy Hermite-Hadamard inequalities for the product of two up and down -convex fuzzy-number valued mappings are found in the results.

    Theorem 7. Let be two up and down -convex fuzzy-number valued mappings with non-negative real valued functions and whose -levels define the family of i-v-ms are given by and for all and for all . If and , then

    (41)

    where and and

    Proof. Let be two up and down -convex and -convex fuzzy-number valued mappings. Then, we have

    And

    From the definition of up and down -convex fuzzy number valued mapping it follows that and , so

    Integrating both sides of above inequality over [0, 1] we get

    It follows that,

    that is

    Thus,

    and the theorem has been established.

    Example 4. We consider for , and the fuzzy-number valued mappings defined by,

    Then, for each we have and Since end point functions and , -convex functions for each . Hence both are up and down -convex fuzzy-number valued mappings. We now computing the following

    for each that means

    Hence, Theorem 7 is demonstrated.

    Theorem 8. Let be two up and down -convex and -convex fuzzy-number valued mappings with non-negative real-valued functions , respectively and respectively, whose -levels define the family of i-v-ms are given, respectively, by and for all and for all . If , then

    (42)

    where and and

    Proof. By hypothesis, for each we have

    Integrating over we have

    that is

    hence, the required result.

    Example 5. We consider for , and the fuzzy-number valued mappings as in Example 4. Then, for each we have and and, are up and down -convex and up and down -convex fuzzy-number valued mappings, respectively. We have and , . We now computing the following

    for each that means

    hence, Theorem 8 is demonstrated.

    The H-H Fejér inequalities for up and down -convex fuzzy number valued mappings are now presented. The second H-H Fejér inequality for up and down -convex fuzzy number valued mapping is firstly obtained.

    Theorem 9. Let be an up and down -convex fuzzy number valued mapping with , whose -levels define the family of i-v-ms are given by for all and for all . If and symmetric with respect to then

    (43)

    Proof. Let be an up and down -convex fuzzy number valued mapping. Then, for each we have

    (44)

    And

    (45)

    After adding (44) and (45), and integrating over we get

    Since is symmetric, then

    (46)

    Since

    (47)

    Then from (47), (46) we have

    that is

    hence

    Now, generalizing the first H-H Fejér inequalities for classical convex functions and we build the first H-H Fejér inequality for up and down -convex fuzzy number valued mapping.

    Theorem 10. Let be an up and down -convex fuzzy number valued mapping with , whose -levels define the family of i-v-ms are given by for all and for all . If and symmetric with respect to and , then

    (48)

    Proof. Since is an up and down -convex, then for we have

    (49)

    Since , then by multiplying (48) by and integrate it with respect to over we obtain

    (50)

    Since

    (51)

    Then from (51), (50) we have

    from which, we have

    that is

    This completes the proof.

    Remark 6. From Theorem 9 and 10, we clearly see that:

    If , then we acquire the inequality (25).

    Let and . Then from (43) and (48), we acquire the following inequality, see [1]:

    (52)

    If is lower up and down convex fuzzy-number valued mapping on and then we acquire the following coming inequality, see [33]:

    (53)

    If is lower up and down convex fuzzy-number valued mapping on with and then from (43) and (48) we acquire the following coming inequality, see [45]:

    (54)

    If is lower up and down convex fuzzy-number valued mapping on with and , then from (43) and (48) we acquire the following coming inequality, see [45]:

    (55)

    Let and with . Then from (43) and (48), we obtain following classical Fejér inequality.

    (56)

    Example 6. We consider for , and the fuzzy-number valued mapping defined by,

    Then, for each we have . Since end point mappings are convex mappings for each , then is up and down convex fuzzy-number valued mapping. If

    then , for all . Since and . Now we compute the following:

    (57)

    And

    (58)

    From (57) and (58), we have

    for all

    Hence, Theorem 9 is verified.

    For Theorem 10, we have

    (59)
    (60)

    From (59) and (60), we have

    Hence, Theorem 10 has been verified.

    In this work, the class of up and down -convex fuzzy-number valued mappings is introduced s an extension of classical convex functions and some new Hermite-Hadamard inequalities are established by means of fuzzy order relation on fuzzy-number space. Useful examples that verify the applicability of theory developed in this study are presented. We intend to use various types of up and down convex fuzzy-number valued mappings to construct fuzzy inequalities for fuzzy-number valued mappings. We hope that this concept will be helpful for other authors to pay their roles in different fields of sciences. Future work will explore fuzzy fractional integrals to study H-H type and weighted H-H type fuzzy inclusions for up and down convex fuzzy-number valued mappings.

    The authors would like to thank the Rector, COMSATS University Islamabad, Islamabad, Pakistan, for providing excellent research and academic environments. The authors would like to thank the Deanship of Scientific Research at Umm Al-Qura University for supporting this work by Grant Code: 22UQU4330052DSR12 and also, the research was funded by the project ProCode-UCM (PID2019-108528RB-C22) from the Spanish Ministerio de Ciencia e Innovación.

    The authors declare that they have no competing interests.


    Acknowledgments



    There were no sources of funding of this study. This review report was not published in a repository.

    Conflict of interest



    Both the authors declare no conflicts of interest in this paper.

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