Search

Abstract Background Medical diagnostic laboratories are an essential work environment that plays an important role in diagnosing, treating, and being sensitive to diseases. One way to evaluate laboratories’ performance is to calculate their efficiency. This study investigates the efficiency of laboratories that are related to health centers in the south of Iran. Methods This study was conducted in 2021. The input numbers include: the number of technical personnel and the number of cell counters, and the output data includes: the scores obtained from the level 2 health laboratory evaluation list. And efficiency was calculated with DEAP software. The analysis is accomplished by the assumption of input-oriented. Findings The efficiency of laboratories of Orzueeyeh and Ravar Cities had the highest efficiency with the assumption of variable returns to scale efficiency 1, and the model of all laboratories is the laboratory of Ravar City. The laboratories of Kuhbanan and Rabor cities had the lowest efficiency with the assumption of variable returns to scale efficiency of 0.859 and 0.899, respectively. The average scale efficiency, Variable returns to scale, and constant returns to scale for laboratories in the cities of Kerman province are 0.842, 0.943, and 0.895, respectively. Conclusions To increase the efficiency of laboratories, significant resources and funds should be used, as well as few studies have been done on the efficiency of laboratories, which requires more attention.

Abstract Background Bipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022. Methods This partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients’ medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC. Findings : The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well. Conclusion In general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.

Background: Cerebral palsy is a movement disorder syndrome in early childhood. Signs and symptoms vary among people and over time but include poor coordination, stiff muscles, and weak muscles. Some affected children can achieve near-normal adult lives with appropriate treatment. In recent years, transplantation of human mesenchymal stem cells (hMSC) has become a promising therapeutic strategy for CP. Every year, a lot of costs are spent on the treatment and management of this disease. The purpose of this study is to investigate the safety and effectiveness of this method on CP. Methods: This article is a systematic review. At first, a search strategy was written and performed in Scopus, PubMed, and Google Scholar databases(The search was conducted from March 14 to March 28, 2021), and the inclusion and exclusion criteria were determined. Study inclusion criteria: review studies, cohort studies, clinical trial studies (randomized and non-randomized), control case, and retrospective , exclusion criteria: non-English articles and studying on animals. After removing duplicate articles, two authors independently reviewed the studies according to the inclusion and exclusion criteria. Disagreements among the authors were resolved through discussion. Findings: In total, 9236 articles were found in the initial search, after reading the titles, of 37 articles, 21 articles were selected in the abstract stage and 18 articles remained in the full-text stage. We finally found 18 articles that showed that using stem cell technology as a scientific method could improve sick patients’ quality of life and movement defects. Conclusion: According to the available evidence and limited studies, stem cell technology can be safeand cost-effective in improving CP patients, but there is insufficient evidence. On the other hand, there are many studies confirming the effectiveness of these cells in the treatment of movement impairment. In conclusion, stem cells may have a very promising future. Finally, stem cell technology combined with innovative biotechnologies may soon bring promising results to patients.

Background and Aim: Hospital is organization which its performance improvement is very important. In order to do this, we must evaluate the allocated resources and performance of hospitals. Calculating hospitals efficiency is one of the possible ways to evaluate the performance of them. In this study, the efficiency of allocated financial and human resources of public hospitals by provinces is examined. Materials and Methods: This study was conducted in 2017-2018. Data were collected from 31 provinces of Iran. Input (including: number of physicians, number of nurses and number of active beds per ten thousand population) and output (number of hospitalizations and number of outpatients per ten thousand people). Data were collected from studies. The efficiency analyzing of the provincial treatment department was performed with DEAP software. Results: The input population (nurse, doctor, bed) is related to hospitals and health centers in Semnan, Yazd and Mazandaran provinces And the least amount of input was related to Sistan and Baluchestan, Khuzestan, North Khorasan provinces. The highest output (inpatient and outpatient) belongs to East Azarbaijan province and the lowest output belonged to Hamedan province. Efficiency score, variable return to scale and constant return to scale for all hospitals in the country are 0.565, 0.813 and 0.47, respectively. Conclusion: proper and correct distribution of resources between provinces may increase efficiency of resource distribution.

Context: skin and wound health a serious public health problem with high morbidity and mortality rates worldwide. Although there are different treatment options presented, there is no agreement on the best treatment for severe burns and wound problems as of yet. Stem cell therapy has a bright prospect in many preclinical studies of burn wounds. The rapid review was performed to assess the efficacy and possible mechanisms of stem cells in wound healing. Methods: This is a rapid review of the evidence for the potential effects of stem cell on wound healing, which intended to create a policy guide. To do so, health technology assessment studies indexed in PubMed, Scopus and Scholar on March 13, 2021 were searched using the keywords, including stem cell effects and wound healing. In addition, references of recovered studies were checked to ensure through the capture of the literature. Studies on the safety and efficacy of stem cell on wound healing, both in Persian or English, were included. Results: In total 92 titles were identified, which after eliminating duplicates and applying inclusion criteria, 22 were included. The overall review showed that stem cell therapy improved wound but more study is needed though it is promising. Also, studies showed using stem cell technology as a non-invasive way can be a good alternative to older treatments. Finally, Restrictions of this technology may include the need to improve cell delivery methods, cell viability, heterogeneity in the preparation of mesenchymal stem cells, and wound substrate. Further studies may be needed to determine its safety and efficiency. Conclusions: Evidence on the safety and efficacy of stem cell on wound were very limited to make a decision but Studies showed that stem cell technology is a good alternative to traditional therapies. These findings also demonstrate the need for considering variations in future clinical studies using stem cells to treat a burn wound in order to maximize the effectiveness.

