AIMS To evaluate the clinical impact of early administration of glycoprotein IIb/IIIa agents (IIb/IIIa agents) in the context of a dedicated hub and spoke network allowing very prompt pharmacological/mechanical interventions. METHODS AND RESULTS Using a prospective database, we conducted a cohort study of ST-elevation myocardial infarction (STEMI) patients (n = 1124) undergoing primary percut...

BACKGROUND AND PURPOSE Because of a shortage of stroke specialists, many outlying or "spoke" hospitals initiate intravenous (IV) thrombolysis using telemedicine or telephone consultation before transferring patients to a regional stroke center (RSC) hub. We analyzed complications and outcomes of patients treated with IV tissue plasminogen activator (tPA) using the "drip and ship" approach compa...

In this paper, we present a collaborative approach for the health care systems. The expert knowledge is embedded within DSS to provide intelligent decision support. The problem space contains multiple Hub and Spoke networks. Information about these networks is dynamically captured and represented in a Meta-data table. This master table enables collaboration between any two networks in the probl...

This paper presents a framework to analyze global alliances and mergers in the airline industry under competition. The framework can help airlines identify partners and network structures, and help governments predict changes in social welfare before accepting or rejecting proposed mergers or alliances. The research combines profit-maximizing objectives to cost-based network design formulations...

Business-to-business integration (B2Bi) solutions offered by vendors fall into two broad categories: hub-and-spoke (interaction between partners takes place through a central hub that acts as an intermediary), and peer-to-peer (interaction takes place directly between partners). Vendors are increasingly offering cloud based solutions; a hub-and-spoke architecture is well suited to SaaS level pr...

In this study a hierarchical hub location problem with two layers is considered. The first layer includes small hubs and the second one includes a star-shaped network central hub. The considered case is a cargo delivery network where there is hierarchy between hubs. All the hubs and links are capacitated and there are three kinds of commodities for each of which there is a special kind of vehic...

This study formulates a two-objective model to determine the optimal liner routing, ship size, and sailing frequency for container carriers by minimizing shipping costs and inventory costs. First, shipping and inventory cost functions are formulated using an analytical method. Then, based on a trade-off between shipping costs and inventory costs, Pareto optimal solutions of the twoobjective mod...

In this paper, a comprehensive model for hub location-routing problem is proposed which no network structure other than connectivity is imposed on backbone (i.e. network between hub nodes) and tributary networks (i.e. networks which connect non-hub nodes to hub nodes). This model is applied in public transportation, telecommunication and banking networks. In this model locating and routing is c...