•Developed a practical decision support system for COVID-19 healthcare supply chain.•Grouped people and provided an independent classification method for each group.•Evaluated the efficiency of the ...proposed approach using real-world data.
The disasters caused by epidemic outbreaks is different from other disasters due to two specific features: their long-term disruption and their increasing propagation. Not controlling such disasters brings about severe disruptions in the supply chains and communities and, thereby, irreparable losses will come into play. Coronavirus disease 2019 (COVID-19) is one of these disasters that has caused severe disruptions across the world and in many supply chains, particularly in the healthcare supply chain. Therefore, this paper, for the first time, develops a practical decision support system based on physicians' knowledge and fuzzy inference system (FIS) in order to help with the demand management in the healthcare supply chain, to reduce stress in the community, to break down the COVID-19 propagation chain, and, generally, to mitigate the epidemic outbreaks for healthcare supply chain disruptions. This approach first divides community residents into four groups based on the risk level of their immune system (namely, very sensitive, sensitive, slightly sensitive, and normal) and by two indicators of age and pre-existing diseases (such as diabetes, heart problems, or high blood pressure). Then, these individuals are classified and are required to observe the regulations of their class. Finally, the efficiency of the proposed approach was measured in the real world using the information from four users and the results showed the effectiveness and accuracy of the proposed approach.
Supplier selection is an important and challenging problem in sustainable supply chain management. We propose a dynamic decision support system (DSS) for sustainable supplier selection in circular ...supply chains. Unlike the linear take-make-waste-dispose production systems, circular supply chains are nonlinear make-waste-recycle production systems with zero-waste vision. The proposed DSS allows users to customize and weight their economic, social, and circular criteria with a fuzzy best-worst method (BWM) and select the most suitable supplier with the fuzzy inference system (FIS). Machine learning is used to maintain and synthesize the criteria scores for the suppliers after each supplier selection engagement. We present a case study at a petrochemical holding company with a controlling interest over several subsidiary companies to demonstrate the applicability of the proposed approach.
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Maximizing the value of resources and producing less waste are strategic decisions affecting sustainability and competitive advantage. Sustainable closed-loop supply chains (CLSCs) are designed to ...minimize waste by circling back (repairing, reselling, or dismantling for parts) previously discarded products into the value chain. This study presents a novel two-stage fuzzy supplier selection and order allocation model in a CLSC. In Stage 1, we use the fuzzy best-worst method (BWM) to select the most suitable suppliers according to economic, environmental, social, and circular criteria. In Stage 2, we use a multi-objective mixed-integer linear programming (MOMILP) model to design a multi-product, multi-period, CLSC network, and inventory-location-routing, vehicle scheduling, and quantity discounts considerations. In the proposed MOMILP, the total network costs, the undesired environmental effects, and the lost sales are minimized while job opportunities and sustainable supplier purchases are maximized. A fuzzy goal programming approach is proposed to transform the MOMILP into a single objective model. We present a case study to demonstrate the applicability of the proposed method in the garment manufacturing and distribution industry.
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•We present a novel two-stage fuzzy supplier selection and order allocation model in a closed-loop supply chain (CLSC).•We use the fuzzy best-worst method to select the most suitable suppliers.•A multi-objective mixed-integer linear programming model represents the CLSC network.•We minimize network costs, undesired environmental effects, and lost demand.•We maximize job opportunities and sustainable supplier purchases.
The present study aimed to examine the effects of dietary L-carnitine supplementation on performance parameters and egg quality measurements of white Leghorn hens at two dietary fat levels. Two ...hundred 22-weeks old white Leghorn hens were randomly distributed into 40 cages of five birds each. Two basal diets different in added fat level (0 or 3%) were formulated and supplemented with incremental levels of L-carnitine (0, 50, 100, 150 mg/kg diet). The experiment lasted 98 d (two weeks for adaptation and 12 weeks as the main experimental period). At the final day of trial, ten randomly selected hens per treatment were euthanized to measure abdominal fat content. Dietary inclusion of 3% soybean oil caused a significant (P<0.05) increase in egg weight and egg mass, and decrease in feed consumption by the birds. Daily energy intake, however, was not affected by dietary fat supplementation. Except of feed conversion ratio, none of performance parameters were found to be influenced by dietary fat by carnitine interaction. Feed conversion ratio improved (P<0.05) when L-carnitine was supplemented to diets contained in 3% added fat. The albumen height and subsequently Haugh unit were improved (P<0.05) by dietary supplementation of L-carnitine, particularly the level of 150 mg/kg; however, eggshell quality indexes (thickness and breaking strength) were not affected by dietary L-carnitine inclusion, but influenced (P<0.05) by fat supplementation of diets. Moreover, dietary addition of fat increased abdominal fat percentage and supplementary dietary L-carnitine significantly (P<0.05) decreased abdominal fat and yolk cholesterol contents. From the present results, it can be seen that although the supplemental L-carnitine had no considerable effect on most performance parameters, it had a beneficial impacts on lipid metabolism and internal egg quality indexes of 24 to 36 wk-aged laying hens.
Hereditary sensory and autonomic neuropathy type 2 (HSAN2) is an autosomal recessive disorder with predominant sensory dysfunction and severe complications such as limb destruction. There are ...different subtypes of HSAN2, including HSAN2A, which is caused by mutations in WNK1/HSN2 gene.
An Iranian family with four siblings and autosomal recessive inheritance pattern whom initially diagnosed with HSAN2 underwent whole exome sequencing (WES) followed by segregation analysis.
