The importance of home healthcare is growing rapidly since populations of developed and even developing countries are getting older and the number of hospitals, retirement homes, and medical staff do not increase at the same rate. We consider the Home Healthcare Nurse Scheduling Problem where patients arrive dynamically over time and acceptance and appointment time decisions have to be made as soon as patients arrive. The objective is to maximise the average number of daily visits for a single nurse. For the sake of service continuity, patients have to be visited at the same day and time each week during their episode of care. We propose a new heuristic based on generating several scenarios which include randomly generated and actual requests in the schedule, scheduling new customers with a simple but fast heuristic, and analysing results to decide whether to accept the new patient and at which appointment day/time. We compare our approach with two greedy heuristics from the literature, and empirically demonstrate that it achieves significantly better results compared to these other two methods.
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http://dx.doi.org/10.1007/s10729-017-9428-0 | DOI Listing |
Cureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFActa Clin Croat
December 2023
Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
The aim of our 5-year study (from January 2008 to December 2012) was to compare the incidence of peptic ulcer bleeding (PUB) to bleeding from tumors of the upper gastrointestinal tract. The percentage of re-bleeding within the first 30 days of hospital admission, as well as the need of blood transfusions, are also reported. Statistical data were collected on 2198 patients who were treated in our emergency department due to upper gastrointestinal bleeding (UGIB) in the form of melena or hematemesis.
View Article and Find Full Text PDFBackground: In this study, we aimed to determine the effects of the coronavirus disease 2019 (COVID-19) pandemic on in-hospital cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest (OHCA).
Methods And Results: Using the Japanese Diagnosis Procedure Combination inpatient database, we included patients with OHCA who were transported to hospitals between April 2018 and March 2021. Patients were categorized into groups, before and during the COVID-19 pandemic, according to the day of admission (before or after April 1, 2020, respectively).
Int J Stroke
January 2025
Department of Neurology, National Center for Neurological Disorders, National Clinical Research Centre for Aging and Medicine, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
Background: It is acknowledged that penumbra can exist beyond 24 hours after stroke onset.
Aims: The aim of this study was to explore the association between penumbral persistence at 24-72 hours and clinical outcomes in patients who did not achieve major reperfusion.
Methods: Eligible patients participating in the International Stroke Perfusion Imaging Registry with repeated 24-72 hours perfusion imaging were retrospectively included in this study.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery (A.M.C., L.V., A.L.C.), University of Pittsburgh; University of Pittsburgh School of Public Health (J.F.L., S.R.W.); Department of Emergency Medicine (F.X.G.), University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Surgery (B.A.C.), University of Texas Health Science Center, Houston, Texas; Department of Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery (M.A.S.), Oregon Health & Science University, Portland, Oregon; Department of Surgery (E.E.M.), Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado Health Sciences Center, Denver, Colorado; Department of Surgery (N.N.), University of Miami/Jackson Memorial Hospital, Miami, Florida; Department of Surgery (J.P.M.), University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Pathology (M.H.Y.), Department of Radiology (V.A.), and Trauma and Transfusion Medicine Research Center, Department of Surgery (J.B.B., C.M.L., M.D.N., R.M.F., J.L.S.), University of Pittsburgh, Pittsburgh, Pennsylvania.
Introduction: Whole blood resuscitation is associated with survival benefits in observational cohort studies. The mechanisms responsible for outcome benefits have not been adequately determined. We sought to characterize the achievement of hemostasis across patients receiving early whole blood versus component resuscitation.
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