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The fashion industry is the fourth biggest industry globally, with a value of $3 trillion and a workforce of 3384 million. However, the rapid development of the fashion industry negatively impacts the environment. With industrial practice, blockchain technology is found to be efficient and effective in helping fashion supply chain members cope with sustainability issues with accessibility, security, traceability, and transparency. This paper makes a systematic literature review and in‐depth exploration of adopting blockchain technology to facilitate sustainable supply chain practices with a particular case study on the fashion industry in coastal areas and a discussion of the application of blockchain technology in the global fashion industry. Based on the combination of the literature review, the case study, and the discussion, managerial insights are generated concerning blockchain adoption for boosting sustainability in the fashion industry in various domains. Future research opportunities are also discussed. [ABSTRACT FROM AUTHOR]

Background In 2019, the World Health Organization called for operational research on all-oral shortened regimens for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). We report safety and effectiveness of three 9-month all-oral regimens containing bedaquiline (Bdq), linezolid (Lzd), and levofloxacin (Lfx) and reinforced with cycloserine (Cs) and clofazimine (Cfz), delamanid (Dlm) and pyrazinamide (Z), or Dlm and Cfz. Methods We conducted a prospective cohort study of patients initiating treatment for pulmonary MDR/RR-TB under operational research conditions at public health facilities in Kazakhstan. Participants were screened monthly for adverse events. Participants with baseline resistance were excluded from the study and treated with a longer regimen. We analyzed clinically relevant adverse events of special interest in all participants and sputum culture conversion and end-of-treatment outcomes among individuals who were not excluded. Results Of 510 participants, 41% were women, the median age was 37 years (25th–75th percentile: 28–49), 18% had a body mass index <18.5 kg/m2, and 51% had cavitary disease. A total of 399 (78%) initiated Bdq-Lzd-Lfx-Cs-Cfz, 83 (16%) started Bdq-Lzd-Lfx-Dlm-Z, and 28 (5%) initiated Bdq-Lzd-Lfx-Dlm-Cfz. Fifty-eight individuals (11%) were excluded from the study, most commonly due to identification of baseline drug resistance (n = 52; 90%). Among the remaining 452 participants, treatment success frequencies were 92% (95% CI: 89–95%), 89% (95% CI: 80–94%), and 100% (95% CI: 86–100%) for regimens with Cs/Cfz, Dlm/Z, and Dlm/Cfz, respectively. Clinically relevant adverse events of special interest were uncommon. Conclusions All regimens demonstrated excellent safety and effectiveness, expanding the potential treatment options for patients, providers, and programs. [ABSTRACT FROM AUTHOR]

The sequence leading to conflict, as specifically in July 1914, reveals the changes in each protagonist's propensity to wage war. To characterize its timing, escalation is viewed as a viability (differential) game in progress under the protagonists' actions. The chronicle of confrontations and accommodations allows for estimating a responsiveness structure at the heart of the game. As the moves, which are the controls, are observed, and not the state variables, the game reduces to the minimization of a viability criterion under dynamics. Early estimation of the responsiveness structure operationalizes the procedure for crisis management and provides a way to anticipate the consequences of possible moves in escalations to conflict. The application to July 1914 shows the strength of the method. [ABSTRACT FROM AUTHOR]

The paper analyzes how to improve the teaching of Operational Research, focusing on distance learning courses where professors and students are separated through space and time. This case study was done in a public Industrial Engineering undergraduate course, and the work structure is divided into three main parts: an exploratory‐descriptive documentary analysis, application of free software, and evaluation of learning. The authors showed the feasibility of using the SageMath tool in the teaching‐learning process. The study revealed the importance of developing alternative solutions to educational realities marked by economic and financial constraints, where structure teaching with free software is a ruling factor once Engineering education is not a similar global event everywhere. Distance learning is a phenomenon that has been growing over the last 20 years in Brazil, but this was one of the first experiences with the use of SageMath. So, it can serve as a reference for countries with socioeconomic conditions similar to Brazil. Also, this case study can help other professors to enhance their teaching in a distance learning context even in scarcity scenarios of educational resources. The software implementation would be justified in part of the groups studied. [ABSTRACT FROM AUTHOR]

