Method for Production Planning and Inventory Control in OilRenery

In this paper, we propose a simultaneous optimization method for inventory control and production planning problem for a chemical batch plant. The plant consists of blending process, intermediate storage tanks and filling process. In the proposed method, the original problem is decomposed into production planning sub-problem and inventory control sub-problem. Then the decision variables are optimized by alternately solving each sub-problem. The solution of the proposed method is compared with that of centralized optimization method. The effectiveness of the proposed method is investigated from numerical computational results

Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi

<p>Abstract</p> <p>Background</p> <p>Acute pyelonephritis (APN) is a common complication of ureteral obstruction caused by urolithiasis, and it can be lethal if it progresses to septic shock. We investigated the clinical characteristics of patients undergoing emergency drainage and assessed risk factors for septic shock.</p> <p>Methods</p> <p>A retrospective study was performed of 98 patients (101 events) requiring emergency drainage at our urology department for obstructive APN associated with upper urinary tract calculi from January 2003 to January 2011. Clinical characteristics were summarized, and risk factors for septic shock were assessed by logistic regression analysis.</p> <p>Results</p> <p>Objective evidence of sepsis was found in 64 (63.4%) events, and 21 events (20.8%) were categorized as septic shock. Ninety-six patients recovered, but 2 patients died of septic shock. Multivariate analysis revealed that age and the presence of paralysis were independent risk factors for septic shock.</p> <p>Conclusions</p> <p>APN associated with upper urinary tract calculi is a severe disease that should be treated with caution, particularly when risk factors are present.</p

Evans syndrome during pembrolizumab therapy for upper urinary tract cancer

Introduction Immune checkpoint inhibitors are available for the treatment of advanced urothelial carcinoma; however, serious adverse events occasionally occur. Here, we report a rare case of Evans syndrome attributed to the use of an immune checkpoint inhibitor. Case presentation A 56‐year‐old man was diagnosed with left renal pelvic cancer and underwent left laparoscopic radical nephroureterectomy. Eight months postoperatively, computed tomography revealed para‐aortic lymph node metastasis. Despite receiving chemotherapy, the disease progressed, and pembrolizumab was initiated. After 26 months of pembrolizumab treatment, the patient developed fever and anemia. Hematologic examination confirmed the diagnosis of Evans syndrome. He was treated with blood transfusions and corticosteroids, and gradual symptom improvement was observed. Conclusion This report highlights the potential risk of Evans syndrome associated with immune checkpoint inhibitor treatment. Clinicians should be aware of this possibility and consider early intervention with corticosteroids