INTEGRASI ANALITICAL HIERARCHY PROCESS-FUZZY DALAM PEMILIHAN SUPPLIER

This study discusses the selection of wood raw material suppliers using the AHP-F method. Problems by UD. Bless Furniture is the difficulty of determining which supplier has good performance in terms of price, quality, service, delivery, quantity determination, location as well as guarantees and claims. With many competitors and different raw material prices from each supplier. Many raw materials such as wood cracks are hollow and broken at the ends of the wood, the color of the wood, and the shape of the wood. Delivery plans that are often complained by companies where delivery is not according to the schedule in the agreement. The results of data processing carried out by the AHP fuzzy method show that the criteria that become a priority in supplier selection are the price criteria which have a weight of 0.47. By taking into account the seven criteria above, it is obtained that the supplier recommended being prioritized as the best supplier based on the highest priority weight, namely supplier C with a weight of 0,39 then supplier A with a weight of 0,37 and the third is supplier B with a weight of 0,24

Evidence for validity of five secondary data sources for enumerating retail food outlets in seven American Indian Communities in North Carolina

Abstract Background Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data. Methods Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data. Results 699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0.49). Evidence for validity was comparatively lower for Dun & Bradstreet, online Yellow Pages, and the NC Department of Agriculture. Conclusions Secondary data sources both over- and under-represented the food environment; they were particularly problematic for identifying convenience stores and specialty markets. More attention is needed to improve the validity of existing data sources, especially for rural local food environments

ROLE OF MEDICAL SOCIAL WORKERS IN MANAGEMENT OF ANXIETY AND STRESS AMONG BLOOD DONORS WITH TRANSFUSION TRANSMISSIBLE INFECTIONS

Blood transfusion is a life-saving intervention and millions of lives are saved each year globally through this proce- dure. Unsafe transfusion practices put millions of people at risk of transfusion-transmissible infections (TTIs) and it is mandatory to test the donated blood for blood borne infectious diseases. This is an alarming situation requiring immediate action in appropriate counseling of donors before and after testing of their blood. It is really a challenge for blood banks and motivators if a blood donor is positive for infectious diseases. What is the role of blood bank in helping or guiding the donors to overcome their anxiety and stress? How a medical social worker could psycho- logically support and guide them to act as cause ambassadors for voluntary blood donation? Guidance and counsel- ing would help them to live positively. Health education, compassionate care and teaching coping mechanisms would encourage them in overcoming their stress and anxiety

Evidence for validity of five secondary data sources for enumerating retail food outlets in seven American Indian Communities in North Carolina

Abstract Background Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data. Methods Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data. Results 699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0.49). Evidence for validity was comparatively lower for Dun & Bradstreet, online Yellow Pages, and the NC Department of Agriculture. Conclusions Secondary data sources both over- and under-represented the food environment; they were particularly problematic for identifying convenience stores and specialty markets. More attention is needed to improve the validity of existing data sources, especially for rural local food environments

Potencialidades e limitações da Rede Sentinela para o aperfeiçoamento do monitoramento pós-comercialização/pós-uso de produtos sob vigilância sanitária adotado pela Anvisa

