سعید کلانتری

Establishing the structure and expansion of sustainable closed-loop supply chains is critical to meeting environmental, economic, and social standards to strengthen their position in competitive markets. This study aims to decide on operational and tactical levels to configure the Stable Closed Chain Supply Chain Network (SCLSC) to maximize Net Present Value (NPV) and seek to minimize carbon emissions while maintaining environmentally friendly policies and considering inflation.

This paper considers a solid Fuzzy Robust Optimization (FRO) approach to deal with stable, closed-loop supply chain uncertainties. Also, due to the complexity of the model and its multi-objective, a new combined method of Heuristic algorithm (HA) and Multi-Choice Goal Programming with Utility Function (MCGP-UF) is used. The proposed Mixed Integer Linear Programming (MILP) model is applied in the electronics industry.

The proposed model is evaluated in several experiments and discussed in different scenarios to confirm the efficiency and validity of the proposed model and method. The results were compared with the two factors of optimal gap and solution time, which showed the proper performance of the proposed method. Then, the tactical results and model strategy were presented for a case study in which the optimal flow between facilities, selection of suitable suppliers, selection of transportation type, and opening of facilities were presented. The findings showed that in different scenarios, the effective improvement of the obtained solutions by reducing the solution time by twenty percent could address large-scale problems.

Originality/Value:

 By considering a new combined method of heuristic algorithm and multi-choice ideal programming with a utility function, this paper is done to solve the problem of designing a stable closed-loop supply chain network under uncertainty.

Despite the considerable advances in acquired immunodeficiency syndrome (AIDS) treatment and management, finding the cure for this disease has been hindered by emerging challenges such as virus resistance and treatment failures. The purpose of this study is to compare the cytokine profiles of patients with successful treatment and patients with unsuccessful treatment to gain a better understanding of treatment failure mechanisms.

Sixty-nine human immunodeficiency virus (HIV) positive patients who were referred to the west health center of Tehran between September 2018 and March 2021 were included in this study. Blood CD4+ cell count and viral load was measured using the flow cytometry and quantitative real-time polymerase chain reaction (RT-qPCR) methods respectively. Based on the viral load test results patients were divided into successful treatment (viral load<200 copies/ml, n=36) and unsuccessful treatment (viral load>200 copies/ml, n=33) groups. Subsequently, tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) serum levels were measured using the enzyme-linked immunosorbent assay (ELISA) method.

 Analysis of data revealed that there was no difference in demographic data, medical history and clinical laboratory test results between the study groups. Elisa test results showed that serum TNF-α levels were significantly higher in the unsuccessful treatment group compared to the successful treatment group (10.43±10.17 vs 5.37±5.25, P=0.01) but no differences were observed in IL-10 levels between the study groups. Furthermore, age and sex-adjusted linear regression models showed that non-nucleoside reverse-transcriptase inhibitors (NNRTI)-based treatment regimen is positively associated with serum IL-10 levels in patients with unsuccessful treatment (B coefficient 10.88 (95% CI: 1.32-20.45), P=0.03). Moreover, based on the results of the linear regression models, no relationship between HIV viral load and serum IL-10 and TNF-α level was observed.

Results of this study showcased the importance of TNF-α in disease progression and treatment failure. Further future studies regarding this relationship can provide vital information in AIDS treatment research.

 In recent years, researchers have proposed various methods for gas separation because of rising greenhouse gases in the atmosphere and causing enormous environmental problems. One of the newest and emerging methods is membrane gas separation. In the last decade, mixed matrix membranes (MMMs) have received much attention due to their ability to successful separation of polar gases from mixtures.

In this study, a novel two-component mixed matrix membrane was prepared by incorporating the nickel zinc iron oxide nanoparticles into the Pebox polymer matrix. This is owing to combination the unique features of Pebax copolymer such as high mechanical strength and gas permeability, with nanoparticle properties as considerable permeability and selectivity, and appropriate mechanical and thermal stability. The gas permeability test was performed for pristine membrane and MMMs at 35 °C and pressure range from 2 to 10 bar. Fabricated membranes were also evaluated by FESEM, FTIR-ATR, DSC and XRD tests

Results demonstrated that in the case of the optimum membrane with 1 wt.% of filler loading and at 10 bar, the CO2 permeability was increased about 128% and reached to 278 Barrer, compared to pristine membrane. However, the CO2/CH4 and CO2/N2 selectivities were improved by 175 and 183 percent, respectively. This superior results was due to the presence of iron, nickel, and zinc atoms in the filler structure, which resulted in a better interaction with CO2. On the other hand, the presence of CO2-friendly segments in the Pebax structure caused much higher CO2 permeability in comparison with other light gases.

