An integrated approach for fire extinguishers selection with DEMATEL and TODIM methods

Fire is a type of disaster that has caused significant loss of property and life from past to present. If the necessary measures are not taken, they cause serious property damage, interruption of processes, death and injury. Especially in industrial facilities, the density of flammable, explosive and hazardous chemicals, chimneys, hot surfaces, static electricity and electrical hazards, hot work increases the risk of fire. Therefore, necessary precautions should be taken. The choice of extinguisher device, which includes both passive and active precaution in fire safety, provides the correct intervention in case of possible fire. In case of being a fire, it is necessary to quickly and easily extinguish without damaging the system. For this reason, choosing the right extinguisher is important. In this study, effective criteria were determined by negotiating with supplier companies for the selection of suitable fire extinguishers. After scoring for the criteria, the weights of the criteria were determined by DEMATEL method. With TODIM method, appropriate fire extinguishing agent selection and sequencing were made.

Evaluating the Inappropriate Prescribing and Utilization of Caspofungin, a Four-Year Analysis at a Teaching Hospital in Saudi Arabia

The appropriate use of antimicrobial agents improves clinical outcomes and reduces antimicrobial resistance. Nevertheless, data on inappropriate prescription and negative outcomes are inconsistent. The objective of this study was to assess the prescription appropriateness of Caspofungin at a tertiary teaching hospital in Saudi Arabia and the impact on mortality at 30 days. A retrospective chart review was performed for patients who received Caspofungin from May 2015 to December 2019 to obtain prescription information and culture and susceptibility tests. The appropriateness of the dosage (ApD), initiation time (ApI), agent selection (ApS), and duration of therapy (ApDUR) was evaluated based on recommendations of the infectious diseases society of America. 355 eligible patients who received 3458 Caspofungin doses were identified. Their median age was 54 years (range 18–96). Overall, 270 (76.1%) patients received empirical prescriptions, of which 74.4% had the appropriate dose, and 56.3% had received it for more than five days, despite no proven Candida infection. This was not influenced by past medical history (p = 0.394). Only 39% of patients who received definitive prescriptions met all four study criteria for appropriate prescription. Therefore, antimicrobial stewardship programs can improve the appropriate utilization of antifungal therapies.

Pharmacotherapy review: Emerging treatment modalities in transthyretin cardiac amyloidosis

Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose This review aims to summarize the evidence and pharmacological characteristics of treatment options for transthyretin amyloid cardiomyopathy (ATTR-CM). Additionally, this review highlights the role of clinical pharmacists in helping to secure newly introduced therapies. Summary ATTR-CM, a disease characterized by misfolded protein that is deposited in the myocardium and disrupts cardiac functioning, has historically been underdiagnosed due to the need for invasive biopsy and an illusion of rarity. Once diagnosed, limited treatment modalities for ATTR-CM have led providers to rely on nonpharmacological remedies or off-label use of medications with limited evidence of benefit. However, recent noninvasive diagnostic advancements and heightened disease state awareness have revealed increased prevalence of ATTR-CM. This has led to the introduction of several first-in-class pharmaceuticals with actions targeted at inhibiting the various phases of amyloidosis: TTR stabilizers include diflunisal and first-in-class, Food and Drug Administration (FDA)-approved tafamidis; TTR silencers include patisiran and inotersen; fibril disrupters include doxycycline with tauroursodeoxycholic acid; and alternative agents include green tea extract and curcumin. Conclusion ATTR-CM treatments have emerged and, despite current limited data, are continuing to evolve. Tafamidis, the only agent approved by FDA for ATTR-CM, shows promise to improve survival and quality of life in patients with ATTR-CM. Pharmacists can play a key role in assisting with agent selection for this disease state, as well as providing knowledge about current and future clinical trials evaluating the safety and efficacy of the available treatment modalities.

Advice from Robots: Would You Choose a Robot that Looked More or Less Human?

Humans are increasingly turning to non-human agents for advice. Therefore, it is important to investigate if human-likeness of a robot affects advice-seeking. In this experiment, participants chose robot advisors with different levels of human-likeness when completing either social or analytical tasks, and the task was either known or unknown when the robot advisor was selected. In the agent first condition, participants chose the advisor before receiving their task assignment, and in the task first condition participants received their task assignment before choosing the advisor. Results indicated that task type did not play a role in agent selection in either condition. However, in the agent first condition, more human-like robots (Nao and Kodomoroid) were selected at a higher rate than machine-like robots (Cozmo) and, in the task first condition, Nao was selected at a higher rate than Cozmo or Kodomoroid. These results should be considered when designing robots for giving advice to improve human-robot interaction.