This study addresses the challenge of selecting outstanding students at higher education institutions under multiple constraints. We propose a novel integer programming solution to manage this process, formulating it as a constrained assignment problem with a maximization objective function. This function prioritizes the fair selection of students while respecting criteria such as academic qualifications, required skills, and student preferences. The goal is to develop a decision support system that efficiently selects qualified students at higher education institutions within a reasonable time. The model was tested using real data from Moroccan preparatory classes, achieving important assignment rates across all student categories. Results demonstrate significance in execution time, fulfillment of student choices, and prioritization of outstanding students. This approach offers a flexible, efficient solution for managing academic merit-based selections, optimizing resource utilization, and enhancing fairness in the selection process. [ABSTRACT FROM AUTHOR]

Abstract Introduction High-quality evidence is crucial for guiding effective humanitarian responses, yet conducting rigorous research, particularly randomised controlled trials, in humanitarian crises remains challenging. The TISA (“traitement intégré de la sous-nutrition aiguë”) trial aimed to evaluate the impact of a Water, Sanitation and Hygiene (WASH) intervention on the standard national treatment of uncomplicated Severe Acute Malnutrition (SAM) in children aged 6–59 months. Implemented in two northern Senegalese regions from December 22, 2021, to February 20, 2023, the trial faced numerous challenges, which this paper explores along with the lessons learned. Methods The study utilised trial documentation, including field reports, meeting minutes, training plans, operational monitoring data and funding proposals, to retrace the trial timeline, identify challenges and outline implemented solutions. Contributions from all TISA key staff—current and former, field-based and headquarters—were essential for collecting and interpreting information. Challenges were categorised as internal (within the TISA consortium) or external (broader contextual issues). Results The TISA trial, executed by a consortium of academic, operational, and community stakeholders, enrolled over 2000 children with uncomplicated SAM across 86 treatment posts in a 28,000 km2 area. The control group received standard outpatient SAM care, while the intervention group also received a WASH kit and hygiene promotion. Initially planned to start in April 2019 for 12 months, the trial faced a 30-month delay and was extended to 27 months due to challenges like the COVID-19 pandemic, national strikes, health system integration issues and weather-related disruptions. Internal challenges included logistics, staffing, data management, funding and aligning diverse stakeholder priorities. Discussion and conclusion Despite these obstacles, the trial concluded successfully, underscoring the importance of tailored monitoring, open communication, transparency and community involvement. Producing high-quality evidence in humanitarian contexts demands extensive preparation and strong coordination among local and international researchers, practitioners, communities, decision-makers and funders from the study’s inception. Trial registration Clinicaltrials.gov NCT04667767 .

The design and management of a supply chain (SC) in a global pandemic require a different approach than those used for more spatially restricted risks, such as earthquakes. A successful SC design and management plan should consider pandemic spatiotemporal characteristics as well as its effects on production and logistical operations, and on the SC workforce at risk. In this paper, a stochastic mixed integer linear programming model is developed to maximise the conditional value at risk (CVaR) of SC profit given a set of pandemic scenarios. An exemplar SC network from the literature is utilised, along with randomly generated pessimistic and optimistic pandemic scenarios. The proposed model is demonstrated by obtaining SC designs for different cases pertaining to pandemic influence and strategic policies. The resultant SC designs are used to contrast the performance of management plans across different pandemic scenarios and for different levels of workforce at risk. Supply chains for socially critical products, such as ventilators, are studied separately to examine the impact of SC network expansion on maximizing satisfied demand. Finally, we investigate the effects of diversifying network node locations across different administrative regions on SC performance. Several managerial insights are presented for SC planners to aid in creating viable designs and management plans. [ABSTRACT FROM AUTHOR]

