Efficient management of pharmaceutical supply chains during the COVID-19 pandemic is critical to mitigate material and human losses. This paper addresses the design of a pharmaceutical supply chain ...network under pandemic disruption, introducing a novel bi-objective mathematical model. Traditional supply chain management strategies often fall short in the face of sudden disruptions, necessitating the development of resilient systems. Our model seeks to minimise economic costs and shortages as primary objectives, addressing the specific challenge of sudden surges in demand for pharmaceuticals. To enhance resilience, we propose solutions including the establishment of temporary distribution points and the creation of backup inventory. We employ a scenario-based, discrete, and linear modelling approach, solving the model using goal-planning methods and validating its efficacy through numerical examples. Additionally, we conduct a case study in the metropolitan area of Mashhad, further demonstrating the applicability and effectiveness of our approach. This research contributes to the advancement of resilient supply chain design in the pharmaceutical sector, offering insights that can inform improved management practices and bolster resilience in pharmaceutical supply chains.
Background: The prevalence of opium addiction in Iran is high probably due to the belief that opium has preventive effects against cardiovascular diseases. In the second phase of Kerman coronary ...artery disease risk factors study, the prevalence, incidence rate, and the association between opium use and other coronary artery disease risk factors (CADRFs) were assessed. Methods: In a cross-sectional study (2014-2018), 9996 inhabitants of Kerman, southeastern Iran, aged 15-80 years were recruited to the study. After taking fasting blood samples, the participants were examined or interviewed for demographic data and CADRFs, including opium use. The participants were categorized into "never", "occasional", and "dependent" users. The association between opium use and CADRFs was assessed with adjusted regression analysis (Stata v.11 software). Results: The overall prevalence of opium consumption was lower than that of five years earlier (P<0.01). The prevalence was currently higher in men than women and decreased in men between the two phases (P<0.001). There was a positive correlation between opium use and depression (P<0.001), anxiety (P<0.05), and a negative association with the level of physical activity (P<0.001). The five-year incident rate of dependent and occasional opium use was 4.2 and 3.9 persons/100 person-years, respectively. The incidence of opium use was higher in diabetic, hypertensive, depressed, anxious, and obese subjects. Conclusion: The study did not demonstrate any protective effects of opium on CADRFs. Considering the higher rate of opium use in subjects with hypertension, diabetes, obesity, and psychological disorders, the health authorities should implement educational programs to warn and correct the unsafe belief. Keywords * Opium dependence * Prevalence * Incidence * Coronary artery disease * Risk factors
The COVID-19 pandemic has had a significant impact on hospitals and healthcare systems around the world. The cost of business disruption combined with lingering COVID-19 costs has placed many public ...hospitals on a course to insolvency. To quickly return to financial stability, hospitals should implement efficiency measure. An average technical efficiency (ATE) model made up of data envelopment analysis (DEA) and stochastic frontier analysis (
) for assessing efficiency in public hospitals during and after the COVID-19 pandemic is offered. The DEA method is a non-parametric method that requires no information other than the input and output quantities.
is a parametric method that considers stochastic noise in data and allows statistical testing of hypotheses about production structure and degree of inefficiency. The rationale for using these two competing approaches is to balance each method's strengths, weaknesses and introduce a novel integrated approach. To show the applicability and efficacy of the proposed hybrid VRS-CRS-SFA (
) model, a case study is presented.
