Vendor evaluation platform for acquisition of medical equipment based on multi-criteria decision-making approach

Abstract The purchase of medical equipment is a critical issue that should be planned properly. The selection of the most appropriate vendor impacts time, effort, and expenses. Therefore, the challenge is to strike a balance between the available budget and the required equipment. The study aims to select the best vendor for supplying medical equipment based on Emergency Care Research Institute (ECRI) standards. The multi-criteria decision-making approach has been adopted through three methods; Multi-Objective Optimization by Ratio Analysis (MOORA), Simple Additive Weighting (SAW), and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). The criteria of selection are divided into general, technical, and financial. The criteria are weighted using three methods: CRITIC, entropy, and expert judgment. The Vendor Evaluation Program for Medical Equipment (VEPME) is designed to automatically select the best vendor. Medical imaging equipment is selected to test the program by four modalities: X-ray equipment, CT, MRI, and ultrasound. The best scenario was given by the entropy-TOPSIS. As a result, this methodology was adopted by the program. The results demonstrate the robustness of the proposed methodology by comparing the VEPME output to expert judgment

The Separation of Blood Components Using Standing Surface Acoustic Waves (SSAWs) Microfluidic Devices: Analysis and Simulation

The separation of blood components (WBCs, RBCs, and platelets) is important for medical applications. Recently, standing surface acoustic wave (SSAW) microfluidic devices are used for the separation of particles. In this paper, the design analysis of SSAW microfluidics is presented. Also, the analysis of SSAW force with Rayleigh angle effect and its attenuation in liquid-loaded substrate, viscous drag force, hydrodynamic force, and diffusion force are explained and analyzed. The analyses are provided for selecting the piezoelectric material, width of the main microchannel, working area of SAW, wavelength, minimum input power required for the separation process, and widths of outlet collecting microchannels. The design analysis of SSAW microfluidics is provided for determining the minimum input power required for the separation process with appropriated the displacement contrast of the particles.The analyses are applied for simulation the separation of blood components. The piezoelectric material, width of the main microchannel, working area of SAW, wavelength, and minimum input power required for the separation process are selected as LiNbO3, 120 μm, 1.08 mm2, 300 μm, 371 mW. The results are compared to other published results. The results of these simulations achieve minimum power consumption, less complicated setup, and high collecting efficiency. All simulation programs are built by MATLAB

Evaluation of stress and strain on mandible caused by changing the bar material in hybrid prosthesis utilizing “All-on-Four” technique

Full edentulism is the complete loss of teeth which affects mastication. The treatment is performed by using the hybrid prostheses to restore the mastication mechanism. The materials of choice for the bar in the hybrid prostheses are titanium and gold. The limitations of metals encourage the researchers to find alternatives materials. This research investigated the possibility of using ceramics, polymers and composites as a bar material instead of titanium. 3D model of mandible with hybrid prosthesis was stimulated with different bar materials. The von Mises stress of each part was extracted, besides the max& min principal stresses /strains were computed for the bone parts. By using PEEK bar, the von Mises stresses on cortical and cancellous bones reduced by (3.4&3.02 %) and (10.4 &3.36 %) under unilateral and bilateral forces, besides the mucosa stress increased to 0.121 and 0.135 MPa respectively. For all used materials, the stresses and strains of bone parts did not exceed the critical limits, besides the mucosa stress was lower than the pain threshold value. As a consequence, it was concluded that all materials included in this study could be used as an alternative to titanium as a bar material

