An evaluation of three DoE-guided meta-heuristic-based solution methods for a three-echelon sustainable distribution network

This article evaluates the efficiency of three meta-heuristic optimiser (viz. MOGA-II, MOPSO and NSGA-II)-based solution methods for designing a sustainable three-echelon distribution network. The distribution network employs a bi-objective location-routing model. Due to the mathematically NP-hard nature of the model a multi-disciplinary optimisation commercial platform, modeFRONTIER®, is adopted to utilise the solution methods. The proposed Design of Experiment (DoE)-guided solution methods are of two phased that solve the NP-hard model to attain minimal total costs and total CO2 emission from transportation. Convergence of the optimisers are tested and compared. Ranking of the realistic results are examined using Pareto frontiers and the Technique for Order Preference by Similarity to Ideal Solution approach, followed by determination of the optimal transportation routes. A case of an Irish dairy processing industry’s three-echelon logistics network is considered to validate the solution methods. The results obtained through the proposed methods provide information on open/closed distribution centres (DCs), vehicle routing patterns connecting plants to DCs, open DCs to retailers and retailers to retailers, and number of trucks required in each route to transport the products. It is found that the DoE-guided NSGA-II optimiser based solution is more efficient when compared with the DoE-guided MOGA-II and MOPSO optimiser based solution methods in solving the bi-objective NP-hard three-echelon sustainable model. This efficient solution method enable managers to structure the physical distribution network on the demand side of a logistics network, minimising total cost and total CO2 emission from transportation while satisfying all operational constraints

Clinical experience of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) in real life practice: data from the Turkish HIV-TR cohort

Gokengin, Ayse/0000-0003-0704-2302;WOS: 000494690300112[No abstract available

Primary peritracheal scwannoma: Report of a case

PubMedID: 15108085Posterior mediastinal tumors of neurogenic origin commonly arise from the sympathetic or intercostal nerves. However, anterior mediastinal tumors rarely originate from the vagus nerve, and primary neurogenic tumors of the trachea are extremely uncommon. A 19-year-old man was admitted to an emergency department in sudden acute respiratory distress. A tracheostomy was performed and he was transferred to our Ear Nose and Throat Department for further investigation. A bronchoscopic biopsy was taken of a mass occupying the tracheal lumen and intraoperative frozen section examination suggested a schwannoma, so tracheal resection was performed. Although rare, primary tracheal schwannoma should be considered in the differential diagnosis of sudden respiratory distress of unknown origin

Primary peritracheal schwannoma: Report of a case

WOS: 000221055900012PubMed ID: 15108085Posterior mediastinal tumors of neurogenic origin commonly arise from the sympathetic or intercostal nerves. However, anterior mediastinal tumors rarely originate from the vagus nerve, and primary neurogenic tumors of the trachea are extremely uncommon. A 19-year-old man was admitted to an emergency department in sudden acute respiratory distress. A tracheostomy was performed and he was transferred to our Ear Nose and Throat Department for further investigation. A bronchoscopic biopsy was taken of a mass occupying the tracheal lumen and intraoperative frozen section examination suggested a schwannoma, so tracheal resection was performed. Although rare, primary tracheal schwannoma should be considered in the differential diagnosis of sudden respiratory distress of unknown origin

Cost analysis of ventilator-associated pneumonia in Turkish medical-surgical intensive care units

A study was carried out to assess treatment success and the overall costs of patients with ventilator-associated pneumonia (VAP). In a prospective case control study, data were collected from 25 intensive care unit (ICU) beds. A total of 162 ICU patients who required mechanical ventilation were assessed. Of these, 81 patients were diagnosed with VAP and the other 81 were controls (without VAP). Risk of mortality was analyzed and total cost of care was recorded. Age, sex and underlying disease were similar between the groups. The mean length of stay (LOS) in the ICUs in the VAP cases (15.7±9.1 days) exceeded that of the controls (4.9±4.9 days) (p<0.0001), and the additional LOS attributable to VAP was estimated at 10.8 days. In the VAP group, 25 patients had early-onset VAP, and the other 56 patients had late-onset VAP. Mortality rates were higher in VAP patients (32%) than controls (19.7%) p<0.05). Total costs were USD 8602.7±5045.5 in the VAP group and USD 2621.9±2053.3 in controls. The additional cost for VAP was found to be USD 5980 per patient. These data suggest that morbidity, mortality, ICU length of stay and costs increase with VAP. The additional costs for VAP are especially based on the use of novel and expensive antibiotics, other drugs, and medical material

Trends in modification and discontinuation of initial antiretroviral treatment in Turkish HIV-TR cohort, 2011-2017

WOS: 00044848220009