Incorporating A New Class of Uncertainty in Disaster Relief Logistics Planning

In recent years, there has been a growing interest among emergency managers in using Social data in disaster response planning. However, the trustworthiness and reliability of posted information are two of the most significant concerns, because much of the user-generated data is initially not verified. Therefore, a key tradeoff exists for emergency managers when considering whether to incorporate Social data in disaster planning efforts. By considering Social data, a larger number of needs can be identified in a shorter amount of time, potentially enabling a faster response and satisfying a class of demand that might not otherwise be discovered. However, some critical resources can be allocated to inaccurate demands in this manner. This dissertation research is dedicated to evaluating this tradeoff by creating routing plans while considering two separate streams of information: (i) unverified data describing demand that is not known with certainty, obtained from Social media platforms and (ii) verified data describing demand known with certainty, obtained from trusted traditional sources (i.e. on the ground assessment teams). These projects extend previous models in the disaster relief routing literature that address uncertainty in demand. More broadly, this research contributes to the body of literature that addresses questions surrounding the usefulness of Social data for response planning

A Constraint Programming Approach for the Team Orienteering Problem with Time Windows

The team orienteering problem with time windows (TOPTW) is a NP-hard combinatorial optimization problem. It has many real-world applications, for example, routing technicians and disaster relief routing. In the TOPTW, a set of locations is given. For each, the profit, service time and time window are known. A fleet of homogenous vehicles are available for visiting locations and collecting their associated profits. Each vehicle is constrained by a maximum tour duration. The problem is to plan a set of vehicle routes that begin and end at a depot, visit each location no more than once by incorporating time window constraints. The objective is to maximize the profit collected. In this study we discuss how to use constraint programming (CP) to formulate and solve TOPTW by applying interval variables, global constraints and domain filtering algorithms. We propose a CP model and two branching strategies for the TOPTW. The approach finds 119 of the best-known solutions for 304 TOPTW benchmark instances from the literature. Moreover, the proposed method finds one new best-known solution for TOPTW benchmark instances and proves the optimality of the best-known solutions for two additional instances

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Jitter Values on Voluntary Active Periocular Muscles of Healthy Subjects with Conventional (37 mm) Concentric Needle Electrode

Introduction: The aim of this study was to re-evaluate jitter values of healthy subjects in whom pairs of single-fiber-like potentials were recorded from voluntary activated periocular muscles using a disposable 37-mm concentric needle electrode (CNE) with 2-kHz low-cut filtering

Electromyography in Pediatric Population

WOS: 000450095400007PubMed ID: 30042639Introduction: Electrodiagnostic evaluation provides an important extension to the neurological examination for the evaluation of pediatric neuromuscular disease. Many pediatric neuromuscular diseases are analogous to those seen in the adult. However, the relative frequency of these illnesses varies greatly when different age populations are compared. The purpose of the present study is to provide a retrospective analysis of children referred to our electromyography (EMG) laboratory for electrophysiological examinations. Methods: We retrospectively reviewed electrodiagnostic records of patients aged between 0-15 years, from January 2004 to June 2013. Patients were classified as having plexopathy, nerve root lesions, polyneuropathy, myopathy, mononeuropathy, anterior horn cell disease, neuromuscular transmission disorder, facial nerve palsy, and other rare disorders. Results: We reviewed totally 5563 pediatric records, which was on the average 578 studies per year. It was about 14% of the all EMG examinations performed in our laboratory. When we looked at all the procedures, 3271 of the records included needle EMGs, 170 of them were single fiber EMGs, 100 of them were repetitive nerve stimulations, and 52 of them were evoked potentials. The results were normal in 55% of the cases. As a result of electrophysiological examinations, the common diagnoses were: plexopathy (28.6%), polyneuropathy (7.4%), and myopathy (6.6%) in patients aged 0-5 years (41.2% of all records); myopathy (9.4%), PNP (8.5%), mononeuropathy (6.4%), and plexopathy (5.9%) in 6-10 years (28.2% of all records); PNP (11.3%), myopathy (6.6%), and mononeuropathy (5.6%) in 11-15 years (30.6% of all records). Conclusion: Infants and toddlers mostly suffered from brachial plexopathy which can be prevented by proper obstetrical management. Nerve conduction studies and EMG yielded diagnostic importance for dernyel inating neuropathy and myopathy in patients older than 6 years of age.Scientific Research Projects (BAP-UDP-project) [40638]This presentation was supported by the Scientific Research Projects (BAP-UDP-project no: 40638)

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Base