There is some controversy as for the roles played by tumor growth factor‐β (TGF‐β), interleukin‐1β (IL‐1β), and IL‐22 in the onset process of type 2 diabetes (T2D). The main aim of this project was ...to examine serum levels of TGF‐β, IL‐1β, and IL‐22 in the new cases and long period T2D patients as well as healthy controls. In this study, 115 new T2D patient cases (group 1), 434 T2D patients who have suffered from the disease more than 2 years (group 2), and 104 healthy controls have been selected from 6240 (3619 females) patients who were under study population from Kerman Coronary Artery Disease Risk Factor Study. Serum levels of TGF‐β, IL‐1β, and IL‐22 have been evaluated using commercial kits. Serum levels of TGF‐β and IL‐1β significantly increased, while IL‐22 decreased in 2 groups in comparison to healthy controls. Serum levels of IL‐22, but not TGF‐β and IL‐1β, were significantly decreased in group 1 in comparison to healthy controls. There were no significant differences between groups 1 and 2 as for the cytokine levels. Serum levels of IL‐22 increased in the females in group 2 when compared to females in group 1. It appears that TGF‐β and IL‐1β participate in the induction of inflammation after establishment of T2D, while decrease in IL‐22 may be considered as a key factor for onset of the disease. Gender can also be considered as the main risk factor for variation in cytokine levels.
Cytokines may participate in the etiology and pathogenesis of type 2 diabetes. This study demonstrated that IL‐22 can be considered as a risk factor for onset of type 2 diabetes.
Scheduling is a decision-making process that plays an important role in the service and production industries. Effective scheduling can assist companies to survive in the competitive market. Single ...machine scheduling is an important optimization problem in the scheduling research area. It can be found in a wide range of real-world engineering problems, from manufacturing to computer science. Due to the high complexity of single machine scheduling problems, developing approximation methods, particularly metaheuristic algorithms, for solving them have absorbed considerable attention. In this study, a Lion Optimization Algorithm (LOA) is employed to solve a single machine with maintenance activities, where the objective is to minimize the Total Absolute Deviation of Compilation Times (TADC). In the scheduling literature, TADC as an objective function has hardly been studied. To evaluate the performance of the LOA, it was compared against a set of well-known metaheuristics. Therefore, a set of problem was generated, and a comprehensive experimental analysis was conducted. The results of computational experiments indicate the superiority of the proposed optimization method.
Background: We aimed to identify the level of known risk factors of diabetes associated with doubled likelihood of diabetes type 2.
Methods: In this cross-sectional study, an analysis was performed ...on the data of 9930 individuals aged 15 yr and older participating from 2014 to 2018 in the second phase of the Kerman coronary artery disease risk factors study (KERCADRS), Kerman, Iran. Data were collected using a standard questionnaire. Multivariable logistic regression was performed to identify factors associated with doubled chance of diabetes.
Results: The mean age of participants was 46.1±15.5 yr from which 59.5% were women. Overall, 1105 (11.1%) individuals had type 2 diabetes. An increase of 13.86 yr in age, an increase of 17.32 kg/m2 unit in the amount of body mass index, an increase of 0.17 in the waist-to-hip ratio, a 77 mmHg increase in systolic blood pressure and 6.07 unit increase in triglyceride to HDL ratio doubled the chances of developing type 2 diabetes.
Conclusion: Slight changes in the waist-to-hip circumference ratio (0.17), aging (14 yr), and increase in TG/HDL ratio (6.07 unit) were the most important risk factors, while intense physical activity was the most important protective factor associated with doubling of the chances of developing diabetes. Since most of these risk factors are modifiable, increase in physical activity and providing facilities to improve lifestyle in the community seems necessary.
•Stenotrophomonas maltophilia clinical isolates significantly differ in their biofilm-forming ability.•Ticarcillin/clavulanate, ceftazidime, ciprofloxacin or doxycycline resistance is associated with ...strong biofilm production.•Presence of the rpfF gene is associated with biofilm formation.
The molecular mechanisms involved in biofilm formation inStenotrophomonas maltophilia are poorly understood. Here, we examined whether the presence of smf-1, rmlA, spgM and rpfF genes is associated with biofilm formation and antibiotic resistance in S. maltophilia.
A total of 150 S. maltophilia isolates were collected from three tertiary-care hospitals in Iran and were identified through PCR amplification of the 23S rRNA gene. Biofilm formation was determined by microtitre plate assay. Presence of smf-1, rmlA, spgM and rpfF genes was examined by PCR.
