Design of humanitarian supply chain system by applying the general two-stage network DEA model

PurposeThe recent COVID-19 outbreak and severe natural disasters make the design of the humanitarian supply chain network (HSCN) a crucial strategic issue in a pre-disaster scenario. The HSCN design problem deals with the location/allocation of emergency response facilities (ERFs). This paper aims to propose and demonstrate how to design an efficient HSCN configuration under the risk of ERF disruptions.Design/methodology/approachThis paper considers four performance measures simultaneously for the HSCN design by formulating a weighted goal programming (WGP) model. Solving the WGP model with different weight values assigned to each performance measure generates various HSCN configurations. This paper transforms a single-stage network into a general two-stage network, treating each HSCN configuration as a decision-making unit with two inputs and two outputs. Then a two-stage network data envelopment analysis (DEA) approach is applied to evaluate the HSCN schemes for consistently identifying the most efficient network configurations.FindingsAmong various network configurations generated by the WGP, the single-stage DEA model does not consistently identify the top-ranked HSCN schemes. In contrast, the proposed transformation approach identifies efficient HSCN configurations more consistently than the single-stage DEA model. A case study demonstrates that the proposed transformation method could provide a more robust and consistent evaluation for designing efficient HSCN systems. The proposed approach can be an essential tool for federal and local disaster response officials to plan a strategic design of HSCN.Originality/valueThis study presents how to transform a single-stage process into a two-stage network process to apply the general two-stage network DEA model for evaluating various HSCN configurations. The proposed transformation procedure could be extended for designing some supply chain systems with conflicting performance metrics more effectively and efficiently.

Safety of inactivated COVID-19 vaccines in autoimmune encephalitis: a real-world cross-sectional survey

Objective To assess safety data of the inactivated COVID-19 vaccines in a real-world sample of people with autoimmune encephalitis (pwAE). Methods A cross-sectional study was performed between 1 March and 30 April 2022. We invited pwAE from our previous ONE-WC (Outcome of Autoimmune Encephalitis Study in Western China) registration study database, to attend neurological clinics, at West China Hospital to participate in a face-to-face survey using a custom-designed questionnaire for this study. The ONE-WC study began in October 2011 and prospectively enrolled pwAE from four large comprehensive neurological centers in Sichuan province, China. Results Of the 387 pwAE, 240 (62.0%) completed the questionnaire. Half the 240 participants (121, 50.4%) reported receiving at least one dose of COVID-19 vaccine, which in all but two patients received inactivated COVID-19 vaccine. Among vaccinated pwAE, the median age was 35 years (range 15-69) and 57.8% of them were women. The most frequent reasons that unvaccinated individuals reported for not receiving the COVID-19 vaccine were concern about vaccine-induced relapse of AE (50.4%) and advice from a physician to delay vaccination (21.0%). Small proportions of vaccinated individuals reported adverse events after the first dose (11.5%) or the second dose (10.2%), and none of the adverse events was serious. Across the entire sample, one individual reported relapsing within 30 days after the first dose and three individuals reported relapsing more than 120 days after the first dose. Conclusions This real-world survey indicates an overall favorable safety profile of the inactivated COVID-19 vaccine for pwAE.

Association between the peripheral blood eosinophil counts and COVID-19: A meta-analysis.

BACKGROUND: The conclusions about the relationship between eosinophil counts and the severity of coronavirus disease 2019 (COVID-19) were controversial, so we updated the evidences and reassessed it. METHODS: We searched the PubMed, Cochrane library, Excerpta Medica Database, and Web of Science to compare the eosinophil counts about non-severe disease group (mild pneumonia, moderate pneumonia, non-critical disease and recovery group) and severe disease group (severe pneumonia, critical pneumonia, critical disease and death group) in COVID-19. RESULTS: A total of 1228 patients from 10 studies were included. Compared with non-severe group, severe group had strikingly lower average eosinophil counts (SMD 0.65, 95% confidence intervals [CI] 0.29-1.01; P < .001). The result of subgroup analysis of different countries showed SMD 0.66, 95% CI 0.26-1.06; P < .001. Another subgroup analysis between mild-moderate pneumonia versus severe-critical pneumonia showed SMD 0.69, 95% CI 0.25-1.13; P < .001, and no significant risk of publication bias (Begg test 0.063 and Egger test 0.057) in this subgroup. The heterogeneity was substantial, but the sensitivity analyses showed no significant change when individual study was excluded, which suggested the crediblity and stablity of our results. CONCLUSIONS: The eosinophil counts had important value as an indicator of severity in patients with COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020205497.

Efficacy and safety of umbilical cord mesenchymal stem cells for the treatment of patients with COVID-19.

OBJECTIVES: The coronavirus disease (COVID-19) outbreak has catastrophically threatened public health worldwide and presented great challenges for clinicians. To date, no specific drugs are available against severe acute respiratory syndrome coronavirus 2. Mesenchymal stem cells (MSCs) appear to be a promising cell therapy owing to their potent modulatory effects on reducing and healing inflammation-induced lung and other tissue injuries. The present pilot study aimed to explore the therapeutic potential and safety of MSCs isolated from healthy cord tissues in the treatment of patients with COVID-19. METHODS: Twelve patients with COVID-19 treated with MSCs plus conventional therapy and 13 treated with conventional therapy alone (control) were included. The efficacy of MSC infusion was evaluated by changes in oxygenation index, clinical chemistry and hematology tests, immunoglobulin (Ig) levels, and pulmonary computerized tomography (CT) imaging. The safety of MSC infusion was evaluated based on the occurrence of allergic reactions and serious adverse events. RESULTS: The MSC-treated group demonstrated significantly improved oxygenation index. The area of pulmonary inflammation decreased significantly, and the CT number in the inflammatory area tended to be restored. Decreased IgM levels were also observed after MSC therapy. Laboratory biomarker levels at baseline and after therapy showed no significant changes in either the MSC-treated or control group. CONCLUSION: Intravenous infusion of MSCs in patients with COVID-19 was effective and well tolerated. Further studies involving a large cohort or randomized controlled trials are warranted.