Introduction: HIV self‐testing (HIVST) has been shown to increase the uptake of HIV testing and help achieve the UNAIDS 95‐95‐95 targets. This study assessed the acceptability, usability (ease of use and result interpretation) and the willingness to pay for HIVST kits distributed through three distribution models, namely the community‐based, PLHIV network‐led and private practitioners models, in India. Methods: This cross‐sectional study was implemented across 14 states in India between September 2021 and June 2022. All participants could choose between blood‐based or oral‐fluid‐based test kits. Participants were shown a test‐kit usage demonstration video, and pre‐ and post‐test counselling was provided for all. Participants were followed‐up after testing, and if reported reactive, were further supported for linkage to confirmatory testing and antiretroviral therapy (ART) initiation. Results: Among the 90,605 participants found eligible, 88,080 (97%) accepted an HIVST kit. Among the 87,976 who reported using an HIVST kit, 45,207 (51%) preferred a blood‐based kit, and 42,120 (48%) reported testing for the first time. For future testing, 77,064 (88%) reported preferring HIVST over other HIV testing methods. Among those who used the kit, 83,308 (95%) found the kit easy to use, and 83,237 (95%) reported that the test results were easy to interpret. Among those who preferred HIVST for future use, 52,136 (69%) were willing to pay for the kit, with 35,854 (69%) of those willing to pay less than US$ 1.20. Only one instance of social harm was reported, with a participant reporting suicidal tendencies due to discord with their partner. Out of 328 participants (0.4%) who tested reactive with HIVST, 291 (89%) were linked to confirmatory testing; of these, 254 were confirmed HIV positive, and 216 (85%) successfully initiated ART. Conclusions: Overall, we report that nearly all participants were willing to accept HIVST, found the test kits easy to use and interpret, and about two‐thirds were willing to pay for HIVST. Given the high levels of acceptance and the ability to reach a large proportion of first‐time testers, HIVST in India could contribute to achieving the UNAIDS first 95 and ending the HIV epidemic. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of one dose of the COVID-19 vaccine on care-home residents. Natural experiment. We compared the effectiveness of single doses of Pfizer/BioNTech BNT162b2 (effective at 10 days) and AstraZeneca ChAdOx1 (effective at 14 days) vaccines in vaccinated and control (unvaccinated) homes. Using routine data, all care-homes reporting COVID-19 outbreaks between 11/12/2020 and 12/3/2021 in a sub-region of North West England were included. Of 126 care-homes (4042 residents), with outbreaks, 55 (44%, 1686 residents) reported onset dates before vaccination commenced; 38 (30%, 1304 residents) reported onset < 10 (BNT162b2) and < 14 days (ChAdOx1) after vaccine administration; and 33 (26%, 1052 residents) reported onset > 10 (BNT162b2) and > 14 (ChAdOx1) days after vaccination. Eighty-nine (71%) homes used ChAdOx1 vaccine. A single dose of vaccine before the outbreak onset significantly lowered the risk of symptoms (reduced by 48%), positivity (by 65%), hospitalisation (by 68%), and death (by 81%). Some vaccine effectiveness was also noted in care-homes that received one dose of vaccine within 10–14 days of outbreak onset. The number needed to vaccinate to prevent one resident from COVID-19-related hospitalisation was 34, and death was 17. This real-world, natural experiment adds to the evidence of COVID-19 vaccine effectiveness from different studies using varying designs. In the context of lockdown's impact on infection rates and on-going care-home outbreaks, a single dose of either ChAdOx1 or BNT162b2 vaccine had a significant impact on reducing COVID-19 related hospitalisation and death in care-home residents. Natural experiments should be used more in public health. [Display omitted] [ABSTRACT FROM AUTHOR]

