A dynamic programming model for designing a quality control plan in a manufacturing process

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Process quality planning should establish the quality control plan to achieve the desired quality level with the minimum quality cost (appraisal and failure costs) for the final product. This plan sets out the critical quality variables, the control stations in the process, and the control method at each control station. The quality costs associated with quality control and defective products can be greater than or less than ideal regarding the required quality level. The purpose of this paper is to provide a stochastic dynamic programming model for designing the quality control plan in a manufacturing process, which allows obtaining the desired level of control with the lowest cost. Inputs to the model are, in particular, control stations in the process, levels of quality, control methodologies (no control, statistical process control, 100% inspection), probabilities of changing the quality level and quality costs. The output of this model is the quality control plan that satisfies the desired level of quality at the lowest cost. This plan establishes the control stations, the methodology used in each control station, the desired quality level for the final product, and the estimated quality costs. Finally, an illustrative example based on a manufacturing process demonstrates the applicability of this approach and several considerations are reported about future research directions.FCT - Fundação para a Ciência e a Tecnologia(UID/CEC/00319/2019

Histopathological Study of Pure Primary Nephrotic Syndrome in Adolescents and Young Moroccan Adults

Introduction: The primary nephrotic syndrome (PNS) is the most common glomerular nephropathy in children. Its diagnosis and management don’t require histopathological study. It occurs mainly in the form of minimal glomerular lesion and in most cases respond to corticosteroids. The literature on histological lesions of pure PNS in adolescents and young adults is rare. Thus, there are no criteria or recommendations regarding the indications for renal biopsy in patients aged 12-18 years. Methods: This is a retrospective study in which we encountered a total of 386 patients aged 12 to 25 years who were admitted and biopsied at the Nephrology Unit of Ibn Roshd Hospital in Casablanca during the period from January 1st, 2000 to September 30th, 2009 . Patients with pure PNS were 77 (20%), all were included in this study. Results: The average incidence of pure PNS was 7.7 cases per year. The study included 47 males (61%) and 30 females (39%). Patients were sent from all parts of Morocco and the average length of hospital stay was four days. Renal biopsies showed the following morphological lesions: minimal glomerular lesions in 61 cases (79.20%), focal segmental hyalinosis in 7 cases (9.10%), extramembranous glomerulonephritis in 7 cases (9.10%) and 2 cases of renal amyloidosis (2.6%). Conclusion: The minimal glomerular lesions were the most common cause of pure primary nephrotic syndrome in patients aged 12-25 years. Initial renal biopsy may not be indicated in this age group, and an empiric therapeutic trial with corticosteroids may be initially considered.Keywords: Glomerular Disease; Children; Nephrotic Syndrome; Renal Biops

DELMU: A Deep Learning Approach to Maximising the Utility of Virtualised Millimetre-Wave Backhauls

Advances in network programmability enable operators to 'slice' the physical infrastructure into independent logical networks. By this approach, each network slice aims to accommodate the demands of increasingly diverse services. However, precise allocation of resources to slices across future 5G millimetre-wave backhaul networks, to optimise the total network utility, is challenging. This is because the performance of different services often depends on conflicting requirements, including bandwidth, sensitivity to delay, or the monetary value of the traffic incurred. In this paper, we put forward a general rate utility framework for slicing mm-wave backhaul links, encompassing all known types of service utilities, i.e. logarithmic, sigmoid, polynomial, and linear. We then introduce DELMU, a deep learning solution that tackles the complexity of optimising non-convex objective functions built upon arbitrary combinations of such utilities. Specifically, by employing a stack of convolutional blocks, DELMU can learn correlations between traffic demands and achievable optimal rate assignments. We further regulate the inferences made by the neural network through a simple 'sanity check' routine, which guarantees both flow rate admissibility within the network's capacity region and minimum service levels. The proposed method can be trained within minutes, following which it computes rate allocations that match those obtained with state-of-the-art global optimisation algorithms, yet orders of magnitude faster. This confirms the applicability of DELMU to highly dynamic traffic regimes and we demonstrate up to 62% network utility gains over a baseline greedy approach.Comment: remove LaTeX remains in abstract; change the font for acrony

Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery.

INTRODUCTION: Postoperative morbidity and mortality in older patients with comorbidities undergoing gastrointestinal surgery are a major burden on healthcare systems. Infections after surgery are common in such patients, prolonging hospitalisation and reducing postoperative short-term and long-term survival. Optimal management of perioperative intravenous fluids and inotropic drugs may reduce infection rates and improve outcomes from surgery. Previous small trials of cardiac-output-guided haemodynamic therapy algorithms suggested a modest reduction in postoperative morbidity. A large definitive trial is needed to confirm or refute this and inform widespread clinical practice. METHODS: The Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is a multicentre, international, parallel group, open, randomised controlled trial. 2502 high-risk patients undergoing major elective gastrointestinal surgery will be randomly allocated in a 1:1 ratio using minimisation to minimally invasive cardiac output monitoring to guide protocolised administration of intravenous fluid combined with low-dose inotrope infusion, or usual care. The trial intervention will be carried out during and for 4 hours after surgery. The primary outcome is postoperative infection of Clavien-Dindo grade II or higher within 30 days of randomisation. Participants and those delivering the intervention will not be blinded to treatment allocation; however, outcome assessors will be blinded when feasible. Participant recruitment started in January 2017 and is scheduled to last 3 years, within 50 hospitals worldwide. ETHICS/DISSEMINATION: The OPTIMISE II trial has been approved by the UK National Research Ethics Service and has been approved by responsible ethics committees in all participating countries. The findings will be disseminated through publication in a widely accessible peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: ISRCTN39653756.The OPTIMISE II trial is supported by Edwards Lifesciences (Irvine, CA) and the UK National Institute for Health Research through RMP’s NIHR Professorship

Technology acquisition and efficiency in Dubai hospitals

The paper studies the impact of the acquisition of relevant medical technology and information technology on the efficiency of hospital wards in three public hospitals in Dubai. Efficiency scores are obtained through bootstrapped data envelopment analysis, and are then regressed on variables assessing the extent of technology acquisition using truncated regression. Results show that both the acquisition of medical technology and of information technology have a positive impact on the ward efficiency, but that the strength of this relation is moderated by several variables related to organizational and managerial factors. In particular, results point out that the relationship between efficiency and technology is positively moderated by the ability of the head of ward to manage internal conflicts, by the managerial goals, and by the tenure of the head of ward. A negative moderating impact is exerted by perceived constraints to managerial actions, such as conflicting priorities with the hospital general management

The impact of multi-cultural teams on the efficiency of hospital care in Dubai

Ancarani A., Ayach A., Di Mauro C., GITTO S., Mancuso P. (2015). The impact of multi-cultural teams on the efficiency of hospital care in Dubai. Research in the Decision Sciences for Global Business: Best Papers from the 2013 Annual Conference. p. 153-170, Pearson FT Press, ISBN/ISSN: 978-0-13-405232-