Minimizing the sum of flow times with batching and delivery in a supply chain

The aim of this thesis is to study one of the classical scheduling objectives that is of minimizing the sum of flow times, in the context of a supply chain network. We consider the situation that a supplier schedules a set of jobs for delivery in batches to several manufacturers, who in tum have to schedule and deliver jobs in batches to several customers. The individual problem from the viewpoint of supplier and manufacturers will be considered separately. The decision problem faced by the supplier is that of minimizing the sum of flow time and delivery cost of a set of jobs to be processed on a single machine for delivery in batches to manufacturers. The problem from the viewpoint of manufacturer is similar to the supplier's problem and the only difference is that the scheduling, batching and delivery decisions made by the supplier define a release date for each job, before which the manufacturer cannot start the processing of that job. Also a combined problem in the light of cooperation between the supplier and manufacturer will be considered. The objective of the combined problem is to find the best scheduling, batching, and delivery decisions that benefit the entire system including the supplier and manufacturer. Structural properties of each problem are investigated and used to devise a branch and bound solution scheme. Computational experience shows significant improvements over existing algorithms and also shows that cooperation between a supplier and a manufacturer reduces the total system cost of up to 12.35%, while theoretically the reduction of up to 20% can be achieved for special cases.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Posttransplant malignancies and their relationship with human leukocyte antigens in kidney allograft recipients.

INTRODUCTION: Kidney transplant recipients are at increased risk of cancers, most frequently skin cancers, and in some regions, Kaposi sarcoma and non-Hodgkin lymphoma. We sought to investigate the associate of the most frequent malignancies among our patients with human leukocyte antigens (HLAs). MATERIALS AND METHODS: We performed a retrospective study on 44 kidney allograft recipients who had posttransplant malignancy and 44 kidney allograft recipients without malignant lesions (control group). All of the patients had been treated by immunosuppressive regimens including cyclosporine plus prednisolone or cyclosporine, prednisolone, and mycophenolate mofetil. Data on HLA typing were achieved from their transplant records. RESULTS: There were 15 patients (34.1) with Kaposi sarcoma; 13 (29.6) with non-Hodgkin lymphoma, 6 (13.6) with skin cancer, 2 (4.5) with ovary cyst adenocarcinoma, and 8 (18.2) with other tumors. The mean interval from transplantation to diagnosis of malignancy was 15.3 month. Twelve patients died of cancer during the follow-up (mean, 12.3 years). No significant difference was noted in the age, sex, and time of transplantation between these patients and those in the control group. Kaposi sarcoma was associated with HLA-CW4 (P = .03) with an odds ratio of 4.96 (95 confidence interval, 2.90 to 8.12). CONCLUSIONS: We found HLA-CW4 as a risk factor of Kaposi sarcoma in kidney allograft recipients. Screening for malignancies after kidney transplantation sounds very important with special attention to the specific environmental and genetic factors in each population

Posttransplant malignancies and their relationship with human leukocyte antigens in kidney allograft recipients.

INTRODUCTION: Kidney transplant recipients are at increased risk of cancers, most frequently skin cancers, and in some regions, Kaposi sarcoma and non-Hodgkin lymphoma. We sought to investigate the associate of the most frequent malignancies among our patients with human leukocyte antigens (HLAs). MATERIALS AND METHODS: We performed a retrospective study on 44 kidney allograft recipients who had posttransplant malignancy and 44 kidney allograft recipients without malignant lesions (control group). All of the patients had been treated by immunosuppressive regimens including cyclosporine plus prednisolone or cyclosporine, prednisolone, and mycophenolate mofetil. Data on HLA typing were achieved from their transplant records. RESULTS: There were 15 patients (34.1) with Kaposi sarcoma; 13 (29.6) with non-Hodgkin lymphoma, 6 (13.6) with skin cancer, 2 (4.5) with ovary cyst adenocarcinoma, and 8 (18.2) with other tumors. The mean interval from transplantation to diagnosis of malignancy was 15.3 month. Twelve patients died of cancer during the follow-up (mean, 12.3 years). No significant difference was noted in the age, sex, and time of transplantation between these patients and those in the control group. Kaposi sarcoma was associated with HLA-CW4 (P = .03) with an odds ratio of 4.96 (95 confidence interval, 2.90 to 8.12). CONCLUSIONS: We found HLA-CW4 as a risk factor of Kaposi sarcoma in kidney allograft recipients. Screening for malignancies after kidney transplantation sounds very important with special attention to the specific environmental and genetic factors in each population

Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran

Introduction: The incidence of end-stage renal disease is increasing worldwide. Earlier studies reported high prevalence rates of obesity and hypertension, two major risk factors of chronic kidney disease (CKD), in Golestan Province, Iran. We aimed to investigate prevalence of moderate to severe CKD and its risk factors in the region. Methods: Questionnaire data and blood samples were collected from 3591 participants (≥18 years old) from the general population. Based on serum creatinine levels, glomerular filtration rate (GFR) was estimated. Results: High body mass index (BMI) was common: 35.0 of participants were overweight (BMI 25-29.9) and 24.5 were obese (BMI ≥30). Prevalence of CKD stages 3 to 5 (CKD-S3-5), i.e., GFR <60 mL/min/1.73 m2, was 4.6. The odds ratio (OR) and 95 confidence interval (95 CI) for the risk of CKD-S3-5 associated with every year increase in age was 1.13 (1.11- 1.15). Men were at lower risk of CKD-S3-5 than women (OR = 0.28; 95 CI 0.18-0.45). Obesity (OR = 1.78; 95 CI 1.04-3.05) and self-reported diabetes (OR = 1.70; 95 CI 1.00-2.86), hypertension (OR = 3.16; 95 CI 2.02-4.95), ischemic heart disease (OR = 2.73; 95 CI 1.55-4.81), and myocardial infarction (OR = 2.69; 95 CI 1.14-6.32) were associated with increased risk of CKD-S3-5 in the models adjusted for age and sex. The association persisted for self-reported hypertension even after adjustments for BMI and history of diabetes (OR = 2.85; 95 CI 1.77-4.59). Conclusion: A considerable proportion of inhabitants in Golestan have CKD-S3-5. Screening of individuals with major risk factors of CKD, in order to early detection and treatment of impaired renal function, may be plausible. Further studies on optimal risk prediction of future end-stage renal disease and effectiveness of any screening program are warranted. © 2010 Najafi et al

A mathematical model for weighted tardy jobs scheduling problem with a batched delivery system A R T I C L E I N F O A B S T R A C T

This study investigates minimizing the number of weighted tardy jobs on a single machine when jobs are delivered to either customers or next station in various size batches. In real world, this issue may happen within a supply chain in which delivering goods to customers entails costs. Under such circumstances, keeping completed jobs to deliver in batches may result in reducing delivery costs; nevertheless, it may add to the tardy jobs, which in turn leads to higher costs. In literature review, minimizing the number of weighted tardy jobs is known as NP-Hard problem, so the present issue aiming at minimizing the costs of delivering, in addition to the aforementioned objective function, remains an NP-Hard problem. In this study, the issue is assessed where the customers are numerous, and a mathematical model is presented. We also present a meta-heuristic method based on simulated annealing (SA) and the performance of the SA is examined versus exact solutions

Pulmonary Infection In Renal Transplant Recipients

Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences."nMaterials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran."nResults: 164 renal transplant recipients were studied, 14 patients (8.5%) had pulmonary infection, 11 of them (78.6%) were female and 3 (21.4%) were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4%) was between 1 to 6 months post transplantation, 11 cases (78.6%) were occurred beyond 6 months after transplantation. In 7 cases (50%), pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8%) of pulmonary infection, and organism were detected in 5 of them (83.3%). The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%), this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment."nConclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation."n"n"n"n"n"n"n&nbsp

The Impact Of Nandrolone Decanovate On Lipid Profile In Chronic Hemodyalysis Patient

LP(a) level in uremic patients is high. It has recently considered that the effect of androgens on lipids vary widely. The aim of this study was to determine the effect of nandrolone decanoate on lipid profile in chronic hemodialysis patients."nMaterials and Methods: thirty six stable male patients over 40 years who were under maintenance hemodialysis were randomized to receive nandrolone decanoate , 100 mg weekly for six month, by intramuscular injection on nondialysis day (Group A, N=18) or B complex (Group B, N=18). Between September 2001 and 2002, male hemodialysis patients more than 40 years old without history of high prostatic specific antigen (PAS) or sensitization to drug were started on treatment with androgen therapy. The evolution in the liquid profile was prospectively assessed immediately before the first dose of nandrolone decanoate (basal values) and at 2, 4 and 6 month of therapy. The evolution of lipids after withdrawal of androgens at 2 month after the last dose was also studied. The patients underwent hemodialysis 3 to 4 hours three times a week. The dialysis schedule was not modified during the period of study."nResults: Mean decrease of LP(a) level in group A was significantly lower then group B in second month (p<0.05). Surprisingly HP level decreased also in second month. Other lipid parameters did not show significant changes."nConclusion: In this study we observed that nandrolone decanoate affects on LP(a) leveK but the changes of it did not correlate with those of hemoglobin or other lipid parameters< suggesting that the underlying mechanisms are unrelated. Our finding might be affected by low dose of the drug. Further studies with higher doses will be requied to clarify the beneficial or adverse effects of this type of therapy

