Solving the time capacitated arc routing problem under fuzzy and stochastic travel and service times

[EN] Stochastic, as well as fuzzy uncertainty, can be found in most real-world systems. Considering both types of uncertainties simultaneously makes optimization problems incredibly challenging. In this paper we propose a fuzzy simheuristic to solve the Time Capacitated Arc Routing Problem (TCARP) when the nature of the travel time can either be deterministic, stochastic or fuzzy. The main goal is to find a solution (vehicle routes) that minimizes the total time spent in servicing the required arcs. However, due to uncertainty, other characteristics of the solution are also considered. In particular, we illustrate how reliability concepts can enrich the probabilistic information given to decision-makers. In order to solve the aforementioned optimization problem, we extend the concept of simheuristic framework so it can also include fuzzy elements. Hence, both stochastic and fuzzy uncertainty are simultaneously incorporated into the CARP. In order to test our approach, classical CARP instances have been adapted and extended so that customers' demands become either stochastic or fuzzy. The experimental results show the effectiveness of the proposed approach when compared with more traditional ones. In particular, our fuzzy simheuristic is capable of generating new best-known solutions for the stochastic versions of some instances belonging to the tegl, tcarp, val, and rural benchmarks.Spanish Ministry of Science, Grant/Award Number: PID2019-111100RB-C21/AEI/10.13039/501100011033; Barcelona Council and the "la Caixa" Foundation under the framework of the Barcelona Science Plan 2020-2023, Grant/Award Number: 21S09355-001; Generalitat Valenciana,Grant/Award Number: PROMETEO/2021/065Martín, XA.; Panadero, J.; Peidro Payá, D.; Pérez Bernabeu, E.; Juan-Pérez, ÁA. (2023). Solving the time capacitated arc routing problem under fuzzy and stochastic travel and service times. Networks. 82(4):318-335. https://doi.org/10.1002/net.2215931833582

Characterization fo the molecular mechanism of action of a new inhibitor of the complex cyclin-dependent kinase 2-cyclin A

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Solving the time capacitated arc routing problem under fuzzy and stochastic travel and service times

Stochastic, as well as fuzzy uncertainty, can be found in most real-world systems. Considering both types of uncertainties simultaneously makes optimization problems incredibly challenging. In this paper we propose a fuzzy simheuristic to solve the Time Capacitated Arc Routing Problem (TCARP) when the nature of the travel time can either be deterministic, stochastic or fuzzy. The main goal is to find a solution (vehicle routes) that minimizes the total time spent in servicing the required arcs. However, due to uncertainty, other characteristics of the solution are also considered. In particular, we illustrate how reliability concepts can enrich the probabilistic information given to decision-makers. In order to solve the aforementioned optimization problem, we extend the concept of simheuristic framework so it can also include fuzzy elements. Hence, both stochastic and fuzzy uncertainty are simultaneously incorporated into the CARP. In order to test our approach, classical CARP instances have been adapted and extended so that customers' demands become either stochastic or fuzzy. The experimental results show the effectiveness of the proposed approach when compared with more traditional ones. In particular, our fuzzy simheuristic is capable of generating new best-known solutions for the stochastic versions of some instances belonging to the tegl, tcarp, val, and rural benchmarks.This work has been partially supported by the Spanish Ministry of Science (PID2019-111100RB-C21/AEI/10.13039/01100011033), as well as by the Barcelona Council and the “laCaixa” Foundation under the framework of the Barcelona Science Plan 2020-2023 (grant21S09355-01) and Generalitat Valenciana (PROMETEO/2021/065).Peer ReviewedPostprint (published version

The impact of age and comorbidity on the postoperative outcomes after emergency surgical management of complicated intra-abdominal infections