Diabetes can affect organs including the oral mucosa. There is a disagreement about the prevalence of oral mucosal disease in diabetic patients. We therefore decided to investigate more about that. The aim of this study was to determine the prevalence of soft tissue pathologies by assessing burning mouth and xerostomia in diabetic patients on the basis of type of diabetes and control status of diabetes.

This descriptive, analytic study was done by visiting 486 known diabetic patients who were referred to the Endocrine Clinic in summer of 2005. Their demographic information with history of systemic diseases accompanied by the amount of HbAIC and duration of disease was recorded in their questionnaire. Diagnosis of oral lesions was done by clinical examination. Burning mouth was assessed by visual analog scale in persons who suffered and subjective xerostomia was evaluated by standard questionnaire. Data collection was done by software SPSS 10, and statistical analysis was done by X2 and logistic regression test.

In this study, 34 patients were type I and 434 were type II patients with mean age of 47.84±9.77 years. Frequency of all candidasis lesions was 15.4% which included denture stomatitis 5.3%, angular cheilitis 4.1%, median rhomboid glossitis 1.5%and papillary atrophy of tongue 4.5%. Frequency of non-candidal lesions was 20.1%, which included fissured tongue 10.5%, geographic tongue 7.9% and lichen planus 1.7%. 6.2% of patients suffered from glossodyna. 15.6% of patients had xerestomia. By logistical regression test, we found that type of diabetes affects denture stomatitis, angular cheilitis, tongue atrophy and amount of HbA1c.

All of the pathologies were greater in type I than type II diabetes patients. Level of HbA1c had an important role in appearance of oral lesions and level changes can cause problems in the mouth. Thus, patients should maintain their oral hygiene and control their glucose regularly

Diabetes millitus is one of the most common disorders that its complications involved every organ such as skin. Some of skin Conditions can be regarded as cutaneous markers of diabetes while others are related to its characteristic complications such as vascular disorders or peripheral neuropathy. Early diagnosis and treatment of skin disorders can prevent other serious complications such as diabetic foot.

Thus, with the aim of detecting the prevalence of cutaneous manifestations of DM, we examined 351 diabetic patients that consecutively attending the outpatient diabetes clinic at the Razi hospital in Rasht in 2000–1, on the basis of complete dermatological examination in a analytic descriptive convenience non-probability sampling study. We made use of paraclinic examinations in suspicious cases. We studied the relation of cutaneous manifestations to type of DM, age, sex and diabetes duration. Analysis was performed by Chi–square and t test.

Diabetic skin manifestations were detected in 70.1% diabetic patients. Majority of patients with skin lesions were older than 45 years (65%). Our study showed significant difference between involvement by skin lesions and duration of DM (p=0.001) and sex (male>female) (p=0.01). This study did not show significant difference between involvement by skin lesions and age, and type of DM. Infection (28.6%) was the most common finding followed by skin tag (25.8%), pruritus (23.8%), pallid and cool skin on distal extremities (19.4%) and diabetic dermopathy (13.6%). Among skin infections, the most common were fungal infections (24%).

Thus, in this study skin lesions were common in DM patients and the most frequent cutaneous manifestations were infections (especially fungal infections). For these reasons, education and special attention to medical staff and patients and searching practical approach to early diagnosis and treatment of skin lesions seem to be necessary.

Hypothyroidism and associated mental disorders are prevalent in iodine deficient regions. Since the prevalence of hypothyroidism is unknown in mentally retarded patients in Iran the present study was carried out over 2003 patients hospitalized in Tehran institutes.

Following the physical examination and filling the questionnaire, blood samples were obtained for measuring T4, T3, and TSH. Radioimmunoassay technique was used for this purpose.

Among 2003 candidates, 295(17%) had goiter of grade lb, whereas grade II and grade III goiter were reported in 136(6.7%) and 16(0.8%) of the cases, respectively. T4 level was reported as below: 4.1- 4.5 ug/dl in 1.5%, 3.1- 4 in 1.7%, 2.1- 3 in 0.6%, and below 2.1u.g/dl in 0.1% of the mentally retarded patients. 53(2.65%) had TSH level of more than 5mU/l, where most of them (2.15%) had TSH level of 5-10 mU/1. TSH>10mU/l was recorded in 10 cases. 3 patients were received levothyroxine due to previously diagnosed hypothyroidism. 76(3.8%) cases were found to have mongolism, where 7(7.9%) of them had hypothyroidism.

Results have revealed the relatively high prevalence of hypothyroidism in mentally retarded patients. Controlling iodine deficiency disorders as well as screening hypothyroidism seems to be necessary for eliminating mental disorders.