According to the filtering criteria of the WES data, a novel candidate variation, c.3718C > A in WNK1/HSN2 gene that causes p.Tyr1025* was identified. This variation results in a truncated protein with 1025 amino acids instead of the wild-type product with 2645 amino acids. Sanger sequencing revealed that the mutation segregates with disease status in the pedigree.
The identified novel nonsense mutation in WNK1/HSN2 in an Iranian HSAN2 pedigree presents allelic heterogeneity of this gene in different populations. The result of current study expands the spectrum of mutations of the HSN2 gene as the genetic background of HSAN2A as well as further supports the hypothesis that HSN2 is a causative gene for HSAN2A. However, it seems that more research is required to determine the exact effects of this product in the nervous system.
In the present work, a direct Z-scheme composite photocatalyst, NH2-MIL-101(Cr)@CuS, with high photodegradation efficiency of Rhodamine B (RhB) degradation in the visible light spectrum, is ...fabricated through a solvothermal method. It was found that the NH2-MIL-101(Cr)@CuS composite with an appropriate amount of NH2-MIL-101(Cr) exhibited high catalytic performance in the RhB photodegradation. The photocurrent density and results from the electrochemical impedance spectroscopy (EIS) analysis confirm the promoted photocatalytic activity of the NH2-MIL-101(Cr)@CuS composite compared to the pristine MIL-101(Cr) and CuS nanoparticles, which were supported by the electron lifetime (τn) calculations for the samples. The trapping experiments and Mott-Schottky analysis revealed that the superoxide radicals (O2−) played an essential role in the photodegradation of RhB and the promoted photocatalytic activity contributed to a direct Z-scheme mechanism between CuS and NH2-MIL-101(Cr). Stability study also shows acceptable results during photocatalytic reaction. Furthermore, Density Functional Theory (DFT) calculations were performed to gain a better understanding of the electronic properties of the NH2-MIL-101(Cr)@CuS nanocomposite. The calculated band structures showed that the nanocomposite has a higher photocatalytic efficiency in the visible region compared to the pristine MIL-101(Cr) and CuS. The calculated band gap of both the semiconductors and the hybrid nanocomposite confirms the experimental results.
•Synthesis novel NH2-MIL-101(Cr)@CuS photocatalyst with direct Z-scheme mechanism•Electrochemical analysis revealed the role of CuS in activation of NH2-MIL-101(Cr).•Electron lifetime (τn) calculation confirmed efficiency of NH2-MIL-101(Cr)@CuS.•DFT calculations confirm the experimental study of band structures of samples.
Abstract The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, ...particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 ± 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio HR = 1.06, P < .001), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.
We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals ...in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (
P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.
The Pleurotus eryngii species-complex includes taxa of the northern hemisphere growing in association with plants of the family Apiaceae (umbellifers). In this study, 45 Pleurotus strains were ...isolated from five different host-plants: Ferula ovina, F. assa-foetida, Smyrniopsis aucheri, Kellusia odoratissima, and Cachrys ferulacea; all plant species, with the exception of C. ferulacea, are reported for the first time as hosts for this fungal group. Random amplified polymorphic DNA-PCR (RAPD) analysis and nucleotide sequence data from the internal transcribed spacer of the nuclear rRNA genes (ITS1, 5.8S and ITS2) were used for assessing genetic diversity and for determining phylogenetic relationships among the populations studied. Results permitted the grouping of the strains studied into three major clusters corresponding mainly to the nature of the host-plant: the first included isolates collected from Ferula spp. only, the second included isolates originating from C. ferulacea only but from various sampling locations, and the third included all K. odoratissima and S. aucheri associated strains plus a few isolates collected from F. ovina and C. ferulacea. The grouping of the Iranian material, in conjunction with the position in the resulting phylograms of other previously obtained P. eryngii complex sequences, revealed that the first cluster is related to the asiatic ‘P. nebrodensis' (or to the asiatic Ferula spp. associated Pleuroti), the second forms a rather distinct lineage which is linked with reference strains originally classified as P. fossulatus, whereas the third cluster falls within the main part (or the “core”) of this complex, i.e., P. eryngii. Pleurotus populations growing on umbellifers in Iran seem either to have recently diverged through a sympatric speciation process based mainly on ecological factors (e.g., P. fossulatus), or they form part of a rather wide agglomerate associated with various host-plants where exchange of genetic material is still in progress (i.e., P. eryngii).
Breast cancer in Iranian women occurs about a decade earlier than in Western countries. This study sought to evaluate the impact of triple negative phenotype on early onset of ductal cell breast ...cancer and its prognosis in Iranian females.
Estrogen and progesterone receptors, Her-2 overexpression and nuclear accumulation of P53 were assessed in sixty surgically resected formalin-fixed paraffin embedded breast invasive ductal carcinomas. They were divided into triple negative and non triple negative phenotypes and impact of the phenotypes were evaluated on prognostic factors of all patients and based on menopausal status.
The result showed that the mean age of patients with triple negative breast tumors, especially in postmenopausal group, was significantly lower than with non triple negative phenotypes. Although the latter was significantly associated with higher histological grade, it also showed a significant correlation with smaller size of tumor and a lower rate of axillary lymph node metastasis in young patients.
The higher rate of breast cancer with triple negative phenotype in Iranian females is a feasible reason for the reported lower mean age of breast cancers. In premenopausal patients, triple negative phenotype reveals a positive impact on prognostic factors, but it is associated with a poorer prognosis in postmenopausal patients. Hence, a distinct ethnic profile of triple negative phenotype in Iranian females is suggested.
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