Among the isolates examined, 148 (98.7%) were able to produce biofilm, of which 69 (46.0%) were strong biofilm-producers, whereas 32 (21.3%) and 47 (31.3%) were moderate and weak biofilm-producers, respectively. The frequency ofsmf-1, rmlA, spgM and rpfF was 99.3%, 98.0%, 97.3% and 70.0%, respectively. Statistical analysis indicated a direct correlation between presence of the rpfF gene and biofilm formation (P < 0.001). The high prevalence of smf-1 (99.3%) among the isolates is noted and there was a significant association between smf-1 and biofilm-forming ability (P < 0.01), but lower than rpfF. Additionally, a direct association was found between resistance to ticarcillin/clavulanate, ceftazidime, ciprofloxacin and doxycycline and strong biofilm formation in the S. maltophilia isolates (P < 0.01).
This study demonstrated thatS. maltophilia clinical isolates significantly differ in biofilm-forming ability. Moreover, presence of rpfF and smf-1, but not spgM, could be associated with biofilm formation. This study highlights the importance of rpfF in formation of biofilm compared with the other genes involved.
In recent years, with the progressive advancement of industries, an enormous amount of polluted effluent has been generated and discharged into the ecosystem. Thus, the aqueous environment has been ...affected by various kinds of pollution, which threatened the health of living organisms, especially human. Numerous procedures have been developed to eliminate the pollution from the environment, among which the adsorption has been known as an effective method. Up to this point, activated carbon was commercially available as an adsorbent for wastewater treatment. Lately, 3-Dimensional (3D) porous structures, such as Graphene Aerogels (GA) demonstrated supreme potentials of an ideal adsorbent, which introduced the next generation of carbonaceous adsorbents. Herein, we proposed a method based on a mild chemical reduction route to prepare reduced Graphene-Oxide (rGO)/Cellulose Nano-Crystal (CNC) hybrid aerogels. Cellulose Fibers (CFs) extracted from waste-papers were incorporated into the pore-structure as reinforcing agents. Moreover, CNCs were employed to enhance the mechanical stability of rGO sheets, resulting in a 280% increase in the compressive strength of the aerogels. Adsorption performance of the synthesized aerogels, according to ASTM F726-17, exhibited an adsorption capacity of 59 g g−1 for toluene uptake. Besides, the batch adsorption experiments confirmed the pseudo-second-order and Langmuir isotherms as the best-fitted models to explain the adsorption behavior of the adsorbent. The Langmuir isotherm revealed the maximum adsorption capacity of 454 mg g−1 for the removal of toluene from aqueous media. The study showed promising results for graphene-based aerogels to act as the new class of adsorbents.
•rGO/CNC hybrid aerogel prepared via mild chemical reduction.•Cellulose fibers extracted from waste-papers employed to enhance the integrity.•CNCs as nano-supports for improvement in compressive strength.•Great potentials in adsorption performance for the removal of Toluene pollution.
ORTA ASYA HALK HEKİMLİĞİNDE DUA, VİRD VE ZİKİR SHADKAM, ZUBAIDA; KYDYRBAYEVA, UMIT; TUYAKBAYEV, OMIR
Türk Kültürü ve Hacı Bektaş Velî Araştırma Dergisi,
06/2023, Letnik:
106
Journal Article
Recenzirano
It is of great importance for us to unearth and examine such Turkic texts, which are important both in terms of history and geography of Turkic world and shed light on a large part of it. Finding and ...examining historical texts written in Central Asia is one of the important steps to be taken, especially in Turkic medical history studies. One of these values is the reflection of Yesevilik and Sufism, which reflects the culture, Islamic understanding and philosophy of Turkiс tribes’ life, in prayers and virds, which are important actions for mental and physical health. The manuscript “Dastūr al-‘Ilāj” written in the Chagatai language by Sultan Ali Tabīb Khorasani, who was chief physician in palace of Kyoskunju Khan of 16th century, is discussed. In the text, various prayers and rituals are used in addition to the drugs and classical methods used in the treatment of various diseases. In this classical and traditional medicine book written in the 16th century Central Asia, the treatment methods of various diseases, its functions and reasons of prayers used with drugs will be explained with examples. In the study, the meaning and importance of prayer and its effect in traditional medicine, that is, in folk medicine, as well as the fact that it is a supportive and auxiliary power and method besides medical treatment on the basis of domestic and foreign sources compiled from various scientific publications, the importance of spiritual treatment used on the basis of prayer, its psychodynamics are still up-to-date in Turkic culture. It has been emphasized that our spiritual values and mystical views play an important role in not being forgotten. Keywords: Traditional Medicine In Turks, Spiritual Treatment, Religious Rituals, Yesevilik, Historical Medical Texts.
