Transport Time Research Articles

Current mortality from war injuries-Anarrative review

The war in Ukraine has led to astrategic reorientation of the German Armed Forces towards national and alliance defense. This has also raised the need for medical and surgical adaptation to scenarios of conventional warfare. In order to develop appropriate and effective concepts it is necessary to identify those war injuries that are associated with arelevant primary and secondary mortality and that can be influenced by medical measures (potentially survivable injuries). The aim of this selective literature review was to identify war injuries with high primary and secondary mortality. Aselective literature review was performed in the PubMed® database with the search terms war OR combat AND injury AND mortality from 2001 to 2023. Studies including data of war injuries and associated mortality were included. Atotal of 33studies were included in the analysis. Severe traumatic brain injury and thoracoabdominal hemorrhage were the main contributors to primary mortality. Injuries to the trunk, neck, traumatic brain injury, and burns were associated with relevant secondary mortality. Among potentially survivable injuries, thoracoabdominal hemorrhage accounted for the largest proportion. Prehospital blood transfusions and short transport times significantly reduced war-associated mortality. Control of thoracoabdominal hemorrhage has the highest potential to reduce mortality in modern warfare. Besides that, treatment of traumatic brain injury, burns and neck injuries has ahigh relevance in reducing mortality. Hospitals of the German Armed Forces need to focus on these requirements.

A hybrid genetic programming algorithm for the distributed assembly scheduling problems with transportation and sequence-dependent setup times

This paper investigates a distributed assembly permutation flow-shop scheduling problem with transportation and sequence-dependent set-up times (DAPFSP-TSDST). A hybrid genetic programming (HGP) algorithm is proposed to optimize the makespan of the assembly stage, which inherits the merits of genetic programming (GP) and neighbourhood search operators. In HGP, a hybrid problem-specific initialization heuristic is developed to make populations more diverse. Multiple neighbourhood search operators are employed as the leaf nodes, which are vital for the success of GP. A product shift strategy is proposed to strengthen its exploitability. In addition, a simulated annealing criterion is adopted to make the HGP explore more thoroughly. Finally, statistical and computational experiments are carried out on the benchmark instances. The results exhaustively identify the notable competitiveness of the HGP algorithm in coping with the DAPFSP-TSDST.

Characteristics and special challenges of neonatal emergency transports

BackgroundAs a rule, newborns do not require special medical care. If unexpected complications occur peripartum or postpartum, support from and transport to specialised neonatal hospitals might be needed. MethodsIn a retrospective study, all transport protocols of a supraregional paediatric‑neonatological maximum care hospital in northwestern Germany from 01.10.2018 through 30.09.2021 were analysed. The particular focus was on transports of newborns (<7 days) and the leading symptoms that led to contact. ResultsA total of 299 patients were included (average age of 15.4 h, 61.6 % males). The average complete transport time was approximately 2 h. Five leading neonatal diseases (respiratory, infectious, asphyxia, cardiac, haematological) were found to represent the causes of >80 % of transfers. Respiratory adaptation disorders are the main reason for transferring a newborn to a centre, whereas asphyxia is the most severe condition. The various symptoms differ in their time of onset, a factor which must be taken into account in practice. Differences were also found between different types of hospitals: while a large proportion of transports were carried out from maternity hospitals (80.6 %), children transported from children's hospitals were generally more severely ill. DiscussionTransfers of neonates, especially from maternity hospitals to neonatal intensive care units due to special neonatal diseases, are not rare. In times of increasingly scarce resources, the effective care of sick or at-risk neonates is essential. For low-population regions, this means professional cooperation between maximum care providers and smaller children's hospitals and maternity-only hospitals.

