Structural transformation of fuzzy analytical hierarchy process: a relevant case for Covid-19

Covid-19 has posed difficult and challenging situations to the supply chains and companies are in fix how to choose the vendors under the uncertainty and complexity in recent years. Therefore, this research aims to incorporate structural transformation of the fuzzy analytical hierarchy process (FAHP) that is most appropriate for the uncertainty and disruption caused by Covid-19 like situation for ensuring supplies from vendors. The conventional approaches for vendor selection and evaluation use numerous multi-criteria decision-making tools that may not ensure reliability in a dynamic situation caused due to Covid-19. In this research, Fleiss’ Kappa method ensures the reliability of responses from eight respondents by using pairwise comparisons and assigning weights as envisaged in FAHP. In addition to determine the reliability of responses, a step under FAHP has been altered. This alteration is demonstrated in the vendor selection case in the Covid-19 scenario. The research suggests a plausible system required to address the uncertainties associated with Covid-19 to select and evaluate vendors by modifying a FAHP. The proposed altered mechanism can be incorporated in a similar type of other decision-making circumstances such as Covid-19, where the decision-makers are more than one, and the situation is very dynamic. The study is likely to facilitate information management, algorithmic development in decision making, or machine-driven decisions in uncertain conditions. The study offers managerial implications to purchase managers to accommodate and combine multiple factors and responses concerning the vendor performances for their evaluation, thus making a process more reliable.

PET/CT localisation of a scapular haemangiopericytoma with tumour-induced osteomalacia

Oncogenic osteomalacia, or tumour-induced osteomalacia (TIO), is a rare paraneoplastic syndrome characterised by hypophosphataemia, phosphaturia, inappropriately low serum levels of 1,25-dihydroxyvitamin D for hypophosphataemia. TIO is caused by mesenchymal tumours that secrete phosphaturic substances, leading to increased renal wasting of phosphates. These tumours are very small in size and grow slowly. Localisation of these tumours has always been difficult with the available biochemical and imaging techniques. At times, despite all efforts, the tumour could not be localised. We report our experience with a 42-year-old woman with TIO where whole-body magnetic resonance imaging could not localise the tumour, a scapular haemangiopericytoma. PET/CT was helpful in the localisation of the tumour which, when surgically removed, resulted in the normalisation of biochemical parameters with clinical improvement.