During the Annual Operational Research Society Simulation Workshop in Worchester, UK, in 2010, a panel discussion entitled "discrete‐event simulation (DES) is dead, long live agent‐based simulation (ABS)!" was held. Subsequent debates on the topic have captured the interest of many simulation professionals and researchers. This study lends credence to the discourse with evidence. In January 2020, a global health crisis named coronavirus disease (COVID‐19) occurred, infecting and killing millions of people globally, leading to community lockdowns and travel restrictions, and bringing the world to a standstill. Scientists scrambled for quick, practical solutions to stem the tide. Operational research (OR) and management science (MS) techniques, including modeling and simulation, provide effective methods to make COVID‐19 infection forecasts, assign/optimize intensive care unit beds, initiate healthcare management/control strategies, and decision‐making. The global pandemic problems offer an opportunity to evaluate the discourse on DES's continuous relevance and potency as an OR/MS technique. Utilizing bibliometric performance evaluation and text analytics of publications addressing various COVID‐19 pandemic problems, the results show an extensive use, relevance, and impact of the DES technique across multidisciplinary domains, including medical/healthcare, social and behavioral sciences, business, molecular biosciences, and more. The intellectual structure highlights strong multidisciplinary collaboration among sources in decision sciences, healthcare, natural, behavioral, and social sciences. The social network analysis of the publications shows the contributions and collaborations among authors, institutions, and countries. The study demonstrates that DES is still alive and robust, notwithstanding the hype about ABS. [ABSTRACT FROM AUTHOR]

Abstract The paper analyzes how to improve the teaching of Operational Research, focusing on distance learning courses where professors and students are separated through space and time. This case study was done in a public Industrial Engineering undergraduate course, and the work structure is divided into three main parts: an exploratory‐descriptive documentary analysis, application of free software, and evaluation of learning. The authors showed the feasibility of using the SageMath tool in the teaching‐learning process. The study revealed the importance of developing alternative solutions to educational realities marked by economic and financial constraints, where structure teaching with free software is a ruling factor once Engineering education is not a similar global event everywhere. Distance learning is a phenomenon that has been growing over the last 20 years in Brazil, but this was one of the first experiences with the use of SageMath. So, it can serve as a reference for countries with socioeconomic conditions similar to Brazil. Also, this case study can help other professors to enhance their teaching in a distance learning context even in scarcity scenarios of educational resources. The software implementation would be justified in part of the groups studied.

It is essential that communities at risk from TB are involved in TB research. Community advisory groups (CAGs) are one mechanism for involving communities in research and creating platforms for discussions between researchers and community members. We organised a CAG meeting with community members and people with lived experience in Ho Chi Minh City, Vietnam, to explore the community’s knowledge about TB and their perspectives on different diagnostic tests in Vietnam, a low-middle-income country with a high TB burden. Researchers shared basic information and addressed questions about TB. CAG members commented on preference of TB screening tests, and suggested that chest X-rays and blood tests were more acceptable than sputum tests because of the difficulty in sputum expectoration. In addition, clinical studies that required fewer visits to the hospitals would be preferred, even if this meant a greater reliance on blood sampling.

To reduce TB deaths, Tamil Nadu, a southern Indian state, implemented the first state-wide differentiated TB care strategy starting April 2022. Triage-positive severely ill patients are prioritised for comprehensive assessment and inpatient care. Routine program data during October–December 2022 revealed that documentation of total score after comprehensive assessment was available in only 39%, possibly indicating poor quality of comprehensive assessment. We confirmed this using operational research. The case record form to record comprehensive assessment was used only in 26% and among these, the completeness and correctness in filling out the form were sub-optimal. There is a clear need to enhance the quality of comprehensive assessments.