Age-adjusted Charlson Comorbidity Index (a-CCI) score has been used to weight comorbid conditions in predicting adverse outcomes. A retrospective cohort study on adult patients diagnosed with complicated intra-abdominal infections (cIAI) requiring emergency surgery was conducted in order to elucidate the role of age and comorbidity in this scenario. Two main outcomes were evaluated: 90-day severe postoperative complications (grade ≥ 3 of Dindo-Clavien Classification), and 90-day all-cause mortality. 358 patients were analyzed. a-CCI score for each patient was calculated and then divided in two comorbid categories whether they were ≤ or > to percentile 75 (= 4): Grade-A (0–4) and Grade-B (≥ 5). Univariate and multivariate regression analyses were performed, and the predictive validity of the models was evaluated by the area under the receiver operating characteristics (AUROC) curve. Independent predictors of 90-day severe postoperative complications were Charlson Grade-B (Odds Ratio [OR] = 3.49, 95% confidence interval [95%CI]: 1.86–6.52; p < 0.0001), healthcare-related infections (OR = 7.84, 95%CI: 3.99–15.39; p < 0.0001), diffuse peritonitis (OR = 2.64, 95%CI: 1.45–4.80; p < 0.01), and delay of surgery > 24 hours (OR = 2.28, 95%CI: 1.18–4.68; p < 0.02). The AUROC was 0.815 (95%CI: 0.758–0.872). Independent predictors of 90-day mortality were Charlson Grade-B (OR = 8.30, 95%CI: 3.58–19.21; p < 0.0001), healthcare-related infections (OR = 6.38, 95%CI: 2.72–14.95; p < 0.0001), sepsis status (OR = 3.98, 95%CI: 1.04–15.21; p < 0.04) and diffuse peritonitis (OR = 3.06, 95%CI: 1.29–7.27; p < 0.01). The AUROC for mortality was 0.887 (95%CI: 0.83–0.93). Post-hoc sensitivity analyses confirmed that the degree of comorbidity, estimated by using an age-adjusted score, has a critical impact on the postoperative course following emergency surgery for cIAI. Early assessment and management of patient’s comorbidity is mandatory at emergency setting

Evaluation of a program for updating recommendations about hand hygiene

Introducción. La higiene de manos (HM) es la medida más importante para prevenir las infecciones nosocomiales. El objetivo es evaluar el programa de actualización de las recomendaciones sobre HM implantado. Material y métodos. Intervenciones: marzo-octubre/2005 se realizaron sesiones de actualización sobre cuándo y cómo realizar la HM y mayo/2006 se repartió un tríptico explicativo a todos los trabajadores informando del grado de cumplimiento de las recomendaciones. Indicadores: nivel conocimientos (NC) medido con un cuestionario de cinco preguntas que se pasaba antes y después de las sesiones y se consideró respuesta inadecuada cuando se fallaban tres o más preguntas; el consumo soluciones alcohólicas (CSA) en ml/estancia agrupado en semestres desde 2004-2006; el grado cumplimiento de recomendaciones (GCR) sobre la HM medida por observación directa en dos momentos (diciembre/2005-febrero/2006 y octubre-noviembre/2006) y la prevalencia de infecciones nosocomiales (PI) y de pacientes con infección nosocomial (PPI) a partir estudios EPINE 2004-2005-2006. Resultados. La frecuencia de respuestas inadecuadas para evaluar NC pasó de un 57,5% antes a 18,9% después (p<0,001). El CSA para HM pasó de 3 ml/estancia en 2º semestre/2004 a 17 ml/estancia en 2º semestre/2006 (p<0,001). El GCR ha pasado del 31,0% al 55,6% (p<0,001). La PI y PPI han pasado del 11,4% y el 9,6% respectivamente en el 2004 al 9,4% y 8,9% en 2006 (N.S.). Conclusión. El programa está consiguiendo de manera progresiva sus objetivos ya que los tres indicadores de proceso (NC, CSA, GC) han mejorado de manera estadísticamente significativa, y los de resultado (PI y PPI) han mejorado aunque sin significación estadística.Background. Hand Hygiene (HH) is the most important measure in the prevention of nosocomial infections. The objective was to evaluate the program for updating recommendations on HH that had been introduced. Methods. Interventions: between March-October/2005 realisation of updating sessions about when and how to realize HH and May/2006 distribution of an explicative three-part document to all healthcare workers reporting on compliance with the recommendations. Indicators: level of knowledge (LK) measured with a questionnaire of five questions that was given to those attending before and after sessions, responses were considered inadequate when three or more questions were not answered; consumption of alcoholic solutions (CAS) on ml/stay grouped into semesters from 2004-2006; compliance (CO) with recommendations on HH was measured by direct observation at two times (December/2005-February/2006 and October-November/2006); and infections prevalence (IP) and patients with infection (IPP) for EPINE studies 2004-2005-2006. Results. The frequency of inadequate answers for evaluating LK has fallen from 57,5% before to 18,9% afterwards (p <0.001). The CAS for HH has passed from 3 ml/stay in 2nd semester/2004 to 17 ml/stay 2nd semester/2006 (p <0.001). The CO with HH has risen from 31,0% to 55,6% (p <0.001). The IP and IPP have risen respectively from 11,4% and 9,6% in 2004 to 9,4% and 8,9% in 2006 (N.S.). Conclusion. The program is progressively achieving its objectives as the three process indicators (LK, CAS, CO) have improved in a statistically significant way, and the indicators of results (IP and IPP) have improved but without achieving statistical significance.Proyecto de investigación financiado por el Fondo de Investigaciones Sanitarias del Ministerio de Sanidad, Nº Expte: PI0542075 y la Dirección General de Calidad de la Conselleria de Sanitat de la Generalitat Valenciana. Nº Expte: 12-2004