Abstract This paper investigates the effect of different additive manufacturing process parameters such as chamber temperature, Printing temperature, layer thickness, and print speed on five essential parameters that characterize the manufactured components: cylindricity, circularity, strength, and Young’s modulus, and deformation by Gray Relational Analysis method simultaneously. Taguchi method was used to design the experiments, and the PA6 cylindrical parts were fabricated using a German RepRap X500® 3D printer. Then the Gray Relational Grade (GRG) values were calculated for all experiments. In the 8th trial, the highest value of GRG was observed. Then, to discover the optimal parameters, the GRG data were analyzed using ANOVA and S/N analysis, and it was determined that the best conditions for enhancing GRG are 60 °C in the chamber temperature, 270 °C in the printing temperature, 0.1 mm layer thickness, and 600 mm/min print speed. Finally, by using optimal parameters, a verification test was performed, and new components were investigated. Finally, comparing the initial GRG with the GRG of the experiments showed an improvement in the gray relational grade (14%) which is accompanying with improving of GRG value.

In this paper, a new model of hub locating has been solved considering reliability and importance of flow congestion on hub nodes in a dynamic environment. Each of nodes considered as hubs and their communication paths with other non-hubs nodes have specific reliability. In order to reduce input flow to any hub and avoid creation unsuitable environmental and traffic conditions in that area, efficiency capacity is allocated to each hub, which is subject to a penalty in case of exceeding this amount. Another capability of this model is the ability of deciding whether hubs are active or inactive in each period, so hub facilities can be established or closed due to different conditions (such as changes in demand, legislative, etc.). The model is non-linear and bi-objective that the first goal is reducing transportation costs, hub rental fees and extra flow congestion penalties on hub nodes and the second goal is to increase the minimum designed network reliability. After linearization of the model, using ε-constraint method, optimal boundary is obtained. Also, to demonstrate the performance of the model, we use IAD dataset for solving problem. To evaluate the model, sensitivity analysis is presented for some of important parameters of the model.

Fused filament fabrication (FFF) is a layer-by-layer additive manufacturing (AM) process for producing parts. For industries to gain a competitive advantage, reducing product development cycle time is a basic goal. As a result, industries’ attention has turned away from traditional product development processes toward rapid prototyping techniques. Because different process parameters employed in this method significantly impact the quality of FFF manufactured parts, it is essential to optimize FFF process parameters to enhance component quality. The paper presents optimization of fused filament fabrication process parameters to improve the shape deviation such as cylindricity and circularity of 3D printed parts with the Taguchi optimization method. The effect of thickness, infill pattern, number of walls, and layer height was investigated as variable parameters for experiments on cylindricity and circularity. The MarkForged® used Nylon White (PA6) to create the parts. ANOVA and the S/N ratio are also used to evaluate and optimize the influence of chosen factors. As a result, it was concluded that the hexagonal infill pattern, the thickness of 5 mm, wall layer of 2, and a layer height of 1.125 mm were known to be the optimal process parameters for circularity and cylindricity in experiments. Then a linear regression model was created to observe the relationship between the control variables with cylindricity and circularity. The results were confirmed by a confirmation test.

Introduction: Nowadays, Snap-fits have many applications in the automotive industry, especially in assembly lines. They are used instead of the mechanical joints such as bolts, the cabling joints, and the car interior lining joints. Due to the special form of these fasteners, they are usually assembled manually. So, the form of clips’ contact area and the sharpness of the Snap-fits may cause the skin pains on the worker’s fingertips. This fact can cause an ergonomic study of these joints for reducing stress on workers and increasing their efficiency and health. Material and Method: The Finite Element Method (FEM), which is one of the most recognized methods in numeric calculation and computer simulations, is used in order to study the pressures applied to skin due to the pain receptors in the middle layer of skin, and mechanical tensions created in the workers’ thumbs during their work with clips. In order to do this, first a 3D model of a thumb, based on the CT scan data taken from a real thumb sample was created. To identify the different layers of skin, Boolean operations were used. Afterwards, the limit conditions were determined and finally different structures were made to analyze the size, geometric shape and mechanical properties of the clips. Result: In general, the results show that for those clips that their thumb touching surface is only round in edges, the most pressure on the middle layer of skin decreases as the radius of the round edge increases. Whereas such tensions, lightly increase as the radius increases in those clips that have a hybrid design (the combination of flat and curved surfaces). The result of the material analysis for clips shows that using elastic materials has only a limited effect on reducing tensions (only if rubber like materials are used) and for all tough materials, be it plastic or steel, the intensity of pressure tension would increase in the same manner on all the mentioned items. Conclusion: The results suggest that during assembly work there are different factors which affect the tension on the fingers, factors like geometric structure, material and mechanical properties. However, the magnitude of those items’ effects are not the same, and that data can be observed while making an ergonomic design for clips.