Background Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC’s Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. Methods This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Results Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p Conclusions Since

Background In Sierra Leone, the National Emergency Medical Services (NEMS) was designed to facilitate maternal and under-five referrals. During the COVID-19 pandemic, health facilities were repurposed and mobility restrictions were introduced, and this might have negatively influenced access to care. Thus, we compared utilization, timeliness and outcomes of referrals between the pre-COVID-19 and COVID-19 periods. Methods This was a cohort study using routinely collected data by the NEMS. There were 65 weeks in the pre-COVID-19 period (week one of January 2019 to week three of March 2020) and 91 weeks in the COVID-19 period (week four of March 2020 to week four of December 2021). We compared weekly referrals and the duration from initiating the NEMS for a referral to the patient reaching the receiving facility (prehospital delay) using the Mann–Whitney U test. Chi-squared tests were used to compare the mode of transportation and referral outcomes. Results Compared to the pre-COVID-19 period, there was significant decrease during the COVID-19 period in the median number of weekly maternal referrals (277 to 205), under-five referrals (177 to 104) and transfers on NEMS ambulances (348 to 269). The prehospital delays increased during the COVID-19 period for both maternal (72 to 86 minutes) and under-five (75 to 90 minutes) referrals (p Conclusions The performance of the NEMS system in terms of referrals reaching the receiving health facilities was maintained during the pandemic. However, there is a need to sustain the current performance of the NEMS system while making more efforts to increase utilization and reduce delays during outbreaks/pandemics.

Background The 2013-2016 West African Ebola Virus Disease (EVD) outbreak resulted in 28,600 cases and 11,300 deaths officially reported to the World Health Organization. Previous studies investigating factors associated with death had conflicting findings, interventions showing promising outcomes had small sample sizes, studies were often single- or dual-country based and most focused on laboratory-confirmed EVD and not on clinically-suspected EVD. We used the Ebola data platform of the Infectious Disease Data Observatory (IDDO) to review individual patient records to assess factors associated with death, and particularly whether there were differences between laboratory-confirmed and clinically-suspected cases. Methods This was a cohort study involving analysis of secondary data in the IDDO database. The study population included all patients classified as having either clinically-suspected or laboratory-confirmed EVD, admitted to 22 Ebola Treatment Units (ETU) in Guinea, Liberia and Sierra Leone between December 2013 and March 2016. Baseline characteristics and treatments were documented along with ETU exit outcomes. Factors associated with death were investigated by multivariable modified Poisson regression. Results There were 14,163 patients, of whom 6,208 (43.8%) were laboratory-confirmed and 7,955 (56.2%) were clinically-suspected. Outcomes were not recorded in 2,889 (20.4%) patients. Of the 11,274 patients with known outcomes, 4,090 (36.3%) died: 2,956 (43.6%) with laboratory-confirmed EVD and 1,134 (18.8%) with clinically-suspected EVD. The strongest risk factor for death was confirmed disease status. Patients with laboratory-confirmed disease had 2.9 times higher risk of death compared to clinically-suspected patients, after adjusting for other co-variables. Other factors significantly associated with death included a higher risk for patients aged ≥60 years and a lower risk for patients in Sierra Leone. Conclusions Although laboratory-confirmed patients admitted to ETUs fared worse than clinically-suspected patients, the latter still had a substantial risk of death and more attention needs to be paid to this group in future EVD outbreaks.

Background Lassa fever is an endemic and immediately notifiable disease in Liberia, and one laboratory confirmed case constitutes an outbreak. We described the epidemiological characteristics and hospital outcome of Lassa fever cases hospitalized during the 2022-2023 outbreak in Liberia. Methods A cohort study was conducted using routine Lassa fever surveillance data from the 2022-2023 outbreak in Liberia. Descriptive statistics were used to summarize the data and log binomial regression to assess the association between epidemiological characteristics and mortality. Results A total of 439 suspected Lassa fever cases were reported. The median age was 22 (interquartile range: 10-33) years and 233 (53%) were women. The median number of days between symptom onset and admission was 4 (IQR 2-7). Of the 439 cases, 416 (95%) were tested for Lassa fever and 138 were confirmed with 33% positivity rate. The majority, 290 (69%), of confirmed cases were Conclusions The outbreak highlighted a high disease burden of Lassa fever with young adults disproportionately infected, and substantial mortality, even among those who tested negative for the virus. This underscores the urgent need for preventive measures like vaccines and health education campaigns.