The effect of sample medication use on subsequent anti-VEGF agent selection for neovascular age-related macular degeneration

Purpose: To examine the effect of medication sample use (ranibizumab or aflibercept) on future anti-vascular endothelial growth factor (VEGF) agent selection in neovascular age-related macular degeneration (nvAMD). Design: Retrospective cohort study. Methods: nvAMD patients who underwent an initial anti-VEGF injection with a sample medication were compared to nvAMD control patients who never received a medication sample. Charts from 2017 through 2020 were reviewed for data regarding demographics, anti-VEGF agent selection, and visual acuity outcomes for both groups. Anti-VEGF agent selection for the first four injections and at one year were examined in both the sample and control groups. Results: Adherence to the initial agent was high between first and subsequent injections (2nd, 3rd, 4th injection, and 1 year) in both sample (96.2%, 95.9%, 91.9%, 93.4%, respectively) and control groups (98.1%, 94.2%, 94.9%, 87.8%, respectively). Bevacizumab usage was significantly lower among eyes receiving samples relative to controls at the second (1.9% vs. 38.7%, p<0.001), third (3.1% vs. 41.3%, p<0.001), fourth injections (4.7% vs. 40.4%, p<0.001), and at 1 year (0% vs. 33.8%, p<0.001). Aflibercept usage was significantly higher in sample eyes relative to controls at the second (78.3% vs. 43.4%, p<0.001), third (76.3% vs. 41.5%, p<0.001), and fourth injections (76.7% vs. 43.4%, p<0.001), and at 1 year (77.0% vs. 52.7%, p<0.001). Conclusions: Eyes receiving a sample anti-VEGF agent (ranibizumab or aflibercept) for their initial injection were less likely to receive bevacizumab at future visits relative to eyes that did not receive an anti-VEGF sample, even after one year of treatment.

Impact of advertising puffery and celebrity trustworthiness on attitude and purchase intent: a study on Indian youth

PurposeGround handling services are important for effective aircraft operations in the air transportation system. Airlines often outsource these services to ground handling agents through business-to-business (B2B) marketing decisions. Therefore, this paper aims to address the problem of ground handling agent selection in the airline industry.Design/methodology/approachA real-world case study was carried out to demonstrate the applicability of the integrated Best Worst Method and fuzzy multi-attribute ideal real comparative analysis (F-MAIRCA) approach to solve ground handling agent selection problems under uncertainty and imprecision. A two-stage sensitivity analysis was also conducted to ensure the credibility and validity of the application.FindingsIn the weighting stage, “Quality” was determined as the most important criterion in terms of supplier performance. With regard to the performance of the ground handling agents, A2 was found as the optimal supplier in terms of both credibility and validity.Practical implicationsThis study enumerated several criteria that ground handling agents must meet in order to effectively supply services for the airlines. In addition, this study provides a novel framework from which managers can gain additional benefits from their businesses. Finally, it is concluded that this approach will help airline managers quantitatively in choosing the most appropriate ground handling agent.Originality/valueThe contributions of this study to the existing literature are in twofold. First, the authors propose a novel multiple attribute decision-making (MADM) approach to address the problem of supplier selection for airlines under uncertainty and imprecision. Second, the selection of ground handling agents from the B2B perspective is addressed for the first time in the literature.

A novel MADM approach to the ground-handling agent selection problem in B2B markets

PurposeGround-handling services are important for effective aircraft operations in the air transportation system. Airlines often outsource these services to ground-handling agents through business-to-business (B2B) marketing decisions. Therefore, this paper aims to address the problem of ground-handling agent selection in the airline industry.Design/methodology/approachA real-world case study was carried out to demonstrate the applicability of the integrated best worst method and fuzzy multi-attribute ideal real comparative analysis (F-MAIRCA) approach to solve ground-handling agent selection problems under uncertainty and imprecision. A two-stage sensitivity analysis was also conducted to ensure the credibility and validity of the application.FindingsIn the weighting stage, “Quality” was determined as the most important criterion in terms of supplier performance. With regard to the performance of the ground-handling agents, A2 was found as the optimal supplier in terms of both credibility and validity.Practical implicationsThis study enumerated several criteria that ground-handling agents must meet in order to effectively supply services for the airlines. In addition, this study provides a novel framework from which managers can gain additional benefits from their businesses. Finally, it is concluded that this approach will help airline managers quantitatively in choosing the most appropriate ground-handling agent.Originality/valueThe contributions of this study to the existing literature are twofold. First, we propose a novel multiple attribute decision-making approach to address the problem of supplier selection for airlines under uncertainty and imprecision. Second, the selection of ground-handling agents from the B2B perspective is addressed for the first time in literature.