Impurity leakage mechanisms in the Wendelstein 7-X island divertor under friction-dominated conditions

The EMC3-Eirene code was used to study the main impurity leakage mechanism for the island divertor in the standard magnetic field configuration. It was found that under experimentally accessible plasma scenarios in the last experimental campaign, the majority of the island scrape-off layer was friction-force dominated. The impurity force balance was only thermal force dominated for upstream locations closed to the last closed flux surface, beyond the island X-point. No impurity neutral ionization was found in this location and hence the parallel impurity transport provides excellent impurity retention. It was found that impurities approach the confinement region nonetheless via perpendicular transport across the island O-point near the parallel flow stagnation region. This finding points out the specific role of the parallel flow stagnation region in providing lower parallel convective transport and long impurity residence times, which makes non-parallel transport channels more important or even the dominant driver of impurity leakage. In line with the relevance of the particle build-up in the flow stagnation region, different retention behavior as a function of density is seen for various species, which is shown to be due to ionization length changes as the plasma background density is increased.

Apparent Aging and Rejuvenation of Terrestrial Organic Carbon Along the River‐Estuary‐Coastal Ocean Continuum

AbstractThe fates of terrestrial organic carbon (OCterr) during fluvial transport from land to ocean are still not well constrained. This study systematically examines the evolution and dynamics of OCterr along the river‐estuary‐coastal ocean continuum in three fluvial systems discharging to the Chinese marginal seas. The 14C‐depleted characteristics of bulk OC and molecular components of riverine suspended sediments and marine sediments suggest that the Chinese marginal seas are a significant sink of pre‐aged OCterr. Our study reveals significant apparent aging of OCterr within estuaries, likely due to degradation of (younger) labile components, and apparent rejuvenation of OCterr in shelf systems, likely reflecting inputs of younger OCterr from proximal sources along the sediment dispersal pathway. The aging and rejuvenation of OCterr along the river‐ocean continuum confounds the use of plant wax lipid 14C to constrain lateral transport times, and sheds light on more complex OCterr dynamics in marginal seas.

A hybrid multi-objective solution approach for a reliable truck-drone routing problem integrated with pickup and delivery services

ABSTRACT Humanitarian logistics aims to reduce the arrival time of relief goods and optimize services in disaster-affected regions. This paper introduces a multi-objective hybrid truck-drone routing problem with pickup and delivery services, considering reliability (MHTDRP-PD-R) to enhance relief operations within humanitarian logistics. The model is formulated as a mixed-integer linear programming problem with the simultaneous goals of minimizing transportation time and maximizing reliability through routing and inventory decisions made by multiple trucks and drones. An adaptive large neighborhood search (ALNS) algorithm, coupled with heuristic technique, is developed to tackle the problem. The ALNS algorithm refines initial solutions through destroy and repair operators, integrated with multi-objective optimization methods to create a unified objective function. Small and large-scale test problems are then employed to evaluate solution quality using multi-objective optimization. The calculation results show the superiority of the developed ALNS integrated with the ε-constraint method regarding the objective value and solution time.

Urban-rural inequalities in IV thrombolysis for acute ischemic stroke: A nationwide study.

Rural residency has been associated with lower reperfusion treatment rates for acute ischemic stroke in many countries. We aimed to explore urban-rural differences in IV thrombolysis rates in a small country with universal health care, and short transport times to stroke units. In this nationwide cohort study, adult ischemic stroke patients registered in the Danish Stroke Registry (DSR) between 2015 and 2020 were included. The exposure was defined by residence rurality. Data from the DSR, Statistics Denmark, and the Danish Health Data Authority, were linked on the individual level using the Civil Registration Number. Adjusted treatment rates were calculated by balancing baseline characteristics using inverse probability of treatment weights. Among the included 56,175 patients, prehospital delays were shortest for patients residing in capital municipalities (median 4.7 h), and longest for large town residents (median 7.1 h). Large town residents were predominantly admitted directly to a comprehensive stroke center (98.5%), whereas 30.9% of capital residents were admitted to a hospital with no reperfusion therapy available (non-RT unit). Treatment rates were similar among all non-rural residents (18.5%-18.7%), but slightly lower among rural residents (17.2% [95% CI 16.5-17.8]). After adjusting for age, sex, immigrant status, and educational attainment, rural residents reached treatment rates comparable to capital and large town residents at 18.5% (95% CI 17.7-19.4). While treatment rates varied minimally by urban-rural residency, substantial differences in median prehospital delay and admission to non-RT units underscored marked urban-rural differences in potential obstacles to reperfusion therapies.

