Contractual Procurement Alternatives of Air Force Contingency Pharmaceuticals: A Cost-Benefit Analysis

Purpose — This paper aims to explore effective supply chain principles, through the theory of transaction cost economics, as measures to improve current contingency pharmaceutical item shortfalls in the Air Force Medical Service (AFMS) Contingency Pharmaceutical Programme. Design/methodology/approach — In this research, AFMS contingency pharmaceutical data was collected from various databases, including the Joint Medical Asset Repository, Medical Contingency Requirements Workflow and the Medical Requirements List. Through the methodology of cost-benefit analysis, alternative sourcing and fulfilment practices are evaluated. Findings — The findings of this research indicate that the application of centralized purchasing principles, in an effort to leverage prime vendor contract fill rates for shortage items, can lead to 12%–17% increases in pharmaceutical material availability across the programme. Originality/value — This research clearly shows that consolidating demand for shortage items across Active Duty War Reserve Material assemblages, though applications of centralized purchasing principles that leverage prime vendor contract fill rates, can lead to substantial increases in material availability at costs that justify the calculated benefits

Forward positioning and consolidation of strategic inventories

The forward positioning of strategic inventory in the supply chain has an impact on transportation times and is important for sensitive demand profiles. Consolidation of stocks creates pooling effects and minimizes costs. This study analyzes a current military case where forward consolidation of equipment is considered using optimization, and payback periods are calculated for the cost of consolidating inventory at one of six locations. Results indicate that forward positioning and consolidation reduces time and cost, and also creates savings in reverse logistics flows. The study has implications for geographically diverse supply chains such as humanitarian aid and emergency response operations

Analytical techniques and the Air Force logistics readiness officer

The accelerated globalization of logistics activities over the last several decades has spurred a rapid expansion of port facilities all cross the world. However, the recent slowdown of international trade, coupled with a global financial crisis, has created an on-going glut of international port facilities throughout the world. Although the abundance of port facilities provides more transshipment options for carriers and shippers, it makes the port selection decision more complex and difficult. To cope with this new set of challenges, this paper proposes a hybrid data envelopment analysis (DEA)/ analytic hierarchy process (AHP) model that is designed to identify factors specifically influencing transshipment port selection, evaluates the extent of influence of those factors on a transshipment port selection decision, and then determines the most critical ones among various factors. To illustrate the usefulness of the proposed hybrid DEA/AHP model, major container hub ports in Far-East Asia were analyzed

PX Motif of DNA Binds Specifically to Escherichia coli DNA Polymerase I

The PX motif of DNA is a four-stranded structure in which two parallel juxtaposed double-helical domains are fused by crossovers at every point where the strands approach each other. Consequently, its twist and writhe are approximately half of those of conventional DNA. This property has been shown to relax supercoiled plasmid DNA under circumstances in which head-to-head homology exists within the plasmid; the homology can be either complete homology or every-other-half-turn homology, known as PX homology. It is clearly of interest to establish whether the cell contains proteins that interact with this unusual and possibly functional motif. We have examined Escherichia coli extracts to seek such a protein. We find by gel mobility studies that the PX motif is apparently bound by a cellular component. Fractionation of this binding activity reveals that the component is DNA polymerase I (Pol I). Although the PX motif binds to Pol I, we find that PX-DNA is not able to serve as a substrate for the extension of a shortened strand. We cannot say at this time whether the binding is a coincidence or whether it represents an activity of Pol I that is currently unknown. We have modeled the interaction of Pol I and PX-DNA using symmetry considerations and molecular dynamics

Feasibility and effects of adapted cardiac rehabilitation after stroke: a prospective trial

Abstract Background Despite the cardiovascular etiology of stroke, exercise and risk factor modification programs akin to cardiac rehabilitation (CR) are not available. This study aimed to establish the feasibility of adapting a CR model for individuals with mild to moderate stroke disability. A secondary objective was to determine the program's effects on aerobic and walking capacity, and stroke risk factors. Methods A repeated measures design was used with a 3-month baseline period and 6-month adapted CR intervention (n = 43, mean ± SD age 65 ± 12 years, 30 ± 28 months post stroke). Feasibility was determined by the number of participants who completed the study, occurrence of adverse events and frequency, duration and intensity of exercise performed. To determine effectiveness of the program, outcomes measured included aerobic capacity (VO2peak, ventilatory threshold), 6-Minute Walk Test (6MWT) distance, and risk factors. Descriptive statistics characterized the classes attended and number and intensity of exercise sessions. Paired t-tests, one-factor repeated measures analyses of variance contrasts and chi-square analyses were used to compare changes over time. Results Two participants withdrew during the baseline period. Of the remaining 41 participants who commenced the program, 38 (93%) completed all aspects. No serious adverse effects occurred. Post-intervention, VO2peak improved relative to the stable baseline period (P = 0.046) and the increase in ventilatory threshold approached significance (P = 0.062). Conclusions CR is feasible after stroke and may be adapted to accommodate for those with a range of post-stroke disability. It is effective in increasing aerobic capacity. CR may be an untapped opportunity for stroke survivors to access programs of exercise and risk factor modification to lower future event risk. Trial registration ClinicalTrials.gov registration number: NCT0106749

Location optimization of strategic alert sites for homeland defense

This research uses a location analysis approach for selecting aircraft alert sites for the defense of important national areas of interest identified by the US Department of Defense. Solutions are generated in a two step approach where the minimum number of sites is first identified using the location set covering problem and then the result is improved by finding the minimum aggregate network distance or p-median solution from the alternate optimal solutions to the LSCP. This approach also identifies the p-center solution to the problem ensuring equitable response to all areas of interest. Sensitivity analysis is performed to determine the impact of altering aircraft launch and flying times on the number of required alert sites and the amount of coverage provided by selecting fewer locations. Results indicate a significant increase in the number of alert locations needed in comparison to original military estimates. The research points out significant implications about future military base closure decisions and the trade-offs between cost and required response times of aircraft in a defense emergency.Decision making/process Location Optimization Set covering Allocation