Global hydrological models enhance our understanding of the Earth system and support the sustainable management of water, food and energy in a globalized world. They integrate process knowledge with ...a multitude of model input data (e.g., precipitation, soil properties, and the location and extent of surface waterbodies) to describe the state of the Earth. However, they do not fully utilize observations of model output variables (e.g., streamflow and water storage) to reduce and quantify model output uncertainty through processes like parameter estimation. For a pilot region, the Mississippi River basin, we assessed the suitability of three ensemble-based multi-variable approaches to amend this: Pareto-optimal calibration (POC); the generalized likelihood uncertainty estimation (GLUE); and the ensemble Kalman filter, here modified for joint calibration and data assimilation (EnCDA). The paper shows how observations of streamflow (Q) and terrestrial water storage anomaly (TWSA) can be utilized to reduce and quantify the uncertainty of model output by identifying optimal and behavioral parameter sets for individual drainage basins. The common first steps in all approaches are (1) the definition of drainage basins for which calibration parameters are uniformly adjusted (CDA units), combined with the selection of observational data; (2) the identification of potential calibration parameters and their a priori probability distributions; and (3) sensitivity analyses to select the most influential model parameters per CDA unit that will be adjusted by calibration. Data assimilation with the ensemble Kalman filter was modified, to our knowledge, for the first time for a global hydrological model to assimilate both TWSA and Q with simultaneous parameter adjustment. In the estimation of model output uncertainty, we considered the uncertainties of the Q and TWSA observations. Applying the global hydrological model WaterGAP, we found that the POC approach is best suited for identifying a single “optimal” parameter set for each CDA unit. This parameter set leads to an improved fit to the monthly time series of both Q and TWSA as compared to the standard WaterGAP variant, which is only calibrated against mean annual Q, and can be used to compute the best estimate of WaterGAP output. The GLUE approach is almost as successful as POC in increasing WaterGAP performance and also allows, with a comparable computational effort, the estimation of model output uncertainties that are due to the equifinality of parameter sets given the observation uncertainties. Our experiment reveals that the EnCDA approach performs similarly to POC and GLUE in most CDA units during the assimilation phase but is not yet competitive for calibrating global hydrological models; its potential advantages remain unrealized, likely due to its high computational burden, which severely limits the ensemble size, and the intrinsic nonlinearity in simulating Q. Partitioning the whole Mississippi River basin into five CDA units (sub-basins) instead of only one improved model performance in terms of the Nash–Sutcliffe efficiency during the calibration and validation periods. Diverse parameter sets achieved comparable fits to observations, narrowing the range for at least three parameters. Low coverage of observation uncertainty bands by GLUE-derived model output bands is attributed to model structure uncertainties, especially regarding artificial reservoir operations, the location and extent of small wetlands, and the lack of representation of rivers that may lose water to the subsurface. These uncertainties are also likely to be responsible for significant trade-offs between optimal fits to Q and TWSA. Calibration performed exclusively against TWSA in regions without Q observations may worsen the Q simulation as compared to the uncalibrated model variant. We recommend that modelers improve the realism of the output of global hydrological models by calibrating them against observations of multiple output variables, including at least Q and TWSA. Further work on improving the numerical efficiency of the EnCDA approach is necessary.
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