Correction of stratospheric age of air (AoA) derived from sulfur hexafluoride (SF6) for the effect of chemical sinks

Abstract. Observational monitoring of the stratospheric transport circulation, the Brewer–Dobson circulation (BDC), is crucial to estimate any decadal to long-term changes therein, a prerequisite to interpret trends in stratospheric composition and to constrain the consequential impacts on climate. The transport time along the BDC (i.e. the mean stratospheric age of air, AoA) can best be deduced from trace gas measurements of tracers which increase linearly with time and are chemically passive. The gas sulfur hexafluoride (SF6) is often used to deduce AoA because it has been increasing monotonically since the ∼1950s, and previously its chemical sinks in the mesosphere have been assumed to be negligible for AoA estimates. However, recent studies have shown that the chemical sinks of SF6 are stronger than assumed and become increasingly relevant with rising SF6 concentrations. To adjust biases in AoA that result from the chemical SF6 sinks, we here propose a simple correction scheme for SF6-based AoA estimates accounting for the time-dependent effects of chemical sinks. The correction scheme is based on theoretical considerations with idealized assumptions, resulting in a relation between ideal AoA and apparent AoA which is a function of the tropospheric reference time series of SF6 and of the AoA-dependent effective lifetime of SF6. The correction method is thoroughly tested within a self-consistent data set from a climate model that includes explicit calculation of chemical SF6 sinks. It is shown within the model that the correction successfully reduces biases in SF6-based AoA to less than 5 % for mean ages below 5 years. Tests using only subsampled data for deriving the fit coefficients show that applying the correction scheme even with imperfect knowledge of the sink is far superior to not applying a sink correction. Furthermore, we show that based on currently available measurements, we are not able to constrain the fit parameters of the correction scheme based on observational data alone. However, the model-based correction curve lies within the observational uncertainty, and we thus recommend using the model-derived fit coefficients until more high-quality measurements are able to further constrain the correction scheme. The application of the correction scheme to AoA from satellites and in situ data suggests that it is highly beneficial to reconcile different observational estimates of mean AoA.

Comparing the Impact of Diluents and Injection Techniques on Patient Comfort During Indocyanine Green Lymphangiography: A Prospective Study.

Background: Indocyanine green (ICG) lymphography, a key diagnostic tool for lymphedema, is influenced by the dilution process of ICG dye, impacting patient experience. Methods and Results: In our study, we assessed three different ICG diluents-water for injection (WFI), normal saline (NS), and Dextrose® plus human albumin-in five healthy volunteer individuals undergoing superficial lymphography of the upper limb over 3 weeks. Results indicated that NS, as a diluent for ICG, caused the least discomfort during injection, in contrast to WFI, which led to the highest levels of discomfort. Transport time of ICG from the injection site to the axillary lymph nodes was notably shorter in intradermal injections than in subdermal injections. Conclusion: Our findings advocate for using NS as the optimal and cost-effective diluent for ICG, enhancing patient experience.

Medical Drone a Life Saver in Emergency Situations (Organ Delivery Drone)

This paper explores the emerging field of medical drones for organ delivery, addressing the critical need for timely transportation of organs to enhance transplantation procedures and save lives. Medical drones offer a novel solution to overcome geographical barriers, particularly in remote or inaccessible regions, by providing rapid and efficient delivery of organs and blood samples. By significantly reducing transportation times compared to conventional methods, medical drones have the potential to revolutionize healthcare logistics and improve access to critical care services. This abstract highlights the key benefits and challenges associated with the integration of medical drones in organ delivery, emphasizing their role in expediting transplant procedures and ensuring timely interventions for patients in need.