New Route for Valorization of Oil Mill Wastes: Isolation of Humic-Like Substances to be Employed in Solar-Driven Processes for Pollutants Removal

[EN] The valorization of olive oil mill solid wastes (OMW) has been addressed by considering it as a possible source of humic-like substances (HLSs), to be used as auxiliary substances for photo-Fenton, employing caffeine as a target pollutant to test the efficiency of this approach. The OMW-HLS isolation encompassed the OMW basic hydrolysis, followed by ultrafiltration and drying. OMW-HLS structural features have been investigated by means of laser light scattering, fluorescence, size exclusion chromatography, and thermogravimetric analysis; moreover, the capability of OMW-HLS to generate reactive species under irradiation has been investigated using spin-trap electronic paramagnetic resonance. The caffeine degradation by means of photo-Fenton process driven at pH = 5 was significantly increased by the addition of 10 mg/L of OMW-HLS. Under the mechanistic point of view, it could be hypothesized that singlet oxygen is not playing a relevant role, whereas other oxidants (mainly OH center dot radicals) can be considered as the key species in promoting caffeine degradation.Authors want to acknowledge the financial support of Spanish Ministerio de Economia y Competitividad (CTQ2015-69832-C04) and European Union (645551-RISE-2014, MAT4-TREAT).García-Ballesteros, S.; Grimalt, J.; Berto, S.; Minella, M.; Laurenti, E.; Vicente Candela, R.; López Pérez, MF.... (2018). New Route for Valorization of Oil Mill Wastes: Isolation of Humic-Like Substances to be Employed in Solar-Driven Processes for Pollutants Removal. ACS Omega. 3(10):13073-13080. https://doi.org/10.1021/acsomega.8b01816S130731308031

A higiene das mãos: as competências profissionais e as áreas de melhoria

El objetivo fue analizar los conocimientos sobre la higiene de las manos de los profesionales del Sistema Sanitario Público Andaluz (España). Estudio mediante encuestas en 2011, utilizando el Hand Hygiene Knowledge Questionnaire for Health-Care Workers con la técnica de análisis de clases latentes. La media de respuestas correctas fue de 17,51 ± 3,68. Las preguntas con porcentajes de respuestas correctas más bajos son las referidas a la prevención, mediante la higiene de las manos, de la transmisión de microorganismos después de la exposición al paciente y aquellas relacionadas con la utilización de preparados de base alcohólica. Se obtuvo un modelo de 7 clases latentes. Principales diferencias socio-demográficas: los profesionales con conocimientos más bajos suelen ser hombres, jóvenes y no sanitarios; el haber recibido formación previa no discrimina a los que presentan excelentes conocimientos. Concluimos que la revisión de los programas de formación en higiene de las manos es necesaria para mejorar los conocimientos sobre aspectos conceptuales de la transmisión de microorganismos a través de las manos.The objective of this study was to analyze knowledge on hand hygiene among staff workers in the Andalusian Public Health System (Spain). This was a cross-sectional study with surveys (2011) using the Hand Hygiene Knowledge Assessment Questionnaire for Healthcare Workers with the latent class analysis technique. The average number of questions answered correctly was 17.51±3.68. Questions with lower percentages of correct responses were those on hand hygiene for prevention of microorganism transmission to patients and those on hand- rubbing versus hand-washing. We obtained a model with 7 latent classes. Workers with lower knowledge tended to be younger, males, and non-healthcare workers. Having received previous training did not necessarily ensure excellent knowledge. The study concludes that hand hygiene training programs need to be revised in order to improve knowledge on conceptual characteristics involved in the transmission of microorganisms via the hands.O objetivo foi analisar o conhecimento sobre a higiene das mãos dos profissionais do Sistema de Saúde Andaluz (Espanha). Os inquéritos foram realizados em 2011, por meio do questionário Hand Hygiene Knowledge Questionnaire for Health-Care Workers, usando a técnica da análise de classe latente. Questões com porcentagens mais baixas de acertos são as relacionadas com a prevenção da transmissão de micro-organismos após exposição ao paciente por higiene das mãos e aquelas relacionadas com a utilização de preparações à base de álcool. Obtivemos um modelo de sete classes latentes. Principais diferenças sociodemográficas: os profissionais de conhecimentos mais baixos são homens, jovens e profissionais não relacionados à saúde; ter recebido treinamento anterior e não discriminar as pessoas com grande conhecimento. Concluímos que é necessária a revisão dos programas de formação de higiene das mãos para melhorar o conhecimento sobre aspectos conceituais da transmissão de micro-organismos pelas mãos