An integrative approach to medical laboratory equipment risk management

Abstract Medical Laboratory Equipment (MLE) is one of the most influential means for diagnosing a patient in healthcare facilities. The accuracy and dependability of clinical laboratory testing is essential for making disease diagnosis. A risk-reduction plan for managing MLE is presented in the study. The methodology was initially based on the Failure Mode and Effects Analysis (FMEA) method. Because of the drawbacks of standard FMEA implementation, a Technique for Ordering Preference by Similarity to the Ideal Solution (TOPSIS) was adopted in addition to the Simple Additive Weighting (SAW) method. Each piece of MLE under investigation was given a risk priority number (RPN), which in turn assigned its risk level. The equipment performance can be improved, and maintenance work can be prioritized using the generated RPN values. Moreover, five machine learning classifiers were employed to classify TOPSIS results for appropriate decision-making. The current study was conducted on 15 various hospitals in Egypt, utilizing a 150 MLE set of data from an actual laboratory, considering three different types of MLE. By applying the TOPSIS and SAW methods, new RPN values were obtained to rank the MLE risk. Because of its stability in ranking the MLE risk value compared to the conventional FMEA and SAW methods, the TOPSIS approach has been accepted. Thus, a prioritized list of MLEs was identified to make decisions related to appropriate incoming maintenance and scrapping strategies according to the guidance of machine learning classifiers

Effects of GLP-1 Receptor Activation on a Pentylenetetrazole—Kindling Rat Model

Objectives: To study the possible anti-seizure and neuroprotective effect of glucagon like peptide 1 (GLP1) analogue (liraglutide) in a pentylenetetrazole (PTZ) induced kindled rat model and its underlying mechanisms. Methods: Thirty Sprague Dawley rats were allocated into 3 equal groups; i) Normal group: normal rats received normal saline, ii) PTZ (kindling) group: received PTZ (50 mg/Kg intraperitoneally (i.p.)) every other day for 2 weeks and iii) PTZ + GLP1 group: same as the PTZ group but rats received liraglutide (75 µg/kg i.p. daily) for 2 weeks before PTZ injection. Seizure severity score, seizure latency and duration were assessed. Also, the expression of caspase-3 (apoptotic marker) and β-catenin (Wnt pathway) by western blotting, markers of oxidative stress (GSH, CAT and MDA) by biochemical assay and the expression of LC3 (marker of autophagy) and heat shock protein 70 (Hsp70) by immunostaining were assessed in hippocampal regions of brain tissues. Results: PTZ caused a significant increase in Racine score and seizure duration with a significant decrease in seizure latency. These effects were associated with a significant increase in MDA, β-catenin, caspase-3, Hsp70 and LC3 in brain tissues (p < 0.05). Meanwhile, liraglutide treatment caused significant attenuation in PTZ-induced seizures, which were associated with significant improvement in markers of oxidative stress, reduction in LC3, caspase-3 and β-catenin and marked increase in Hsp70 in hippocampal regions (p < 0.05). Conclusion: Activation of GLP1R might have anticonvulsant and neuroprotective effects against PTZ-induced epilepsy. These effects could be due to suppression of oxidative stress, apoptosis and autophagy and upregulation of Hsp70

Diagnostic Significance of hsa-miR-21-5p, hsa-miR-192-5p, hsa-miR-155-5p, hsa-miR-199a-5p Panel and Ratios in Hepatocellular Carcinoma on Top of Liver Cirrhosis in HCV-Infected Patients