Sulphate-temperature-time interactions and their influence on rheological characteristics of cemented paste backfill

Cement paste backfill (CPB) can provide social and economic benefits such as treating mine waste, preventing surface settlement, providing a safe working platform in underground mines and improving ore recovery. Rheological properties (including yield stress and viscosity) are key factors influencing the ability of CPB to be successfully transported into specified mine stopes. However, no study has been carried out to comprehensively examine the rheological properties of CPB under the combined effects of sulfate, temperature and time. This study was therefore carried out to evaluate the yield stress and viscosity of CPB samples with different sulfate contents (0 ppm, 5000 ppm, 15,000 ppm and 25,000 ppm), exposed to different temperatures (2 °C, 20 °C and 35 °C) and subjected to different curing or transport times (0, 20 min., 1 h and 2 h). Additional measurements, such as TG/DTG, pH, zeta potential and EC monitoring, were also carried out. It was found that CPB viscosity increased significantly with the simultaneous increase in sulfate, time and temperature, and that yield stress also increased, but at a relatively limited rate. There was competition between the yield stress-reducing factor (e.g. sulfate) and the increasing factors (temperature, time). Higher temperatures had a compensatory or counterbalancing effect on the reduction in CPB yield stress caused by the addition of sulfate. It was also found that the significant increase in viscosity was due to the combined effect of a greater number of ettringite crystals generated by the addition of sulfate and a greater number of hydration products produced by higher temperature and/or longer time. The results of this research will be useful for the efficient design of a long-distance transport system for CPB in mines located in permafrost and/or warm regions, in deep mines as well as for CPB containing sulfate.

Use of Video in Telephone Triage in Out-of-Hours Primary Care: Register-Based Study.

Out-of-hours primary care (OOH-PC) is challenging due to high workloads, workforce shortages, and long waiting and transportation times for patients. Use of video enables triage professionals to visually assess patients, potentially ending more contacts in a telephone triage contact instead of referring patients to more resource-demanding clinic consultations or home visits. Thus, video use may help reduce use of health care resources in OOH-PC. This study aimed to investigate video use in telephone triage contacts to OOH-PC in Denmark by studying rate of use and potential associations between video use and patient- and contact-related characteristics and between video use and triage outcomes and follow-up contacts. We hypothesized that video use could serve to reduce use of health care resources in OOH-PC. This register-based study included all telephone triage contacts to OOH-PC in 4 of the 5 Danish regions from March 15, 2020, to December 1, 2021. We linked data from the OOH-PC electronic registration systems to national registers and identified telephone triage contacts with video use (video contact) and without video use (telephone contact). Calculating crude incidence rate ratios and adjusted incidence rate ratios (aIRRs), we investigated the association between patient- and contact-related characteristics and video contacts and measured the frequency of different triage outcomes and follow-up contacts after video contact compared to telephone contact. Of 2,900,566 identified telephone triage contacts to OOH-PC, 9.5% (n=275,203) were conducted as video contacts. The frequency of video contact was unevenly distributed across patient- and contact-related characteristics; it was used more often for employed young patients without comorbidities who contacted OOH-PC more than 4 hours before the opening hours of daytime general practice. Compared to telephone contacts, notably more video contacts ended with advice and self-care (aIRR 1.21, 95% CI 1.21-1.21) and no follow-up contact (aIRR 1.08, 95% CI 1.08-1.09). This study supports our hypothesis that video contacts could reduce use of health care resources in OOH-PC. Video use lowered the frequency of referrals to a clinic consultation or a home visit and also lowered the frequency of follow-up contacts. However, the results could be biased due to confounding by indication, reflecting that triage GPs use video for a specific set of reasons for encounters.

Investigating the Impact of Drone Transport on the Stability of Monoclonal Antibodies for Inter-Hospital Transportation