Background Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities in Liberia. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, with the highest rates in 2020 (24/1,000 health care workers) and 2021 (14/1,000 health care workers). Case fatality was 2% in both 2020 and 2021 with no deaths thereafter. Among those hospitalized, the highest proportions were nursing cadres with 191(45%), physicians with 63 (15%) and laboratory technicians with 42 (10%). The most frequent reported site for COVID-19 infection was the health facility (326, 89%). COVID-19 vaccination coverage in health care workers was 20%. The majority (91%) of hospitalizations were for mild symptomatic infections. Even in referral centres (n-52), 18 (35%) were for mild infections. Of the 424 who were hospitalized, 412 (97%) recovered, 9 (2%) died and 3 (1%) either left against medical advice or absconded. Of the nine deaths, none were vaccinated, seven had moderate-to-severe disease but were not referred to specialized COVID-19 treatment centers. Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.

Background Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC’s Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. Methods This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Results Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p Conclusions Since

Background Operational research (OR) is a process to improve health system capacity by evaluating interventions to improve health delivery and outcomes. The World Health Organization (WHO) Structured Operational Research Training Initiative (SORT-IT) programme promotes how OR contributes to improved health care delivery and health outcomes. A partnership project between the International Institute of Primary Health Care (IPHCE) in Ethiopia and The University of Queensland (UQ) in Australia modified the SORT-IT programme to deliver a hybrid Training of Trainers programme and improve OR capacity. Objective This study was performed to develop and evaluate the effectiveness of Train-the Trainers approach in building capability to expand the capacity of the IPHCE to deliver the SORT-IT programme. Methods Recruitment of participants and training were aligned with the principles of the SORT-IT programme. Training was face-to-face for the first session with subsequent training sessions delivered via Zoom over a 13-week period. Participants were required to complete all activities in line with SORT-IT deliverables. Slide decks supporting the SORT-IT training videos were developed and adapted to the Ethiopian context. Results Participants had diverse experience from programme directors to research officers. All training sessions were recorded and available for participants to watch and review when required. All participants completed OR protocols to the draft stage. Course evaluation revealed participants found the content and format of the training useful, pertinent, and interesting. Conclusion A hybrid model (face-to-face and video platform) for OR training was implemented. Managing contextual challenges such as information technology were managed easily by programme staff. Translating course requirements at a management level proved challenging with data collection for the protocols but provided insight into potential future challenges. This OR Training of Trainers course demonstrated that sharing of skills and knowledge can occur through a hybrid delivery model and contribute to developing capacity.

OBJECTIVE Use a referral dental clinic model to study how to calculate accurate 95% upper confidence limits for probabilities of workloads (total case duration, including turnover time) exceeding allocated times. ANIMALS Dogs and cats undergoing dental treatments. METHODS Managerial data (procedure date and duration) collected over 44 consecutive operative workdays were used to calculate the daily anesthetist workload. Workloads were compared with a normal distribution using the Shapiro-Wilk test, serial correlation was examined by runs test, and comparisons among weekdays were made using the KruskalWallis test. The 95% confidence limits for normally distributed workloads exceeding allocated times were estimated with a generalized pivotal quantity. The impact of a number of procedures was assessed with scatterplots, Pearson linear correlation coefficients, and multivariable linear regression. RESULTS Mean anesthetist’s workload was normally distributed (Shapiro-Wilk P = .25), without serial correlation (P = .45), and without significant differences among weekdays (P = .52). Daily workload, mean 9.39 hours and SD 3.06 hours, had 95% upper confidence limit of 4.47% for the probability that exceeding 16 hours (ie, 8 hours per each of 2 tables). There was a strong positive correlation between daily workload and the end of the workday (r = .85), significantly larger than the correlation between the end of the workday and the number of procedures (r = .64, P < .0001). CLINICAL RELEVANCE There are multiple managerial applications in veterinary anesthesia wherein the problem is to estimate risks of exceeding thresholds of workload, including the costs of hiring a locum, scheduling unplanned add-on cases, planning for late discharge of surgical patients to owners, and coordinating anesthetist breaks. [ABSTRACT FROM AUTHOR]

