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In this study, the Open Vehicle Routing Problem, which the companies widely employ in practice using third‐party logistics services, is discussed. This problem is in the class of high‐dimensional and complex optimization problems. A three‐phase Variable Neighborhood Search Algorithm was proposed to solve large‐scale problems efficiently. In this proposed method, eight different neighborhoods are used, four within the route and four between the routes. In addition to this, wise shaking strategies are designed to escape local optimal solutions. The method's performance was tested on literature test instances and comparatively reported its competitiveness. [ABSTRACT FROM AUTHOR]

Background: Previous studies have evaluated the presence of juxtapapillary duodenal diverticula (JPDD) and the association with pancreatobiliary disease, but not the association of the papilla with an existing JPDD. We investigated the association of different localizations of the papilla with JPDD. Methods: We studied patients in whom JPDD was detected during endoscopic retrograde cholangiopancreatography. Patients were classified into 3 groups: 1) papilla located inside the diverticulum, 2) papilla located at the edge of the diverticulum and 3) papilla located closer than 3 cm to the diverticulum. The patients were examined with respect to localization of papilla--diverticula and to the association of the localization with pancreaticobiliary disease. Results: We enrolled 274 patients in our study. Biliary stone disease more frequently existed in group 3. The number of patients presenting with obstructive jaundice was higher in groups 2 (83.6%) and 3 (83.3%) than group 1 (66%). Cholangitis was more common in group 1 (21.3%) than in groups 2 (6.7%) and 3 (2.3%). The presence of biliary stone disease among patients presenting with pancreatitis was significantly different between groups 1 and 3 (p = 0.013) and between groups 2 and 3 (p = 0.017). The common bile duct more frequently contained stones or sludge in group 3 than in groups 1 and 2. Conclusion: When the papilla is located close to the JPDD, the incidence of biliary stone disease decreases, and pancreatobiliary diseases are caused mostly in the absence of biliary stone disease. Contexte : Des etudes anterieures ont evalue la presence de diverticules duodenaux juxtapapillaires (DDJP) et leur lien avec la maladie pancreatobiliaire, mais n'ont pas analyse le lien entre la papille et les DDJP existants. Nous avons analyse le lien entre diverses localisations de la papille et les DDJP. Methodes : Nous avons etudie des patients chez qui des DDJP ont ete detectes lors d'une cholangiopancreatographie endoscopique retrograde. Les patients ont ete classes en 3 groupes : 1) papille a l'interieur du diverticule, 2) papille a l'extremite du diverticule et 3) papille a moins de 3 cm du diverticule. L'examen a donc porte sur la localisation de la papille par rapport aux diverticules et sur le lien entre sa localisation et la maladie pancreatobiliaire. Resultats : Nous avons inscrit 274 patients a notre etude. La cholelithiase s'observait davantage dans le groupe 3. Le nombre de patients souffrant d'ictere obstructif etait plus eleve dans les groupes 2 (83,6 %) et 3 (83,3 %) que dans le groupe 1 (66 %). La cholangite etait plus frequente dans le groupe 1 (21,3 %) que dans les groupes 2 (6,7 %) et 3 (2,3 %). Le taux de cholelithiase chez les patients souffrant de pancreatite etait significativement different entre les groupes 1 et 3 (p = 0,013) et entre les groupes 2 et 3 (p = 0,017). Il y avait plus de calculs ou de boue biliaires dans le canal choledoque des patients du groupe 3 que dans ceux des groupes 1 et 2. Conclusion : Lorsque la papille est situee pres des DDJP, l'incidence de la cholelithiase diminue, et les maladies pancreatobiliaires sont pour la plupart causees en l'absence de cholelithiase., Duodenal diverticula (DD) are classified as primary (true) or secondary (false) diverticula. Primary diverticula are mostly solitary and can be observed in the second part of the duodenum, in the [...]

In this paper, two new approaches are proposed for extracting composite priority rules for scheduling problems. The suggested approaches use simulation and gene expression programming and are able to evolve specific priority rules for all dynamic scheduling problems in accordance with their features. The methods are based on the idea that both the proper design of the function and terminal sets and the structure of the gene expression programming approach significantly affect the results. In the first proposed approach, modified and operational features of the scheduling environment are added to the terminal set, and a multigenic system is used, whereas in the second approach, priority rules are used as automatically defined functions, which are combined with the cellular system for gene expression programming. A comparison shows that the second approach generates better results than the first; however, all of the extracted rules yield better results than the rules from the literature, especially for the defined multi-objective function consisting of makespan, mean lateness and mean flow time. The presented methods and the generated priority rules are robust and can be applied to all real and large-scale dynamic scheduling problems. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis is a life-threatening zoonotic disease caused by Echinococcus multilocularis. The disease usually primarily involves the liver and shows tumor-like growth. Early diagnosis of alveolar echinococcosis is difficult because the disease is usually asymptomatic in the early stages. Untreated cases are fatal and result in death within 10 years of liver involvement. In the diagnosis of alveolar echinococcosis, the patient's medical history, radiological imaging findings, and serological and histopathological tests are used together. Radiological imaging methods are very important for early diagnosis and differential diagnosis of the disease. In this article, we wanted to review the diagnosis and treatment of alveolar echinococcosis and emphasize the importance of keeping it in mind, especially in cystic lesions of the liver, and the importance of early diagnosis of the disease. [ABSTRACT FROM AUTHOR]