Operational framework for healthcare supplier selection under a fuzzy multi-criteria environment

PURPOSE: This paper studies how a logistics service provider managing the suppliers for several hospitals can innovatively improve the supplier selection process. The paper examines the attribute set for healthcare supplier selection such as response time, reliability, stock quantity, in order to realize optimal cube utilization, cost, and customer satisfaction. This operational framework developed can help a logistics service provider in supplier order management based on the selected criteria set, criteria weight calculation, and supplier ranking under a fuzzy multi-criteria decision making (MCDM) environment. DESIGN/METHODOLOGY/APPROACH: We adopt a multi-objective decision making approach based on three main criteria of service, cost, and disruption risk. The following modelling approaches are used – (i) the criteria weight are found using fuzzy AHP, and (ii) the ranking of the suppliers are found through fuzzy TOPSIS. FINDINGS: Sometimes a logistics service provider needs to include multiple suppliers for one product instead of the current single supplier policy, in order to share the risks especially when dealing with public health emergencies and uncertainty in disruptions. VALUE: This is a practical industrial problem dealing with various facets of MCDM being applied on actual data, so as to bring to bear the actual challenges of using MCDM in dealing with healthcare supplier management. RESEARCH LIMITATIONS/IMPLICATIONS: Some future extensions and current limitations of this work will include the sole suppliers, namely, suppliers who are exclusive providers of certain unique products mandated by the healthcare regulators, and to include the effects of shelf life and perishability into the products such as the biodegradable sutures. PRACTICAL IMPLICATIONS: This study can help the healthcare logistics service provider to use data judiciously to select and manage the suppliers optimally, without the unnecessary incurrence of buffer stock at the warehouse, which can lead a high degree of obsolescence

Type-2 neutrosophic number based multi-attributive border approximation area comparison (MABAC) approach for offshore wind farm site selection in USA.

The technical, logistical, and ecological challenges associated with offshore wind development necessitate an extensive site selection analysis. Technical parameters such as wind resource, logistical concerns such as distance to shore, and ecological considerations such as fisheries all must be evaluated and weighted, in many cases with incomplete or uncertain data. Making such a critical decision with severe potential economic and ecologic consequences requires a strong decision-making approach to ultimately guide the site selection process. This paper proposes a type-2 neutrosophic number (T2NN) fuzzy based multi-criteria decision-making (MCDM) model for offshore wind farm (OWF) site selection. This approach combines the advantages of neutrosophic numbers sets, which can utilize uncertain and incomplete information, with a multi-attributive border approximation area comparison that provides formulation flexibility and easy calculation. Further, this study develops and integrates a techno-economic model for OWFs in the decision-making. A case study is performed to evaluate and rank five proposed OWF sites off the coast of New Jersey. To validate the proposed model, a comparison against three alternative T2NN fuzzy based models is performed. It is demonstrated that the implemented model yields the same ranking order as the alternative approaches. Sensitivity analysis reveals that changing criteria weightings does not affect the ranking order

Simulation-Based Analyses and Improvements of the Smart Line Management System in Canned Beverage Industry:A Case Study in Europe

Canned water is one of the thriving markets in the food and beverage industry. Given the tight competition in this market, realistic analysis in such production lines has become even more attractive for all participating parties. In this paper, we apply a KPI-driven simulation-based approach to a smart production plant of a key player in the European beverage market. The project covers realistic discrete-event modeling and analysis of the system together with the suggested scenario-based optimization for performance improvement. Here, the smart line management system is modeled and re-coded while considering machine characteristics, failures, and their overall influence on the production process. Our proposed optimized scenario demonstrates noticeably better results in all performance indicators when compared to the existing state of the system. The total increment of the production speed reaches up to 45 percent, resource utilization is evenly optimal, and the overall work-in-progress inventory is reduced significantly

Service supply chain resilience: a social-ecological perspective on last-mile delivery operations

