Scheduling of job shop, make-to-order industries with recirculation and assembly: discrete versus continuous time models

This work studies the performance of two Mixed Integer Linear Programming (MILP) models to solve scheduling problems in a flexible job shop environment with recirculation and assembly using a due-date-based objective function. The models convey different approaches both in the modelling of time (discrete and continuous approaches) as well as in the assignment of jobs to machines. The comparison is carried out for a job shop system considered closer to the industrial reality than the classical job shop problem of a single machine per operation that has been extensively studied in the literature, with the mould making industry providing the motivatin

recommendations based on placebo-controlled trial evidence

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.BACKGROUND: Immunomodulatory therapy has been extensively studied in randomized clinical trials for the treatment of patients hospitalized for COVID-19 with inconsistent findings. Guideline committees, reviewing the same clinical trial data, have generated different recommendations for immunomodulatory therapy. OBJECTIVES: We hypothesize that trial design differences, specifically whether the study utilized an open-label or placebo-controlled design, accounted for the inconsistent mortality effects reported in clinical trials of immunomodulator therapies for COVID-19. SOURCES: We reviewed COVID-19 treatment guidelines (World Health Organization [WHO], Infectious Diseases Society of America [IDSA] and The National Institutes of Health [NIH]) and identified the meta-analyses associated with glucocorticoids, IL-6 inhibitors, JAK kinase inhibitors, and complement C5a inhibitors that were available to the guideline authors at the time recommendations were either made or updated. CONTENT: We identified a meta-analysis for each of the immunomodulator classes that are included in current COVID-19 treatment guidelines: glucocorticoids [WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Shankar-Hari M, Vale CL, Godolphin PJ, Fisher D, Higgins JPT, et al. Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19: A meta-analysis. JAMA. 2021;326:499-518] (cited 419), IL-6 antagonists [WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Shankar-Hari M, Vale CL, Godolphin PJ, Fisher D, Higgins JPT, et al. Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19: A meta-analysis. JAMA. 2021;326:499-518] (cited 419), JAK inhibitors [Kramer A, Prinz C, Fichtner F, Fischer AL, Thieme V, Grundeis F, et al. Janus kinase inhibitors for the treatment of COVID-19. Cochrane Database Syst Rev. 2022;6:CD015209] (cited 34), and complement C5a inhibitors [Tsai CL, Lai CC, Chen CY, Lee HS. The efficacy and safety of complement C5a inhibitors for patients with severe COVID-19: A systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2023;21:77-86] (cited 1). Using the same randomized clinical trials, we evaluated the four meta-analyses accounting for trial design: placebo-controlled or open-label. Glucocorticoids (Risk Ratio [RR] 0.91 [95% CI, 0.49-1.69]), IL-6 inhibitors sarilumab (RR 1.17 [95% CI, 0.96-01.43]), and tocilizumab (RR 0.95 [95% CI, 0.76-1.19]) did not reduce mortality in placebo-controlled trials, whereas baricitinib did confer a large survival benefit (RR 0.65 [95% CI, 0.52-0.81]). The complement C5a inhibitor, vilobelimab, also reduced mortality in a single placebo-controlled trial (RR 0.76 [95% CI, 0.57-1.0]). IMPLICATIONS: Placebo-controlled trial evidence indicates that baricitinib should be the first choice immunomodulator for patients hospitalized for COVID-19 who require any form of oxygen support-low- or high-flow oxygen, non-invasive or invasive ventilation. Vilobelimab warrants study in a large placebo-controlled trial. Treatment guidelines for future pandemics should prioritize the results of placebo-controlled trials.proofepub_ahead_of_prin

The smart waste collection routing problem: alternative operational management approaches

Waste collection is nowadays an increasingly important business. However, it is often an inefficient op- eration due to the high uncertainty associated with the real waste bins’ fill-levels. To deal with such uncertainty the use of sensors to transmit real time information is seen as possible solution. But, in order to improve operations’ efficiency, the sensors’ usage must be combined with optimization procedures that inform on the optimal collection routes to operationalize, so as to guarantee a maximization of the waste collected while also minimizing transportation costs. The present work explores this challenge and studies three operational management approaches to define dynamic optimal routes, considering the access to real-time information on the bins’ fill-levels. A real case study is solved and important results were found where significant profit improvements are observed when compared to the real operation. This shows the potential of the proposed approaches to build an expert system, which can support the operations manager’s decisions.info:eu-repo/semantics/acceptedVersio

