Using Markov Decision Processes with Heterogeneous Queueing Systems to Examine Military MEDEVAC Dispatching Policies

major focus of the Military Health System is to provide efficient and timely medical evacuation (MEDEVAC) to battlefield casualties. Medical planners are responsible for developing dispatching policies that dictate how aerial military MEDEVAC units are utilized during major combat operations. The objective of this research is to determine how to optimally dispatch MEDEVAC units in response to 9-line MEDEVAC requests to maximize MEDEVAC system performance. A discounted, infinite horizon Markov decision process (MDP) model is developed to examine the MEDEVAC dispatching problem. The MDP model allows the dispatching authority to accept, reject, or queue incoming requests based on the request\u27s classification (i.e., zone and precedence level) and the state of the MEDEVAC system. Rejected requests are rerouted to be serviced by other, non-medical military organizations in theater. Performance is measured in terms of casualty survivability rather than a response time threshold since survival probability more accurately represents casualty outcomes. A representative planning scenario based on contingency operations in southern Afghanistan is utilized to investigate the differences between the optimal dispatching policy and three practitioner-friendly myopic baseline policies. Two computational experiments, a two-level, five-factor screening design and a subsequent three-level, three-factor full factorial design, are conducted to examine the impact of selected MEDEVAC problem features on the optimal policy and the system level performance measure. Results indicate that dispatching the closest available MEDEVAC unit is not always optimal and that dispatching MEDEVAC units considering the precedence level of requests and the locations of busy MEDEVAC units increases the performance of the MEDEVAC system. These results inform the development and implementation of MEDEVAC tactics, techniques, and procedures by military medical planners. Moreover, an open question exists concerning the best exact solution approach for solving Markov decision problems due to recent advances in performance by commercial linear programming (LP) solvers. An analysis of solution approaches for the MEDEVAC dispatching problem reveals that the policy iteration algorithm substantially outperforms the LP algorithms executed by CPLEX 12.6 in regards to computational effort. This result supports the claim that policy iteration remains the superlative solution algorithm for exactly solving computationally tractable Markov decision problems

A MATHEMATICAL FRAMEWORK FOR OPTIMIZING DISASTER RELIEF LOGISTICS

In today's society that disasters seem to be striking all corners of the globe, the importance of emergency management is undeniable. Much human loss and unnecessary destruction of infrastructure can be avoided with better planning and foresight. When a disaster strikes, various aid organizations often face significant problems of transporting large amounts of many different commodities including food, clothing, medicine, medical supplies, machinery, and personnel from several points of origin to a number of destinations in the disaster areas. The transportation of supplies and relief personnel must be done quickly and efficiently to maximize the survival rate of the affected population. The goal of this research is to develop a comprehensive model that describes the integrated logistics operations in response to natural disasters at the operational level. The proposed mathematical model integrates three main components. First, it controls the flow of several relief commodities from sources through the supply chain until they are delivered to the hands of recipients. Second, it considers a large-scale unconventional vehicle routing problem with mixed pickup and delivery schedules for multiple transportation modes. And third, following FEMA's complex logistics structure, a special facility location problem is considered that involves four layers of temporary facilities at the federal and state levels. Such integrated model provides the opportunity for a centralized operation plan that can effectively eliminate delays and assign the limited resources in a way that is optimal for the entire system. The proposed model is a large-scale mixed integer program. To solve the model, two sets of heuristic algorithms are proposed. For solving the multi-echelon facility location problem, four heuristic approaches are proposed. Also four heuristic algorithms are proposed to solve the general integer vehicle routing problem. Overall, the proposed heuristics could efficiently find optimal or near optimal solution in minutes of CPU time where solving the same problems with a commercial solver needed hours of computation time. Numerical case studies and extensive sensitivity analysis are conducted to evaluate the properties of the model and solution algorithms. The numerical analysis indicated the capabilities of the model to handle large-scale relief operations with adequate details. Solution algorithms were tested for several random generated cases and showed robustness in solution quality as well as computation time

Towards fog-driven IoT eHealth:Promises and challenges of IoT in medicine and healthcare

Internet of Things (IoT) offers a seamless platform to connect people and objects to one another for enriching and making our lives easier. This vision carries us from compute-based centralized schemes to a more distributed environment offering a vast amount of applications such as smart wearables, smart home, smart mobility, and smart cities. In this paper we discuss applicability of IoT in healthcare and medicine by presenting a holistic architecture of IoT eHealth ecosystem. Healthcare is becoming increasingly difficult to manage due to insufficient and less effective healthcare services to meet the increasing demands of rising aging population with chronic diseases. We propose that this requires a transition from the clinic-centric treatment to patient-centric healthcare where each agent such as hospital, patient, and services are seamlessly connected to each other. This patient-centric IoT eHealth ecosystem needs a multi-layer architecture: (1) device, (2) fog computing and (3) cloud to empower handling of complex data in terms of its variety, speed, and latency. This fog-driven IoT architecture is followed by various case examples of services and applications that are implemented on those layers. Those examples range from mobile health, assisted living, e-medicine, implants, early warning systems, to population monitoring in smart cities. We then finally address the challenges of IoT eHealth such as data management, scalability, regulations, interoperability, device–network–human interfaces, security, and privacy