Early hepatocellular carcinoma (HCC) diagnosis is challenging. Moreover, for patients with alpha-fetoprotein (AFP)-negative HCC, this challenge is augmented. MicroRNAs (miRs) profiles may serve as potential HCC molecular markers. We aimed to assess plasma homo sapiens—(hsa)-miR-21-5p, hsa-miR-155-5p, hsa-miR-192-5p, and hsa-miR-199a-5p—expression levels as a panel of biomarkers for HCC in chronic hepatitis C virus (CHCV) patients with liver cirrhosis (LC), especially AFP-negative HCC cases, as a step toward non-protein coding (nc) RNA precision medicine. Subjects and methods: 79 patients enrolled with CHCV infection with LC, subclassified into an LC group without HCC (n = 40) and LC with HCC (n = 39). Real-time quantitative PCR was used to measure plasma hsa-miR-21-5p, hsa-miR-155-5p, hsa-miR-192-5p, and hsa-miR-199a-5p. Results: Plasma hsa-miR-21-5p and hsa-miR-155-5p demonstrated significant upregulation, while hsa-miR-199a-5p demonstrated significant downregulation in the HCC group (n = 39) when compared to the LC group (n = 40). hsa-miR-21-5p expression was positively correlated with serum AFP, insulin, and insulin resistance (r = 0.5, p r = 0.334, p = 0.01, and r = 0.303, p = 0.02, respectively). According to the ROC curves, for differentiating HCC from LC, combining AFP with each of hsa-miR-21-5p, hsa-miR-155-5p, and miR199a-5p improved the diagnostic sensitivity to 87%, 82%, and 84%, respectively, vs. 69% for AFP alone, with acceptable specificities of 77.5%, 77.5%, and 80%, respectively, and AUC = 0.89, 0.85, and 0.90, respectively vs. 0.85 for AFP alone. hsa-miR-21-5p/hsa-miR-199a-5p and hsa-miR-155-5p/hsa-miR-199a-5p ratios discriminated HCC from LC at AUC = 0.76 and 0.71, respectively, with sensitivities = 94% and 92% and specificities = 48% and 53%, respectively. Upregulation of plasma hsa-miR-21-5p was considered as an independent risk factor for HCC development [OR = 1.198(1.063–1.329), p = 0.002]. Conclusions: Combining each of hsa-miR-21-5p, hsa-miR-155-5p, and hsa-miR-199a-5p with AFP made it possible to identify HCC development in the LC patients’ cohort with higher sensitivity than using AFP alone. hsa-miR-21-5p/hsa-miR-199a-5p and hsa-miR-155-5p/hsa-miR-199a-5p ratios are potential HCC molecular markers for AFP-negative HCC patients. hsa-miR-21-5p was linked, clinically and via in silico proof, to insulin metabolism, inflammation, dyslipidemia, and tumorigenesis in the HCC patients’ group as well as for an upregulated independent risk factor for the emergence of HCC from LC in the CHCV patients

Supplementary figure -Supplemental material for Plasma microRNA-21, microRNA-146a and IL-13 expression in asthmatic children

<p>Supplementary figure</p

Non‐classical monocytes frequency and serum vitamin D3 levels are linked to diabetic foot ulcer associated with peripheral artery disease

Abstract Aims/Introduction Peripheral artery disease (PAD) serves as a risk factor for diabetic foot ulcers (DFUs). PAD pathology involves atherosclerosis and impaired immunity. Non‐classical monocytes are believed to have an anti‐inflammatory role. 1,25‐Dihydroxy vitamin D (vitamin D3) is claimed to have immune‐modulating and lipid‐regulating roles. Vitamin D receptor is expressed on monocytes. We aimed to investigate if circulating non‐classical monocytes and vitamin D3 were implicated in DFUs associated with PAD. Materials and Methods There were two groups of DFU patients: group 1 (n = 40) included patients with first‐degree DFUs not associated with PAD, and group 2 (n = 50) included patients with DFU with PAD. The monocyte phenotypes were detected using flow cytometry. Vitamin D3 was assessed by enzyme‐linked immunosorbent assay. Results DFU patients with PAD showed a significant reduction in the frequency of non‐classical monocytes and vitamin D3 levels, when compared with DFU patients without PAD. The percentage of non‐classical monocytes positively correlated with vitamin D3 level (r = 0.4, P < 0.01) and high‐density lipoprotein (r = 0.5, P < 0.001), whereas it was negatively correlated with cholesterol (r = −0.5, P < 0.001). Vitamin D3 was negatively correlated with triglyceride/high‐density lipoprotein (r = −0.4, P < 0.01). Regression analysis showed that a high vitamin D3 serum level was a protective factor against PAD occurrence. Conclusions Non‐classical monocytes frequency and vitamin D3 levels were significantly reduced in DFU patients with PAD. Non‐classical monocytes frequency was associated with vitamin D3 in DFUs patients, and both parameters were linked to lipid profile. Vitamin D3 upregulation was a risk‐reducing factor for PAD occurrence