Cost-effectiveness analysis for sustainable wastewater engineering : a case study at Minho-Lima’s rivers basins (Portugal)

The present work was focused on a methodological assessment for defining cost-effective measures regarding to wastewater sanitation in rural areas and was carried out within the project AQUA Project – Preliminary Studies for the Water Framework Directive Implementation at the Minho and Lima’s Rivers Basins. In order to assure a good ecological and chemical status in water bodies according to Water Framework Directive, a set of priority and complementary actions combined with a cost-effectiveness analysis was used to select a wastewater treatment strategy to increase public attendance. Using geoprocessing methodologies and geographic information multicriteria analysis (e.g.: soil, land use, topography), locations with high potential for implementation of low-energy wastewater treatment systems were identified and worked out with cost-functions. The results show that a combination of centralized and decentralized plants allow a cost-effectiveness attendance of 1,51 k¤/equivalent inhabitant in Minho and Lima’s river basins. The approach indicates that low-energy wastewater treatment plants are interesting options with a promising cost-effectiveness potential in rural areas

Cost-effectiveness analysis for sustainable wastewater engineering and water resources management : a case study at Minho–Lima river basins (Portugal)

A cost-effectiveness integrated methodology applied in a water resources management and sanitation project in Minho and Lima’s region (Portugal) is presented. First, environmental objectives and programmes of measures (PM) are established and priorities are identified using a cause–effect assessment matrix and a global effectiveness index. Aiming to achieve more demanding goals, some complementary actions are considered, including “decentralized low-energy wastewater treatment plants construction”. A geographic information system was used to select potential implementation sites, and suitable treatment processes for each location are identified. The centralized and decentralized wastewater treatment plants combination is promising, achieving a cost-effectiveness attendance of €1510/equivalent-inhabitant in Minho–Lima river basins

The role of corticosteroids in severe community-acquired pneumonia: a systematic review

Submitted by Sandra Infurna ([email protected]) on 2019-04-04T12:26:57Z No. of bitstreams: 1 JorgeIF_Salluh_etal_IOC_2008.pdf: 215501 bytes, checksum: fb18fede448c1eb9f08f5dc05c97d47c (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-04-04T12:37:41Z (GMT) No. of bitstreams: 1 JorgeIF_Salluh_etal_IOC_2008.pdf: 215501 bytes, checksum: fb18fede448c1eb9f08f5dc05c97d47c (MD5)Made available in DSpace on 2019-04-04T12:37:41Z (GMT). No. of bitstreams: 1 JorgeIF_Salluh_etal_IOC_2008.pdf: 215501 bytes, checksum: fb18fede448c1eb9f08f5dc05c97d47c (MD5) Previous issue date: 2008Instituto Nacional de Câncer. Unidade de Cuidados Intensivos. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.Hospital de São Francisco Xavier. Centro Hospitalar de Lisboa Ocidental. Unidade de Terapia Intensiva Médica. Lisboa, Portugal.Instituto Nacional de Câncer. Unidade de Cuidados Intensivos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.Introduction: The purpose of this review was to evaluate the impact of corticosteroids on the outcomes of patients with severe community-acquired pneumonia (CAP). Methods: We performed a systematic MEDLINE, Cochrane database, and CINAHL search (1966 to November 2007) to identify full-text publications that evaluated the use of corticosteroids in CAP. Results: An initial literature search yielded 109 articles, and 105 studies were excluded after the first analysis. We found four studies eligible for analysis. On the basis of their results, the use of corticosteroids as adjunctive therapy in severe CAP should be categorized as a weak recommendation (two studies) and a strong recommendation (two studies) with either low- or moderate-quality evidence. However, no evidence of adverse outcomes or harm is present in the evaluated studies. Conclusion: According to the GRADE system, available studies do not support the recommendation of corticosteroids as a standard of care for patients with severe CAP. Further randomized controlled trials with this aim should enroll a larger number of severely ill patients. However, in patients needing corticosteroids, it may be reasonable to conclude that corticosteroid administration is safe in patients with severe infections receiving antimicrobial therapy