Mamaroneck EMS and the Continuity of Operations: Homeland Security on a Local Level

The definition of homeland security and all that it encompasses has been an ongoing discussion since the events of 9/11. As a homeland security professional it has become clear to me that homeland security is not only a federal obligation, but a local priority as well. All events are local and the government cannot be solely responsible for the preparation, response, and resilience of each individual community. The Village of Mamaroneck is a small jurisdiction approximately 30 miles from New York City. The prime threat this Village has faced is inclement weather and severe flooding due to the multiple floodplains scattered around the 32 square miles that make up the community. However, due to the rising tensions and hardships around the world, it is imperative that the Village of Mamaroneck be prepared to deal with unique situations that may affect the safety and prosperity of our residents. The following research has been organized into a unified strategic plan for the continuity of operations for Mamaroneck Emergency Medical Services (MEMS). This plan is formatted to better prepare MEMS for unfamiliar situations and enhance our response and resiliency if ever faced with a catastrophic event. Although it is a starting point, this document produces optimism that MEMS will be able to build their operation into a prototype for other EMS agencies in surrounding jurisdictions

Technologies and Applications for Big Data Value

This open access book explores cutting-edge solutions and best practices for big data and data-driven AI applications for the data-driven economy. It provides the reader with a basis for understanding how technical issues can be overcome to offer real-world solutions to major industrial areas. The book starts with an introductory chapter that provides an overview of the book by positioning the following chapters in terms of their contributions to technology frameworks which are key elements of the Big Data Value Public-Private Partnership and the upcoming Partnership on AI, Data and Robotics. The remainder of the book is then arranged in two parts. The first part “Technologies and Methods” contains horizontal contributions of technologies and methods that enable data value chains to be applied in any sector. The second part “Processes and Applications” details experience reports and lessons from using big data and data-driven approaches in processes and applications. Its chapters are co-authored with industry experts and cover domains including health, law, finance, retail, manufacturing, mobility, and smart cities. Contributions emanate from the Big Data Value Public-Private Partnership and the Big Data Value Association, which have acted as the European data community's nucleus to bring together businesses with leading researchers to harness the value of data to benefit society, business, science, and industry. The book is of interest to two primary audiences, first, undergraduate and postgraduate students and researchers in various fields, including big data, data science, data engineering, and machine learning and AI. Second, practitioners and industry experts engaged in data-driven systems, software design and deployment projects who are interested in employing these advanced methods to address real-world problems

Management: A continuing literature survey with indexes

This bibliography lists 782 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1977. The citations, and abstracts when available, are reproduced exactly as they appeared originally in IAA and STAR, including the original accession numbers from the respective announcement journals. Topics cover the management of research and development contracts, production, logistics, personnel, safety, reliability and quality control citations. Includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting

Technologies and Applications for Big Data Value

This open access book explores cutting-edge solutions and best practices for big data and data-driven AI applications for the data-driven economy. It provides the reader with a basis for understanding how technical issues can be overcome to offer real-world solutions to major industrial areas. The book starts with an introductory chapter that provides an overview of the book by positioning the following chapters in terms of their contributions to technology frameworks which are key elements of the Big Data Value Public-Private Partnership and the upcoming Partnership on AI, Data and Robotics. The remainder of the book is then arranged in two parts. The first part “Technologies and Methods” contains horizontal contributions of technologies and methods that enable data value chains to be applied in any sector. The second part “Processes and Applications” details experience reports and lessons from using big data and data-driven approaches in processes and applications. Its chapters are co-authored with industry experts and cover domains including health, law, finance, retail, manufacturing, mobility, and smart cities. Contributions emanate from the Big Data Value Public-Private Partnership and the Big Data Value Association, which have acted as the European data community's nucleus to bring together businesses with leading researchers to harness the value of data to benefit society, business, science, and industry. The book is of interest to two primary audiences, first, undergraduate and postgraduate students and researchers in various fields, including big data, data science, data engineering, and machine learning and AI. Second, practitioners and industry experts engaged in data-driven systems, software design and deployment projects who are interested in employing these advanced methods to address real-world problems