Call centers with a postponed callback offer

We study a call center model with a postponed callback option. A customer at the head of the queue whose elapsed waiting time achieves a given threshold receives a voice message mentioning the option to be called back later. This callback option differs from the traditional ones found in the literature where the callback offer is given at customer’s arrival. We approximate this system by a two-dimensional Markov chain, with one dimension being a unit of a discretization of the waiting time. We next show that this approximation model converges to the exact one. This allows us to obtain explicitly the performance measures without abandonment and to compute them numerically otherwise. From the performance analysis, we derive a series of practical insights and recommendations for a clever use of the callback offer. In particular, we show that this time-based offer outperforms traditional ones when considering the waiting time of inbound calls

EpiNet as a way of involving more physicians and patients in epilepsy research: validation study and accreditation process

Objective EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter cohort studies and investigator‐led trials. Physicians must be accredited to recruit patients into trials. Here, we describe the accreditation process for the EpiNet‐First trials. Methods Physicians with an interest in epilepsy were invited to assess 30 case scenarios to determine the following: whether patients have epilepsy; the nature of the seizures (generalized, focal); and the etiology. Information was presented in two steps for 23 cases. The EpiNet steering committee determined that 21 cases had epilepsy. The steering committee determined by consensus which responses were acceptable for each case. We chose a subset of 18 cases to accredit investigators for the EpiNet‐First trials. We initially focused on 12 cases; to be accredited, investigators could not diagnose epilepsy in any case that the steering committee determined did not have epilepsy. If investigators were not accredited after assessing 12 cases, 6 further cases were considered. When assessing the 18 cases, investigators could be accredited if they diagnosed one of six nonepilepsy patients as having possible epilepsy but could make no other false‐positive errors and could make only one error regarding seizure classification. Results Between December 2013 and December 2014, 189 physicians assessed the 30 cases. Agreement with the steering committee regarding the diagnosis at step 1 ranged from 47% to 100%, and improved when information regarding tests was provided at step 2. One hundred five of the 189 physicians (55%) were accredited for the EpiNet‐First trials. The kappa value for diagnosis of epilepsy across all 30 cases for accredited physicians was 0.70. Significance We have established criteria for accrediting physicians using EpiNet. New investigators can be accredited by assessing 18 case scenarios. We encourage physicians with an interest in epilepsy to become EpiNet‐accredited and to participate in these investigator‐led clinical trials

The role of consignees in empty container management The role of consignees in empty container management The role of consignees in empty container management

Abstract Nowadays, the majority of consumer goods is transported into a maritime container during at least one stage of the journey. Besides the many advantages of containerization, the management of empty containers is a key issue responsible for costly repositioning operations. This article investigates the potential for consignees to manage an inventory of empty containers at their location so as to enable direct reuse of these containers by shippers located in the surroundings. Our model aims at minimizing inventory holding and repositioning costs. These costs depend on the age of the container in the system in practice. We model the problem as a Markov decision process using the waiting time of the oldest container as a decision variable. Next, we use the value iteration technique to prove that a threshold policy in the age of the oldest container in stock is optimal. This paper, to the best of our knowledge, is the first to provide a proof for the optimality of a threshold policy based on the age of the oldest product in the system. We derive closed-form formulas for the system performance under the optimal policy. This allows us to compute numerically the optimal threshold and to derive explicit expressions of the optimal threshold in asymptotic regimes. We next analyze the impact of this proactive management of empty containers by the consignees on the level of direct container reuse. We show that this practice is very promising to enable a high level of direct reuse, but we also highlight that the consignees have little interest in implementing such a solution in the current setting of the container supply chain. We consequently propose remedies illustrated via a series of insights

Deformation behaviour of ultrafine and nanosize-grained Mg alloy synthesized via mechanical alloying

10.1080/14786430600660831Philosophical Magazine86192919-293

Bilateral independent periodic discharges are associated with electrographic seizures and poor outcome: a case-control study

Objective: To identify clinical correlates of BIPDs, their association with seizures and their prognostic significance. Background: Bilateral independent periodic discharges (BIPDs) is an increasingly recognized EEG pattern in the critically ill but its clinical correlates, and association with electrographic seizures and outcome are uncertain. Design/Methods: A retrospective casecontrol study of patients with BIPDs compared to two control groups, one without periodic discharges (?No PDs?) and one with lateralized periodic discharges on only one side (?LPDs?), all matched for age, etiology and level of alertness. Univariate and multivariate statistics were applied. Results: 85 cases and 85 controls were included in each group. The most frequent etiologies of BIPDs were ischemic and hemorrhagic stroke (25%), CNS infections (10%), and anoxic brain injury (10%). 77 (91%) patients with BIPDs had stupor or coma, including 31% in coma. Electrographic seizures were more common in the BIPDs group than No PDs group (45% vs. 8%;

Prophylaxis of the epilepsies: should anti-epileptic drugs be used for preventing seizures after acute brain injury?

In many circumstances antiepileptic drugs are used in patients who have never presented any clinical epileptic seizures. These substances are administered on the assumption of a potential risk for the patients of developing acute or delayed chronic seizures after brain injuries such as trauma, stroke, hemorrages or even neurosurgical interventions. The aim of this paper is to propose therapeutic guidelines for the management of this prophylactic attitude in epilepsy based on basic research and clinical practice in the French community in Belgium. We will distinguish between the prevention of acute (early onset-provoked) seizures and a delayed truly post-lesional (unprovoked) epilepsy. Some therapeutic goals can be achieved under the former circumstances whereas in the latter situation we all agree for the absence of any coherent antiepileptic prophylactic behaviour.Consensus Development ConferenceJournal ArticleReviewinfo:eu-repo/semantics/publishe

Therapeutic issues in women with epilepsy.

Approximately 20% of people with epilepsy are of childbearing potential and about 3 to 5 births per thousand will be to women with epilepsy. Both epilepsy and antiepileptic drugs can cause specific problems in women and embryos (less than 8 weeks of gestational age) or foetuses (more than 8 weeks of gestational age). The aim of this paper is to discuss therapeutic issues for the management of women with epilepsy: initiation of antiepileptic therapy, contraception, pregnancy, breast feeding and menopause. Some fertility issues are also discussed.GuidelineJournal ArticlePractice GuidelineSCOPUS: re.jinfo:eu-repo/semantics/publishe

Therapeutic strategies in the choice of antiepileptic drugs.

The choice of treatment of newly diagnosed epilepsy involves many factors such as age, sex, life style, general health and concomitant medication. The seizure type, syndrome, and the pharmacology, efficacy and safety of the antiepileptic drugs (AEDs) should also be considered. Some of the new AEDs appear to provide at least equivalent efficacy with better tolerability. Some of these drugs have the potential to become drugs of first choice in newly diagnosed epilepsy. At the present time, we also must consider the criteria of reimbursement of these drugs. In this paper, we try to describe common and practical strategies to start a treatment of newly diagnosed epilepsy.GuidelineJournal ArticlePractice Guidelineinfo:eu-repo/semantics/publishe