In the field of healthcare logistics, the reliance on conventional transport methods such as cars for the delivery of monoclonal antibodies (mAbs) is susceptible to challenges posed by traffic and infrastructure, leading to increased and unpredictable transport times. Recognizing the potential role of drones in mitigating these challenges, we aimed to investigate the impact of medical drone transport on the stability of mAbs. Compromised stability could lead to aggregation and immunogenicity, thereby jeopardizing the efficacy and safety of mAbs. We studied the transportation of vials as well as ready-to-administer infusion bags with blinatumomab, tocilizumab, and daratumumab. The methodology involved the measurement of both temperature and mechanical shock during drone transport. Moreover, the analytical techniques High Performance Size-Exclusion Chromatography (HP-SEC), Dynamic Light Scattering (DLS), Light Obscuration (LO), Micro-Flow Imaging (MFI), and Nanoparticle Tracking Analysis (NTA) were employed to comprehensively assess the presence of aggregates and particle formation. The key findings revealed no significant differences between car and drone transport, indicating that the stability of mAbs in both vials and infusion bags was adequately maintained during drone transport. This suggests that medical drones are a viable and reliable means for the inter-hospital transport of mAbs, paving the way for more efficient and predictable logistics in healthcare delivery.

Retrospective Matched Cohort Comparison of Prehospital Finger Thoracostomy and Needle Thoracostomy Performed by Ground Emergency Medical Services

Introduction: Tension pneumothorax related to chest trauma is a rapidly lethal condition that requires immediate treatment, often prior to arrival at definitive care. Recent concerns regarding the safety and efficacy of needle thoracostomy (NT) have led to alternatives. Finger thoracostomy (FT) is a potential life-saving treatment performed by prehospital providers as an alternative to NT. We hypothesize that FT has improved rates of prehospital thoracic decompression and is a safe alternative to NT.&#x0D; Materials and Methods: Retrospective cohort study of consecutive adult trauma patients presenting to a Level 1 trauma center who sustained chest trauma. A matched cohort of patients who underwent prehospital FT was compared to patients who underwent prehospital NT for thoracic decompression. Wilcoxon Rank Sum Test and Chi-Squared Analyses were performed for comparison of prehospital and in-hospital outcome variables.&#x0D; Results: 34 patients were compared, of which 15 underwent prehospital FT and 19 underwent prehospital needle thoracostomy NT. Groups were well matched in terms of demographics and injury characteristics. No difference in transport times were observed. All 15 patients in the FT group sustained cardiac arrest prior to arrival with 20% achieving return of spontaneous circulation (ROSC), while 6/19 NT patients arrived in cardiac arrest, with 66.7% achieving ROSC (p = 0.04). The rate of successful intrathoracic decompression was higher in the FT group (93.3% vs 47.4%, p&lt;0.001). The NT group had a higher rate of chest tube placement (p=0.005). In-hospital mortality was not different between the two groups (p=0.213).&#x0D; Conclusions: FT is a viable alternative to NT for emergent thoracic decompression. The higher success rate of intrathoracic decompression supports the use of FT as an alternative to NT for prehospital tension pneumothorax, although future studies are needed establish superiority and further evaluate mortality and in-hospital outcomes.

Dynamic Job and Conveyor-Based Transport Joint Scheduling in Flexible Manufacturing Systems

Efficiently managing resource utilization is critical in manufacturing systems to optimize production efficiency, especially in dynamic environments where jobs continually enter the system and machine breakdowns are potential occurrences. In fully automated environments, co-ordinating the transport system with other resources is paramount for smooth operations. Despite extensive research exploring the impact of job characteristics, such as fixed or variable task-processing times and job arrival rates, the role of the transport system has been relatively underexplored. This paper specifically addresses the utilization of a conveyor belt as the primary mode of transportation among a set of production machines. In this configuration, no input or output buffers exist at the machines, and the transport times are contingent on machine availability. In order to tackle this challenge, we introduce a randomized heuristic approach designed to swiftly identify a near-optimal joint schedule for job processing and transfer. Our solution has undergone testing on both state-of-the-art benchmarks and real-world instances, showcasing its ability to accurately predict the overall processing time of a production line. With respect to our previous work, we specifically consider the case of the arrival of a dynamic job, which requires a different design approach since there is a need to keep track of partially processed jobs, jobs that are waiting, and newly arrived jobs. We adopt a total rescheduling strategy and, in order to show its performance, we consider a clairvoyant scheduling approach, in which job arrivals are known in advance. We show that the total rescheduling strategy yields a scheduling solution that is close to optimal.

