Optimización de un ruteo vehicular usando algoritmo genético simple chu-beasley

The research presented in the article is geared towards the area of genetic algorithms in the optimization of resources and processes, and then a case study is set based on vehicular routing and optimization of the same, applying the genetic algorithm of Chu-Beasley. This study, which started on November 2013 and finished on March 2014, was applied in Bogotá city, as it is the capital of Colombia. This metropolis counts with many industrial areas, gathering centers, warehouses and other commercial activities. Likewise, the growing of the capital in the last years has been significant, which has generated an exponential territorial extension, causing mobility problems and transport. For that reason, it is imperative for some warehouses that have to distribute their products, to optimize the routes and guarantee effectiveness and efficiency in delivery.  genéticos en la optimización de recursos y procesos; a continuación se establece un estudio de caso fundamentado en el ruteo vehicular y la  optimización del mismo, aplicando el algoritmo genético de Chu-Beasley. Este estudio, que inició en noviembre de 2013 y terminó en marzo de 2014, se aplicó en la ciudad de Bogotá, D.C., por ser la capital de Colombia. Esta metrópoli cuenta con innumerables zonas industriales, centros de acopio, almacenes y demás actividades comerciales. De la misma manera, el crecimiento de la capital en los últimos años ha sido significativo, lo que ha generado una extensión territorial exponencial, causando problemas de movilidad y transporte. Por ello es imperioso para algunas empresas que deben distribuir sus productos optimizar los recorridos y garantizar efectividad y eficiencia en las entregas

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Optimización de un ruteo vehicular usando algoritmo genético simple chu-beasley

The research presented in the article is geared towards the area of genetic algorithms in the optimization of resources and processes, and then a case study is set based on vehicular routing and optimization of the same, applying the genetic algorithm of Chu-Beasley. This study, which started on November 2013 and finished on March 2014, was applied in Bogotá city, as it is the capital of Colombia. This metropolis counts with many industrial areas, gathering centers, warehouses and other commercial activities. Likewise, the growing of the capital in the last years has been significant, which has generated an exponential territorial extension, causing mobility problems and transport. For that reason, it is imperative for some warehouses that have to distribute their products, to optimize the routes and guarantee effectiveness and efficiency in delivery.  </p

Optimización de un ruteo vehicular usando algoritmo genético simple chu-beasley

The research presented in the article is geared towards the area of genetic algorithms in the optimization of resources and processes, and then a case study is set based on vehicular routing and optimization of the same, applying the genetic algorithm of Chu-Beasley. This study, which started on November 2013 and finished on March 2014, was applied in Bogotá city, as it is the capital of Colombia. This metropolis counts with many industrial areas, gathering centers, warehouses and other commercial activities. Likewise, the growing of the capital in the last years has been significant, which has generated an exponential territorial extension, causing mobility problems and transport. For that reason, it is imperative for some warehouses that have to distribute their products, to optimize the routes and guarantee effectiveness and efficiency in delivery.  genéticos en la optimización de recursos y procesos; a continuación se establece un estudio de caso fundamentado en el ruteo vehicular y la  optimización del mismo, aplicando el algoritmo genético de Chu-Beasley. Este estudio, que inició en noviembre de 2013 y terminó en marzo de 2014, se aplicó en la ciudad de Bogotá, D.C., por ser la capital de Colombia. Esta metrópoli cuenta con innumerables zonas industriales, centros de acopio, almacenes y demás actividades comerciales. De la misma manera, el crecimiento de la capital en los últimos años ha sido significativo, lo que ha generado una extensión territorial exponencial, causando problemas de movilidad y transporte. Por ello es imperioso para algunas empresas que deben distribuir sus productos optimizar los recorridos y garantizar efectividad y eficiencia en las entregas

Optimización de un ruteo vehicular usando algoritmo genético simple chu-beasley

The research presented in the article is geared towards the area of genetic algorithms in the optimization of resources and processes, and then a case study is set based on vehicular routing and optimization of the same, applying the genetic algorithm of Chu-Beasley. This study, which started on November 2013 and finished on March 2014, was applied in Bogotá city, as it is the capital of Colombia. This metropolis counts with many industrial areas, gathering centers, warehouses and other commercial activities. Likewise, the growing of the capital in the last years has been significant, which has generated an exponential territorial extension, causing mobility problems and transport. For that reason, it is imperative for some warehouses that have to distribute their products, to optimize the routes and guarantee effectiveness and efficiency in delivery.  genéticos en la optimización de recursos y procesos; a continuación se establece un estudio de caso fundamentado en el ruteo vehicular y la  optimización del mismo, aplicando el algoritmo genético de Chu-Beasley. Este estudio, que inició en noviembre de 2013 y terminó en marzo de 2014, se aplicó en la ciudad de Bogotá, D.C., por ser la capital de Colombia. Esta metrópoli cuenta con innumerables zonas industriales, centros de acopio, almacenes y demás actividades comerciales. De la misma manera, el crecimiento de la capital en los últimos años ha sido significativo, lo que ha generado una extensión territorial exponencial, causando problemas de movilidad y transporte. Por ello es imperioso para algunas empresas que deben distribuir sus productos optimizar los recorridos y garantizar efectividad y eficiencia en las entregas

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols

Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry

Background and Aims: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs—diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods: CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE—CV death, non-fatal MI, or non-fatal stroke). Results: Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08–7.19] vs. 7.68% [95% CI 7.30–8.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions: SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors