Sharing and Lateral Transshipment of Inventory in a Supply Chain with Expensive Low-Demand Items

The emergence of carriers that deliver items to geographically dispersed destinations quickly and at a reasonable cost, combined with the low cost of sharing information through networked databases, has opened up new opportunities to better manage inventory. We investigate these benefits in the context of a supply chain in which a manufacturer supplies expensive, low-demand items to vertically integrated or autonomous retailers via one central depot. The manufacturer's lead time is assumed to be due to the geographical distance from the market or a combination of low volumes, high variety, and inflexible production processes. We formulate and solve an appropriate mathematical model based on one-for-one inventory policies in which a replenishment order is placed as soon as the customer withdraws an item. We find that sharing and transshipment of items often, but not always, reduces the overall costs of holding, shipping, and waiting for inventory. Unexpectedly, these cost reductions are sometimes achieved through increasing overall inventory levels in the supply chain. Finally, while sharing of inventory typically benefits all the participants in decentralized supply chains, this is not necessarily the case---sharing can hurt the distributor or individual retailers, regardless of their relative power in the supply chain.Multi-Echelon Systems, Transshipment, Approximation in Inventory Models

Importance of Selection a Method of Reconstruction of Digestive Continuity After Gastrectomy

Introduction: Gastrectomy is one of the most common surgical methods for the treatment of gastric cancer, which basically destroys the mechanism and digestion chemistry. Reconstruction after gastrectomy attempts to optimize the antireflux and nutritive component of the postgastrectomic syndrome.Objective: To determine which reconstructive method after gastrectomy has the optimal synthesis of antireflux and nutritional components.Patients and Methods: 111 patients were treated for gastric malignancies at the Surgical Clinic of the University Clinical Center in Banja Luka, which were operated with the intention of achieving curability.Results: Based on Fisher’s exact probability test there is no statistically significant difference (p> 0.05) in mortality compared to the restoration of digestive continuity after gastrectomy. Reflux oesophagitis is the dominant modality of morbidity in omega-loop reconstruction (p <0.05). There is no statistically significant difference (p> 0.05) in late dumping syndrome in patients relative to individual gastric substitution options. In the Hunt-Lawrence-Rodino pouch reconstruction option, there is no statistically significant difference (p> 0.05) in the participation of individual modalities of meal quantity in relation to the condition before the disease or the modality of the nutritional status. .Conclusion: The results indicate the antireflux component of reconstruction Roux en Y and the advantage of the nutritive component in the loop modification (the creation of the Hunt-Lawrence-Rodino pouch)