Purpose Considering the last-mile delivery service supply chain as a social-ecological system rather than just a firm-based service system, this research exploit the COVID-19 pandemic disruption to investigate how the supply chain develops resilience from a viewpoint that integrates a social-ecological perspective with the traditional engineering one. Design/methodology/approach This research adopt a multi-case study approach using qualitative data collected via semi-structured interviews with executive-level managers from nine leading UK last-mile delivery companies. Data analysis is guided by a research framework which is developed by combining the social-ecological perspective with the structure–conduct–performance paradigm. This framework aids the investigation of the impacts of external challenges on companies' resilience strategies and practices, as well as performance, in response to disruptions. Findings The research identifies three distinct pathways to resilience development: stabilization, focussing on bouncing back to the original normal; adaptation, involving evolutionary changes to a new normal; transformation, involving revolutionary changes in pursuit of a new normal-plus. Three strategic orientations are identified as operating across these pathways: people orientation, digital orientation, and learning orientation. Originality/value In contrast to the manufacturing supply chain focus of most current research, this research concentrates on the service supply chain, investigating its resilience with a social-ecological perspective alongside the traditional engineering one

Adenosine A2A receptor antagonists act at the hyperoxic phase to confer protection against retinopathy

Abstract Background Retinopathy of prematurity (ROP) remains a major cause of childhood blindness and current laser photocoagulation and anti-VEGF antibody treatments are associated with reduced peripheral vision and possible delayed development of retinal vasculatures and neurons. In this study, we advanced the translational potential of adenosine A2A receptor (A2AR) antagonists as a novel therapeutic strategy for selectively controlling pathological retinal neovascularization in oxygen-induced retinopathy (OIR) model of ROP. Methods Developing C57BL/6 mice were exposed to 75% oxygen from postnatal (P) day 7 to P12 and to room air from P12 to P17 and treated with KW6002 or vehicle at different postnatal developmental stages. Retinal vascularization was examined by whole-mount fluorescence and cross-sectional hematoxylin-eosin staining. Cellular proliferation, astrocyte and microglial activation, and tip cell function were investigated by isolectin staining and immunohistochemistry. Apoptosis was analyzed by TUNEL assay. The effects of oxygen exposure and KW6002 treatment were analyzed by two-way ANOVA or Kruskal-Wallis test or independent Student’s t-test or Mann-Whitney U test. Results The A2AR antagonist KW6002 (P7-P17) did not affect normal postnatal development of retinal vasculature, but selectively reduced avascular areas and neovascularization, with the reduced cellular apoptosis and proliferation, and enhanced astrocyte and tip cell functions in OIR. Importantly, contrary to our prediction that A2AR antagonists were most effective at the hypoxic phase with aberrantly increased adenosine-A2AR signaling, we discovered that the A2AR antagonist KW6002 mainly acted at the hyperoxic phase to confer protection against OIR as KW6002 treatment at P7-P12 (but not P12-P17) conferred protection against OIR; this protection was observed as early as P9 with reduced avascular areas and reduced cellular apoptosis and reversal of eNOS mRNA down-regulation in retina of OIR. Conclusions As ROP being a biphasic disease, our identification of the hyperoxic phase as the effective window, together with selective and robust protection against pathological (but not physiological) angiogenesis, elevates A2AR antagonists as a novel therapeutic strategy for ROP treatment

Enzyme Degradable Hyperbranched Polyphosphoester Micellar Nanomedicines for NIR Imaging-Guided Chemo-Photothermal Therapy of Drug-Resistant Cancers

Multidrug resistance (MDR) is the major cause for chemotherapy failure, which constitutes a formidable challenge in the field of cancer therapy. The synergistic chemo-photothermal treatment has been reported to be a potential strategy to overcome MDR. In this work, rationally designed enzyme-degradable, hyperbranched polyphosphoester nanomedicines were developed for reversing MDR via the codelivery of doxorubicin and IR-780 (hPPE_DOX&IR) as combined chemo-photothermal therapy. The amphiphilic hyperbranched polyphosphoesters with phosphate bond as the branching point were synthesized via a simple but robust one-step polycondensation reaction. The self-assembled hPPE_DOX&IR exhibited good serum stability, sustained release, preferable tumor accumulation, and enhanced drug influx of doxorubicin in resistant MCF-7/ADR cells. Moreover, the degradation of hPPE_DOX&IR was accelerated in the presence of alkaline phosphatase, which was overexpressed in various cancers, resulting in the fast release of encapsulated doxorubicin. The enzyme-degradable polymer generated synergistic chemo-photothermal cytotoxicity against MCF-7/ADR cells and, thus, the efficient ablation of DOX-resistant tumor without regrowth. This delivery system may open a new avenue for codelivery of chemo- and photothermal therapeutics for MDR tumor therapy