Fourth Party Logistics Routing Problem Under Uncertain Time and Random Demand

With the rapid development of the economy, the fourth party logistics (4PL) has become an indispensable part of economic development, and the path optimization is an important topic in the research of 4PL routing problem. This paper studies the fourth party logistics routing problem with random demand and uncertain transportation time and transfer time by considering the randomness and uncertainty of the environment. In order to solve the path optimization strategy that minimizes the total transportation cost, this paper establishes an uncertain random programming model under the constraints of the total transportation time, the carrying capacity of the logistics provider, the transfer capacity of the transfer station, and the demand of the distributor. Subsequently, this paper transforms the uncertain random programming model into an equivalent deterministic programming model based on the distribution functions of random demand and uncertain time, and verifies the effectiveness of the model through two examples. The results show that the uncertain random programming model can give a reasonable path optimization strategy.

An APSO-based TPA-BLSTM model for predicting ship motion in irregular waves using wave-series input

ABSTRACT Combining the bidirectional long short-term memory neural network and temporal pattern attention mechanism, a machine learning model based on multi-feature inputs is developed to predict ship motion in irregular waves. An adaptive particle swarm optimisation algorithm is proposed to adapt the parameters of neural network to different feature inputs. The study indicates that the improved particle swarm optimisation algorithm avoids the problem of poor adaptability of empirical parameters to different advance time. The combination of bidirectional long short-term memory neural network and temporary pattern attention mechanism further enhances the data mining ability. Compared with the prediction mode solely based on the ship motion input, the inclusion of wave elevation input can effectively improve the accuracy and advance time for ship’s motion prediction. Importantly, the prediction accuracy will improve with an increased number of inputs of wave probes, which are arranged along the wave propagation direction.

A Reinforcement Learning Approach for Flexible Job Shop Scheduling Problem With Crane Transportation and Setup Times.

Flexible job shop scheduling problem (FJSP) has attracted research interests as it can significantly improve the energy, cost, and time efficiency of production. As one type of reinforcement learning, deep Q-network (DQN) has been applied to solve numerous realistic optimization problems. In this study, a DQN model is proposed to solve a multiobjective FJSP with crane transportation and setup times (FJSP-CS). Two objectives, i.e., makespan and total energy consumption, are optimized simultaneously based on weighting approach. To better reflect the problem realities, eight different crane transportation stages and three typical machine states including processing, setup, and standby are investigated. Considering the complexity of FJSP-CS, an identification rule is designed to organize the crane transportation in solution decoding. As for the DQN model, 12 state features and seven actions are designed to describe the features in the scheduling process. A novel structure is applied in the DQN topology, saving the calculation resources and improving the performance. In DQN training, double deep Q-network technique and soft target weight update strategy are used. In addition, three reported improvement strategies are adopted to enhance the solution qualities by adjusting scheduling assignments. Extensive computational tests and comparisons demonstrate the effectiveness and advantages of the proposed method in solving FJSP-CS, where the DQN can choose appropriate dispatching rules at various scheduling situations.

Filamentary velocity scaling validation and spin dynamics in the DIII-D tokamak

Measured filament velocities in the DIII-D tokamak are compared against theoretical scalings, finding that the latter often represents an upper limit on experimental velocity distributions with most filaments possessing lower velocity. Filament spin from internal E × B drift is experimentally demonstrated to alter filament radial velocity. A critical spin velocity, where filament radial velocity peaks, is observed and corresponds to approximately 5 km/s. This transition is corroborated using a less direct measure of filament spin in the form of a temperature ratio. These techniques are combined to find that the critical spin velocity closely aligns with transport times along and across filaments becoming comparable. The normalized filament size distribution is consistent with the most stable size as dictated by Kelvin–Helmholtz and curvature-driven instabilities. Overall, the findings suggest filament stability and spin alter filamentary transport that may threaten the integrity of first walls in fusion devices.

Transportation Times at an Inpatient Rehabilitation Facility

Transportation Times at an Inpatient Rehabilitation Facility