Does a medical management program for CKD patients postpone renal replacement therapy and mortality?: A 5-year-cohort study

<p>Abstract</p> <p>Background</p> <p>Many countries have started screening and prevention programs for chronic kidney disease (CKD). However, one of the main concerns of health authorities is whether management strategies for diagnosed CKD patients can decrease mortality or morbidity. This study aimed to investigate the effect of two competing clinical strategies of treatments under nephrologists’ supervision compared with no treatment on the frequency of the need to start renal replacement therapy (RRT) and mortality in CKD patients.</p> <p>Methods</p> <p>Our cohort comprised consecutive newly diagnosed patients with CKD in an outpatient clinic in Tehran between October 2002 and October 2011. CKD Patient enrollment occurred if two criteria of high plasma creatinine level and chronicity of renal disease by at least 3 months of clinical history or small sized kidneys in ultrasound findings were met. Demographic data and time of RRT or mortality in patients who had been followed up regularly were compared with those in the control group. The control group included those patients who did not attend a nephrology clinic to receive CKD management package for at least 1 year during the study period.</p> <p>Results</p> <p>The cohort included 76 patients in the control group and 389 patients in the supervised group. The mean age of the patients was 61.33±14.9 years (16–95 years). The ratio of males/females was 1.47 (277/188). The mean follow-up in the control and supervised groups was 33.29±20.50 (7–111) and 36.03±25.24 (6–124) months , respectively, and the total patient years of follow-up was 1382.3. A substantial number of patients survived without RRT until the first year of follow up (96%) in both groups, but afterward, those in the control group had more deaths or need to start RRT in comparison with those who received medical advice (20 vs. 67 months; p= 0.029). This cohort also showed a higher survival and a longer time to show a GFR of less than 15 cc/min (84 vs 34 months, p<0.0001) in patients who had been under physician supervision compared with the control group.</p> <p>Conclusions</p> <p>Active follow-up of CKD patients appears to significantly decrease the risk of death or progression to end-stage renal disease and the requirement to start renal replacement therapy.</p

The relationship between serum adipokines and glucose homeostasis in normal-weight and obese patients on hemodialysis: a preliminary study

Purpose: Insulin resistance (IR) is a prevalent disorder in advanced renal failure irrespective of diabetes. Adipokines might play a role in IR, which has not been well-documented in uremic conditions. This study investigated the relationship of Zinc-α2-glycoprotein (ZAG), adipose triglyceride lipase (ATGL), and adipolin with glucose�insulin homeostasis in normal weight (NW) and obese (OB) patients with hemodialysis. Methods: In this cross-sectional study, 59 patients (29 NW; 18.5 � BMI &lt; 25 kg/m2, and 30 OB; BMI � 30 kg/m2) were studied. Anthropometries, circulating ZAG, adipolin, ATGL, free fatty acids (FFAs), fasting blood glucose (FBG), insulin, and homeostasis model assessment of IR (HOMA)-IR were assessed. Results: There were no significant differences in age, gender, hemodialysis duration, dialysis adequacy and diabetes between the two groups. ZAG (100.9 ± 37.1 vs. 107.5 ± 30.5 ng/mL, P = 0.03) and adipolin (12.4 ± 1.6 vs. 13.2 ± 2.8 ng/mL, P = 0.002) concentrations were significantly lower, and FFAs (228.1 ± 112.6 vs. 185 ± 119 ng/mL, P = 0.014) were significantly higher in the OB than NW group. No significant differences were observed in ATGL, FBG, insulin and HOMA-IR between the two groups. Patients with lower IR had higher ZAG (112.9 ± 31.7 vs. 94.9 ± 34.5 ng/mL; P = 0.046), lower FFAs (167.8 ± 98.4 vs. 249.9 ± 120.8 ng/mL; P = 0.004), and marginally lower ATGL (9.1 ± 5.2 vs. 12.3 ± 9.6 mIU/mL; P = 0.079) concentrations than those with higher IR. ZAG was negatively (r = � 0.323, P = 0.018 and r = � 0.266, P = 0.054) and FFAs were positively (r = 0.321, P = 0.019 and r = 0.353, P = 0.009) correlated with insulin and HOMA-IR, respectively. ATGL was directly correlated with FFAs (r = 0.314, P = 0.018). Conclusions: Novel adipokines, ZAG and ATGL, might contribute to glucose�insulin homeostasis in hemodialysis. Understanding potential causative, diagnostic or therapeutic roles of adipokines in IR require further studies. © 2020, Springer Nature B.V