Continuous Infusion of Piperacillin/Tazobactam in Septic Critically Ill Patients - a Multicenter Propensity Matched Analysis

The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing

Promoção de uma oferta equitativa no setor dos cuidados continuados integrados: desenvolvimento de uma abordagem multi-período e multiobjetivo para apoio ao planeamento da oferta de cuidados

Este estudo propõe um modelo de programação matemática multi‑objetivo e multi‑período para apoiar as decisões de planeamento no setor dos cuida‑ dos continuados integrados (CCI). O modelo proposto permite apoiar o pla‑ neamento da oferta de CCI em regime de internamento, tanto em termos de seleção das melhores localizações para esses serviços, como também da capa‑ cidade a instalar, e isto com o propósito de construir uma rede de cuidados mais equitativa. Serão, assim, considerados três objetivos de equidade – equi‑ dade de acesso, equidade geográfica e equidade socioeconómica. Serão tam‑ bém contabilizados os custos, mas na forma de restrições do modelo. A funçãoobjetivo do modelo incorpora estes múltiplos objetivos de equidade através da atribuição de pesos que são obtidos com recurso à metodologia Measuring Attractiveness by a Category‑Based Evaluation TecHnique (MACBETH). A uti‑ lidade do modelo é ilustrada através da sua aplicação a um caso de estudo na região da Grande Lisboa em Portugal.info:eu-repo/semantics/publishedVersio

Analysis of risk factors for maxillary denture-related oral mucosal lesions : a cross-sectional study

To evaluate the frequency of maxillary dentures-related lesions and the possible associated risk factors. Ninety-seven participants were selected, and a complete anamnesis, physical examination and tests of occlusion vertical dimension (OVD), retention and stability of the denture, biofilm quantification, cytopathology, sialometry, pH analysis and buffer capacity of the saliva were performed. Statistical analyses were performed with the Pearson?s chi-square, Mann-Whitney tests, and Pearson?s coefficient (p<0.05). In 78% of the participants at least one denture-related lesion was found. Denture-associated stomatitis (63%), inflammatory fibrous hyperplasia (19%) and traumatic ulceration (11%) were the 3 most frequent lesions. The habit of night use of the denture was considered an independent risk factor for the development of oral lesions [OR=3.0 (95% CI 1.09-8.56); p<0.05]. Furthermore, the longest period of use of the same denture and biofilm also had statistically significant relation to oral lesions. The biofilm seems to be more related to the prevalence of oral lesions according to the multiple logistic regression [OR=1.3 (95% CI: 1.01-1.83) p<0.05]. The lack of a dentures? cleaning solution and detrition of the prothesis were independent risk factors for denture-associated stomatitis. Male gender, loss of OVD and bad buffer capacity were risk factors for angular cheilitis. Fractures of the base and repair of broken dentures were risk factors for traumatic ulcers. These results show a high frequency of denture-related lesions. Besides, participants hygiene habits and poor quality of the dentures were the main factors for the development of these lesions

C-reactive protein and albumin kinetics before community-acquired bloodstream infections- A Danish population-based cohort study

aEarly changes in biomarker levels probably occur before bloodstream infection (BSI) is diagnosed. However, this issue has not been fully addressed. We aimed at evaluating the kinetics of C-reactive protein (CRP) and plasma albumin (PA) in the 30 days before community-acquired (CA) BSI diagnosis. From a population-based BSI database we identified 658 patients with at least one measurement of CRP or PA from day-30 (D-30) through day-1 (D-1) before the day of CA-BSI (D0) and a measurement of the same biomarker at D0 or D1. Amongst these, 502 had both CRP and PA measurements which fitted these criteria. CRP and PA concentrations began to change inversely some days before CA-BSI diagnosis, CRP increasing by day-3.1 and PA decreasing by day-1.3. From D-30 to D-4, CRP kinetics (expressed as slopes-rate of concentration change per day) was-1.5 mg/l/day. From D-3 to D1, the CRP slope increased to 36.3 mg/l/day. For albumin, the slope between D-30 to D-2 was 0.1 g/l/day and changed to-1.8 g/l/day between D-1 and D1. We showed that biomarker levels begin to change some days before the CA-BSI diagnosis, CRP 3.1 days and PA 1.3 days before.publishersversionepub_ahead_of_prin