Introduction: Hospitals are essential for the universal coverage of any health system, as well as sources of  valuable information on adverse events and technical complaints of products subjects to health surveillance. Objective: To identify the potentialities and limitations of the Sentinel Network to improve post-marketing/post-use monitoring of products subject to health surveillance adopted by Anvisa. Method: A descriptive quantitative study that used data from a national administrative survey applied to the Sentinel Network, which was conducted between August 4 and September 2, 2021, by the Anvisa. Data were collected using an electronic structured  questionnaire. Statistical analyzes were performed in the Gretl-2022a software, including the calculation of absolute and relative frequencies, medians, and interquartile ranges. Results: A response rate of 69.1% (181/262) was obtained. Among the potentialities, the following stand out: acting as a center for study, teaching, and research of health establishments (n = 145; 80.1%), presence of implanted electronic medical records (n = 142; 78.4%) and the development of initiatives focused on innovation involving risk management of health products (n = 94; 52.0%). As one of the limitations, health establishments that do not have any current excellence/quality certifications predominate (n = 104; 57.5%). Conclusions: The Sentinel Network has  several potentialities and limitations that affect the post-marketing/post-use monitoring of products subject to  health surveillance. Identifying them, as was the objective of this study, demonstrates the need to promote actions that offer the possibility of expanding the potentialities and mitigate the limiting factors to the improvement of post-marketing/post-use monitoring adopted by Anvisa.Introdução: Os hospitais são essenciais para a cobertura universal de qualquer sistema de saúde, bem como são fontes de informações valiosas sobre eventos adversos e queixas técnicas de produtos sob vigilância sanitária. Objetivo: Identificar as potencialidades e limitações da Rede Sentinela para o aperfeiçoamento do monitoramento pós-comercialização/pós-uso de produtos sob vigilância sanitária adotado pela Anvisa. Método: Estudo descritivo quantitativo que utilizou dados de levantamento administrativo nacional aplicado à Rede Sentinela realizado entre 4 de agosto e 2 de setembro de 2021 pela Anvisa. Os dados foram coletados por meio de questionário estruturado eletrônico. As análises estatísticas foram executadas no software Gretl-2022a, compreendendo o cálculo das frequências absoluta e relativa, medianas e  intervalos interquartis. Resultados: Obteve-se uma taxa de resposta de 69,1% (181/262). Dentre as potencialidades, destacam-se: a atuação como centro de estudo, ensino e pesquisa dos estabelecimentos de saúde (n = 145; 80,1%), a presença de prontuário eletrônico implantado (n = 142; 78,4%) e o desenvolvimento de iniciativas voltadas para a inovação envolvendo a gestão de risco de produtos de saúde (n = 94; 52,0%). Como uma das limitações,   predominam os estabelecimentos de saúde que não possuem quaisquer certificações de excelência/qualidade vigentes (n = 104; 57,5%). Conclusões: A Rede Sentinela apresenta várias potencialidades e limitações que afetam o monitoramento pós-comercialização/pós-uso de produtos sob vigilância sanitária. Identificá-las, como foi o objetivo deste estudo, demonstra a necessidade de fomentar ações que ofereçam a possibilidade de ampliar as potencialidades e mitigar os fatores limitantes ao aperfeiçoamento do  monitoramento pós-comercialização/pós-uso adotado pela Anvisa

Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy

Background: B-cell anomalies play a role in the pathogenesis of membranous nephropathy. B-cell depletion with rituximab may therefore be noninferior to treatment with cyclosporine for inducing and maintaining a complete or partial remission of proteinuria in patients with this condition. Methods: We randomly assigned patients who had membranous nephropathy, proteinuria of at least 5 g per 24 hours, and a quantified creatinine clearance of at least 40 ml per minute per 1.73 m(2) of body-surface area and had been receiving angiotensin-system blockade for at least 3 months to receive intravenous rituximab (two infusions, 1000 mg each, administered 14 days apart; repeated at 6 months in case of partial response) or oral cyclosporine (starting at a dose of 3.5 mg per kilogram of body weight per day for 12 months). Patients were followed for 24 months. The primary outcome was a composite of complete or partial remission of proteinuria at 24 months. Laboratory variables and safety were also assessed. Results: A total of 130 patients underwent randomization. At 12 months, 39 of 65 patients (60%) in the rituximab group and 34 of 65 (52%) in the cyclosporine group had a complete or partial remission (risk difference, 8 percentage points; 95% confidence interval [CI], -9 to 25; P=0.004 for noninferiority). At 24 months, 39 patients (60%) in the rituximab group and 13 (20%) in the cyclosporine group had a complete or partial remission (risk difference, 40 percentage points; 95% CI, 25 to 55; P<0.001 for both noninferiority and superiority). Among patients in remission who tested positive for anti-phospholipase A(2) receptor (PLA2R) antibodies, the decline in autoantibodies to anti-PLA2R was faster and of greater magnitude and duration in the rituximab group than in the cyclosporine group. Serious adverse events occurred in 11 patients (17%) in the rituximab group and in 20 (31%) in the cyclosporine group (P=0.06). Conclusions: Rituximab was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months. (Funded by Genentech and the Fulk Family Foundation; MENTOR ClinicalTrials.gov number, .) In a randomized, controlled trial involving patients with membranous nephropathy, rituximab was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission for up to 24 months.Genentech; Fulk Family Foundation6 month embargo; published July 4, 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality. // Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality. // Design, Setting, and Participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis. // Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated. // Main Outcomes and Measures: The primary end point was all-cause mortality within the primary hospitalization. // Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86). // Conclusions and Relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele