Logistic Facility Research Articles

Disparities in lung cancer short- and long-term outcomes after surgery: Analysis from the national cancer database

IntroductionSocial determinants of health are particularly important in lung cancer epidemiology. Previous studies have primarily associated social determinants with long-term outcomes, such as survival, but fail to include short-term outcomes after surgery. The National Cancer Database (NCDB) was used to draw associations between social factors of patients with lung cancer and short-term post-surgical outcomes, while comparing them to prognostic factors, including stage at diagnosis and survival. MethodsThe 2004–17 NCDB was queried for patients with primary epithelial tumor, squamous cell carcinoma, or adenocarcinoma of the lung treated with curative intent. Linear, binary logistic, Kaplan-Meier, and Cox proportional hazards regression models were utilized. ResultsOn logistic regression modeling, male gender, low income, lacking insurance, and facility in the central United States were associated with poor short-term outcomes (<0.05). Increased age, White race, and Black race were associated with increased length of hospital stay and mortality, but negatively correlated with readmission rates (<0.05). Medicare and Medicaid were associated with increased length of stay and mortality, respectively (<0.05). Similar patterns were observed for higher stage at diagnosis (<0.05). Hazard ratios were elevated with increased age, male gender, White race, lacking insurance, Medicaid, and facility in the central United States (<0.05). ConclusionMany social factors previously associated with poor prognosis after lung cancer diagnosis are also associated with poor short-term outcomes after surgery. This study implies that healthcare providers treating lung cancer should proceed with care while aware that patients with the discussed social factors are predisposed to complicated recoveries.

Human-centric production system simulation in mixed reality: An exemplary case of logistic facility design

A production system with manual operations tends to suffer from variations in system performance induced by individual differences of human actions. To re-design the system under such uncertainty can be time-consuming without the support of advanced simulation tools. Hence, this research proposes a novel idea of production system simulation in mixed reality (MR) that facilitates production planning involving human operators. An exemplary case of logistic facility design demonstrates a MR-based planning tool implementing this idea. In this case, a manager and an operator, both wearing a HoloLens, simultaneously collaborate in a facility constructed by overlaying virtual equipment with existing one in real environment. The manager attempts to adjust the production parameters in the facility to reach a new target created by mixed-model production, while the operator accomplishes manual tasks related to material transportation and storage. The planning results show that the MR tool is advantageous over traditional simulation software in terms of planning quality and flexibility. This work validates the feasibility of MR as a new approach to realizing human-centric production system design.

Impact of Social Determinants of Health on Stereotactic Radiotherapy for Vestibular Schwannoma.

Linear accelerator (LINAC) and Gamma Knife (GK) are common stereotactic radiation therapies for treating vestibular schwannoma (VS). There is currently limited literature examining specific demographic and socioeconomic factors, which influence the type of stereotactic radiation therapy a patient with VS receives. Retrospective database review. The National Cancer Database was queried for cases of VS between 2004 and 2016. Patient demographic characteristics were compared using chi-squared and t-tests between GK and LINAC treated groups. Multivariate regression analysis was performed to assess predictors of stereotactic radiation therapy received. Of the 6,208 included patients, 5,306 (85.5%) received GK and 902 (14.5%) received LINAC. The mean age of GK patients was significantly lower than that of LINAC patients (58.0 vs. 59.7, P< .001). Individuals treated with GK had greater proportions of private insurance (P< .001) and incomes greater than $63,332 (P= .003). A greater proportion of GK patients were treated in academic centers (P< .001), in high-volume facilities (P< .001), in metropolitan areas (P< .001), and in the Northeastern United States (P< .001). On multivariate logistic regression analysis, region, metropolitan area, facility type, tumor size, and distance traveled by patients independently predict receipt of GK versus LINAC. Differences in patient demographics and other social determinants of health influence choice of GK versus LINAC therapy for VS patients. Future studies focused on addressing barriers to care, which may influence postprocedural quality of life and clinical outcomes associated with these two treatments are necessary to better understand the impact of these social differences. 4 Laryngoscope, 132:2232-2240, 2022.

The Impact of Using the Total Cost of Ownership (TCO) Account for a Reusable Wooden Flat Pallet in Its Operational Phase on Respecting the Principles of Sustainable Development

Despite the commonly observed trend towards mechanization and automation of operational processes, the potential benefits of wooden pallets as an essential element of the infrastructure of logistic processes are often overlooked in considerations related to sustainable development. Aspects that are mentioned more often include the very idea of the economy itself (circular economy), characteristics of logistics (green), features of the supply chain itself (sustainable) or expectations towards transport (ecological). The authors believe that the idea of total cost of ownership (TCO) in relation to wooden pallets can be a key component of holistic thinking in terms of sustainable development. In a situation where in relation to logistics, reasonable expectations for developing sustainable supply chains are made, paying attention to such a common logistic facility, namely a cargo pallet, which is given so little attention in research, is, in the opinion of the authors, absolutely justified. Therefore, the article presents an original approach to the problem of aggregation of all costs that cargo pallets generate in their operational life cycle, using the total cost of ownership (TCO) analysis methodology. The main goal of the article, however, is to show that the total cost of ownership of a pallet (not only owning it) can become an effective tool used to significantly reduce the costs of logistic activity of enterprises (as well as whole supply chains) and support the idea of sustainable development in practice. Using the primary data from questionnaire research, the focus was on considerations that were of identification character (cognitive and explanatory considerations), which are typical for basic research that aims to explain given phenomena. Thus, the presented cognitive process covers two main areas, namely: the general theory of sustainable development and the specificity of wooden pallets as carriers used in goods trading in terms of their total costs of ownership.

A multi-criteria spatial approach for determination of the logistics center locations in metropolitan areas

Logistics centers are providing integrated services. Due to they are the central points of the logistics activities, these facilities have considerable influence over logistic structure of the cities. Therefore, using spatial data is a way to use the power of the data science instead of considering limited parameters in determining their location. For a location decision, it is necessary to evaluate different decision parameters, especially spatial suitability. A methodology that combines a complex problem structure, expert opinion, geographical characteristics and mathematical modeling approach that provides cost minimization is proposed in the study for multiple logistic facility location analyzes. The proposed method combines different analysis methods under a systematic approach including economic analysis of the centralization level. Results showed that the proposed methodology is capable of dealing such problems with the given considerations.

The use of physical restraints in Chinese long-term care facilities and its risk factors: An observational and cross-sectional study.

To investigate the use of physical restraints among Chinese long-term care facilities older adults and to identify its risk factors. Observational and cross-sectional study. A total of 1,026 older adults from six long-term care facilities in Chongqing were recruited by cluster sampling method from July - November 2019. Data on physical restraint use and older adults' characteristics were collected using physical restraints observation forms and older adults' records. Organizational data were collected by questionnaires asking nursing managers. The independent risk factors for physical restraints use were assessed using chi-square test and binary logistic regression. The study found that the prevalence of physical restraints in six long-term care facilities in China was 25.83%. Waist belt (55.47%) and wrist restraint (52.83%) were most frequently used. Only 61.51% of physical restraints were signed with informed consent. 71.70% of physical restraints were caused by the prevention of falls, 89.06% of physical restraints were without nursing documentation, and 13.58% restrained older adults were observed to have physical complications. According to the binary logistic regression analysis, facility type and ownership, older adults per nursing assistant, length of residence, cognitive impairment, care dependency, mobility restriction, fall risk, physical agitation, and indwelling tubes emerged as important risk factors for the use of physical restraints. The use of physical restraints among Chinese long-term care facilities older adults was at a relatively high level and lack standardized and regulated practices. Moreover, Physical restraint use was associated with facility type and ownership, older adults per nursing assistant, length of residence, cognitive impairment, care dependency, mobility restriction, fall risks, physical agitation, and indwelling tube. This study will provide an effective reference for nursing staff in long-term care facilities to assess high-risk older adults in their use of physical restraints, which can support them to implement effective minimized restraint approaches to targeted people.

Extrauterine Pregnancy: A Nine-Year Review of Incidence, Seasonality and Management at a Tertiary Hospital in Southern Ghana

Introduction: Most cases of extrauterine pregnancies present in the ruptured state in low-resource settings and patients with haemodynamic instability risk mortality without swift intervention. An idea of when ectopic gestations are likely to present may be useful for logistic planning and facility readiness for case management. The study sought to assess the incidence of extrauterine gestation, mode of management and any link with seasonal and/or sociocultural events within the Cape Coast metropolis of Ghana over a 9-year review period. Methods: A retrospective review of all cases of extrauterine pregnancies managed at the Cape Coast Teaching Hospital (CCTH) from January 2010 to December 2018 was conducted. Data on patient age, parity, month of presentation, site and laterality of ectopic gestation, number of abortions and deliveries were retrieved from hospital records and analysed. Yearly and monthly aggregated incidence of extrauterine pregnancies were computed. Result: A total of 480 ectopic pregnancies out of 26,850 total pregnancies were seen over the period, giving an overall occurence of 17.9/1000 pregnancies and almost all were managed surgically. Half of all the cases occurred in the 20 - 29 years age group while the extremes of age recorded the lowest. An average of about 53 cases per year was recorded for the period under review. The peak months of occurrence were October and November. About 83% were ruptured with the ampulla region being the commonest site. Conclusion: The data suggests increased ectopic gestation occurrence in the Cape Coast metropolis about two months after the major traditional festivals and this may have implications for instituting mitigating measures, logistic management and facility preparedness for case management.

National Patterns of Care in the Management of World Health Organization Grade II and III Spinal Ependymomas

Spinal ependymomas are rare, with an incidence of 1 per 100,000. Given the paucity of data for higher grade II and III disease, the management and patterns of care require further investigation. Our study of 1345 patients with higher-grade spinal ependymoma used χ2 tests and simple and multivariable logistic regression models to assess demographic and clinical factors associated with therapy. Kaplan-Meier and log-rank tests were used to assess overall survival (OS). Most grade II patients received surgery alone (81.1%) compared with 36.8% of grade III. Approximately 60% of patients with grade III ependymomas received radiotherapy (RT) versus 15.3% of grade II (P < 0.001). Patients living ≤32 km (20 miles) from a facility were more likely to receive RT (P < 0.001) than were those living further away. On multivariable logistic regression, grade (grade III, odds ratio, 8.6; P < 0.001) and facility distance were significantly associated with receipt of RT (P<0.0001). The 5-year and 10-year OS was 94.7%/85.1% for patients with grade II disease and 58.2%/46.4% for grade III disease (P < 0.0001). OS was highest at facilities treating an average of 15 patients over 10 years, corresponding to the top 81st percentile in volume. The 10-year OS was 92.6% at facilities treating at least 15 patients and 88.0% at facilities treating 6-14 patients. Approximately 40% of patients with grade III ependymomas do not receive immediate adjuvant therapy, which may be related to distance from a facility. Patients with this rare tumor may benefit from multidisciplinary care at facilities with a larger volume.

Assessment of lean manufacturing practices: an operational perspective

The main goal of this study was to propose a new framework to assess the operational activities of lean manufacturing (LM). Lean-related activities of supply chain drivers are less investigated in previous literature. To fill this gap, the operational activities of logistic (facility, transportation and inventory) and cross-functional (information, sourcing and pricing) drivers of supply chain were proposed in this study. These activities were then ranked using an analytical hierarchy process (AHP). The proposed activities were investigated by the cycle view of supply chain. Finally, the proposed framework was translated to a survey (Appendix) to be used for assessing the leanness of manufacturing companies.

Variation in 30-Day Readmission Rates Among Medically Complex Patients at Inpatient Rehabilitation Facilities and Contributing Factors

ObjectiveFew studies have focused on 30-day readmission rates in inpatient rehabilitation facilities (IRFs) and factors that contribute to this. The purpose of this study was to examine the variation in 30-day readmission rates among medically complex patients at IRFs nationally and explore how patient and facility characteristics are associated with this variation. DesignRetrospective review of an administrative database. SettingIRFs throughout the United States. ParticipantsPatients from the medically complex impairment group treated at IRFs nationwide represented in the Uniform Data System for Medical Rehabilitation (UDSMR) from 2002 to 2011. MeasurementsUsing multilevel logistic regression analysis, 16 patient and facility characteristics were examined to identify and adjust for variables with a significant effect on readmission rates. Unadjusted and adjusted readmission rates were plotted by facility rank. Facilities were grouped by decile, based on readmission rates, and the mean unadjusted and adjusted rates for the lowest and highest deciles were compared to quantify the variation due to adjustment. Patient and facility characteristics for the highest and lowest deciles were compared. ResultsA total of 117,156 medically complex patients from 682 IRFs nationwide were included. Patients were 46% male and 84% white with an average age of 71.5 years. Nine of 16 characteristics were identified that significantly increased the odds of readmission, including older age, male gender, poorer admission motor function, longer duration of impairment, higher Elixhauser comorbidity index, unemployed or retired status, larger facility size, lower mean facility admission motor function, and eastern or western geographic area.The average unadjusted and adjusted readmission rates for all facilities were 15.63% and 15.86%, respectively. The unadjusted readmission rates for the lowest and highest deciles were 6.71% and 26.48%, respectively. After adjustment, this narrowed to 10.33% and 21.91%, respectively. Patient and facility characteristics accounted for 41% of the variation seen in the readmission rates for these groups.Facilities with the highest readmission rates (highest decile) more commonly cared for patients at highest risk for readmission: unemployed, male patients with higher comorbidity index and poorer motor function on admission. ConclusionThis study shows significant variation in readmission rates for medically complex patients across IRFs. However, nearly half (41.4%) of this variation was attributed to 9 patient and facility characteristics, suggesting the need for risk adjustment if readmission rates are to be used as a quality indicator for IRFs.

Assessment of hybrid Lean-Agile (Leagile) supply chain strategies

Purpose – The purpose of this paper is to propose a new assessment tool for Leagility. Design/methodology/approach – This research was carried out to systematically propose the operational activities of Leagile supply chains (SCs) with regard to SC drivers. Particularly, SC logistic (facility, transportation and inventory) and cross-functional drivers (information, sourcing and pricing) were selected to classify all operational activities of Leagile SCs. Findings – This study proposed a new framework to evaluate the operational activities of Leagile SCs. Operational activities of Leagile supply chain strategy were determined and categorized with regard to SC drivers. These activities were ranked using an analytic hierarchy process and were then categorized using a cycle view of SC. Originality/value – This study contributed in proposing operational activities of Leagile SC based on its major drivers. The result of this study assist managers, scholars and practitioners to construct new Leagile SCs or assess their Leagility level.

Logistics Facility Distribution in Tokyo Metropolitan Area: Experiences and Policy Lessons

We use the large-scale freight survey data to examine the historical transition of the logistics facility distribution in the Tokyo Metropolitan Area (TMA) and investigate the possible causal factors for the changes. The analysis revealed the decentralization of logistics facilities during the period 1980-2003 and suggested that the asset price bubble during 1986-1991 was likely a significant factor. In addition, the examination of the relationship between logistic facility locations and land-use regulations indicates the challenges that even a relatively common land-use regulation framework faces. The study offers valuable insights into the spatial distribution of logistics facilities in the largest metropolitan area in the world.

Sustainable humanitarian operations: closed-loop supply chain

This paper explores the closed loop supply chain (CLSC) topic by providing a model and evaluating regular humanitarian logistics (R-HL) where the main objective of the operation moves from the reduction of population needs to a minimisation of the overall impact of the disaster and operations. The research focuses on the logistic facility management coupled with material distribution modalities in a situation where items are not just delivered using 'forward channels'. It considers others flows that usually have not been faced by the humanitarian literature, as 'reverse channels' on the management of operations waste. Constraints related to transportation resources in a complex environment, transportation vehicle capacities and delivery time restrictions are considered and different scenarios are analysed. The proposed model optimises resources allocation and prepositioning decisions on a number of test problems. The impact of each proposed practice is evaluated in order to understand its applicability in this particular context.

Demand side integration for electric transport vehicles

Purpose – The purpose of this study is to examine both the technical feasibility and the commercial viability of several demand-side integration (DSI) programs to utilize the charging flexibility of electric transport vehicles in a logistic facility. DSI is important for improving system reliability and assisting in integrating renewables into the energy system. Design/methodology/approach – A pre-assessment of several DSI programs is performed by considering effort for implementation, costs and economic potential. Afterward, the most promising programs are compared economically on the basis of optimization methods and economic analysis. The analysis is based on a comprehensive electric mobility project dealing with electric transport vehicles operating in container terminals. Findings – The pre-assessment of several potential DSI programs revealed that many of these programs are unsuitable, largely due to regulatory requirements. Although using DSI to optimize the company’s load is feasible, controlled charging based on variable prices is particularly advantageous because the implementation requires modest effort while identifying significant cost-saving potentials. Practical implications – Based on the analysis, other companies using electric transport vehicles have a foundation for identifying the most promising demand-side management program. Originality/value – While most research has focused on individually used electric vehicles, here commercial electric transport vehicles operating in closed systems were investigated as this area of application was found to be particularly suitable for participation in DSI programs.

Location of an intermediate hub for port activities

An intermediate hub might increase the accessibility level of ports but also hinterland and so it can be considered more than a facility with a transhipment role. These hubs might lead to the development of other transport services and enhance their role in gathering and covering economic centres within hinterlands and also getting the part of logistic facility for the ports, with effects on port utilization and its connectivity to global economy. A new location for a hub terminal leads to reduced transport distances within hinterland, with decreased transport costs and external effects, so with gains in people's life quality. Because the production and distribution systems are relatively fixed on short and medium term and the location decisions are strategic and on long term, the logistic chains activities location models have to consider the uncertainties regarding the possible future situations. In most models, production costs are considered equal, the location problem reducing itself to a problem that aims to minimize the total transport costs, meaning the transport problem. The main objective of the paper is to locate a hub terminal that links the producers of cereals that are going to be exported by naval transportation with the Romanian fluvial-maritime ports (Galaţi, Brăila). GIS environment can be used to integrate and analyse a great amount of data and has the ability of using functions as location - allocation models necessary both to private and public sector, being able to determine the optimal location for services like factories, warehouses, logistic platforms and other public services.

New spatial clustering-based models for optimal urban facility location considering geographical obstacles

The problems of facility location and the allo- cation of demand points to facilities are crucial research issues in spatial data analysis and urban planning. It is very important for an organization or governments to best locate its resources and facilities and efficiently manage resources to ensure that all demand points are covered and all the needs are met. Most of the recent studies, which focused on solving facility location problems by performing spatial clustering, have used the Euclidean distance between two points as the dissimilarity function. Natural obstacles, such as mountains and rivers, can have drastic impacts on the distance that needs to be traveled between two geographical locations. While calculating the distance between various supply chain entities (including facilities and demand points), it is necessary to take such obstacles into account to obtain better and more realistic results regarding location- allocation. In this article, new models were presented for location of urban facilities while considering geographical obstacles at the same time. In these models, three new distance functions were proposed. The first function was based on the analysis of shortest path in linear network, which was called SPD function. The other two functions, namely PD and P2D, were based on the algorithms that deal with robot geometry and route-based robot navigation in the presence of obstacles. The models were implemented in ArcGIS Desktop 9.2 software using the visual basic programming language. These models were evaluated using synthetic and real data sets. The overall performance was evaluated based on the sum of distance from demand points to their corresponding facilities. Because of the distance between the demand points and facilities becoming more realistic in the proposed functions, results indicated desired quality of the proposed models in terms of quality of allo- cating points to centers and logistic cost. Obtained results show promising improvements of the allocation, the logis- tics costs and the response time. It can also be inferred from this study that the P2D-based model and the SPD-based model yield similar results in terms of the facility location and the demand allocation. It is noted that the P2D-based model showed better execution time than the SPD-based model. Considering logistic costs, facility location and response time, the P2D-based model was appropriate choice for urban facility location problem considering the geo- graphical obstacles.

Research on Logistics Distribution Center Location Based on Improved Immune Algorithm

Logistics center is a mordern logistic facility. The distribution center location determines the operational efficiency of logistics system. The optimum location of distribution center is important to transportation. In order to improved the algorithm's efficiency, elite strategy was introduced based on the standard immune algorithm. The improved algorithm avoid trapping into local optimal solution and solving the problem more slowly. The role of the elite strategy is to make the optimal solution attractively in the next cycle. This method sovles problem both quantitatively and qualitatively, which makes final solution better in accordance with practical demands.