This research is motivated by the extraordinary increase in the use of intermodal shipments in recent years for both domestic and global movement of freight. Three mathematical models, which explore the dynamics of intermodal hub-and-spoke networks, are presented. These models use transportation costs, fixed location costs, modal connectivity costs, modal transit times and service time requirem...

Design of network, through which data, packages or even people can be transported, is an important issue for achieving a desired level of service quality at an acceptable cost. For this purpose, it is possible to design a network comprised of nodes that are connected to each other with dedicated lines. However, this kind of solution will not be cost effective. In order to decrease the total tra...

Hub colonization and subsequent intraluminal progression due to frequent opening and manipulation of intravenous systems is the cause of many catheter-related infections (CRI). A prospective, comparative, randomized study was performed to assess a new closed-needleless hub device (CLAVE) compared with conventional open systems (COS). End-points were hub and skin colonization, catheter tip colon...

OBJECTIVES To quantify geographical concentration of falciparum malaria cases in the UK at a hospital level. To assess potential delay-to-treatment associated with hub-and-spoke distribution of artesunate in severe cases. DESIGN Observational study using national and hospital data. SETTING AND PARTICIPANTS 3520 patients notified to the Malaria Reference Laboratory 2008-2010, 34 patients tre...

Abstract Aim Identify reasons for discharge delays in a tertiary care hospital and find areas of improvement. Method Data were collected seven days, all inpatients (Elective Emergency) admissions included. Patient's demographic data, length stay, data entered on Microsoft Excel analysed using SPSS. Results Out 102 total patients, 48 (47.1%) male 54 (52.9%) females. Mean age was 60.5 years (min ...

In this paper we present two new approaches for finding good starting solutions to the planar p-median problem. Both methods rely on a discrete approximation of continuous model that restricts facility locations given set demand points. The first method adapts phase greedy random construction algorithm proposed minimum sum squares clustering second one implements simple descent procedure based ...