Simple Summary: This research evaluates the production efficiency of broiler batches using the production efficiency factor and unit cost of production. Employing Data Envelopment Analysis (DEA), it considers variables like poultry housing, age at slaughter, feed consumed, mortality, and unit cost, with the total available weight as the output. Among 31 decision-making units (DMUs), only DMU 4 and DMU 23 approached maximum efficiency. Efficient DMUs serve as benchmarks for disseminating best practices to less efficient ones, enhancing overall efficiency and financial sustainability in poultry farming. This study highlights the significance of unit cost in evaluating production efficiency and proposes actionable insights for improving practices in the sector. The production efficiency factor is widely used to measure the zootechnical performance of a batch of broilers. The unit cost of production brings new elements to improve efficiency evaluation and financial sustainability for this activity in agriculture. This research aims to evaluate the production efficiency level of the crop to maximize the return on investment. This study uses Data Envelopment Analysis (DEA) with the computational processing of the SIAD software (Integrated Decision Support System). The variables selected were poultry housing, age at slaughter, feed consumed, mortality, and unit cost. The chosen output variable was the total available weight. The analysis spans 31 decision-making units (DMUs) composed of integrated producers, unveiling a frontier of efficiency delineated by the most exemplary DMUs. Notably, only two DMUs, specifically DMU 4 and DMU 23, approached the threshold of maximum relative efficiency. This research illuminates the critical role of unit cost in enhancing the assessment of production efficiency and financial sustainability within the agriculture environment. By setting benchmarks for efficient management and operational protocols, our findings serve as a cornerstone for improving practices among less efficient DMUs, contributing significantly to the literature on agricultural efficiency and offering actionable insights for the poultry farming sector. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the contribution that problem structuring methods – a branch of the decision support discipline of operational research – have made in helping managers deal with situations of high complexity. The paper reviews the limitations of traditional operational research and argues that problem structuring methods have expanded the entire discipline and significantly contributed to its holistic nature and problem-solving orientation. Design/methodology/approach: The paper provides a critical discussion of the limitations of the traditional operational research approach and examines how the development and successful application of problem structuring methods have opened up a new paradigm of analysis in management science. Findings: In theoretical terms, problem structuring methods have moved the discipline of operational research away from its positivistic epistemology and towards interpretivism and the acceptance of a subjective social reality. In practical terms, they offer managers a broad range of appropriate analytical tools which provide transparency and offer the opportunity to those affected by the problem situation to be actively involved in the entire modelling process within a facilitated environment. Originality/value: The paper offers a critical discussion of the contribution that problem structuring methods have made while also identifying the challenges they face as they try to achieve higher levels of recognition and acceptance in management science. [ABSTRACT FROM AUTHOR]

This paper investigates the planning of virtual ward (VW) capacity including the remote monitoring of frail and elderly patients. The main objective is to optimize VW hub locations across a region in the United Kingdom. Furthermore, assigning the optimal number of clinicians to different regions needs to be considered. We develop a mathematical model that minimizes the setup and travel costs of VW hubs and staff. Our experimental analysis evaluates different levels of demand considering postcode areas within different Trusts, also known as Health Boards, in the National Health Service (NHS). Furthermore, our experiments provide insights into how many hub locations should be deployed and staffed. This can be used to individually find the number of remote monitors and clinicians for each facility as well as the system overall. [ABSTRACT FROM AUTHOR]

Abstract Introduction HIV self‐testing (HIVST) has been shown to increase the uptake of HIV testing and help achieve the UNAIDS 95‐95‐95 targets. This study assessed the acceptability, usability (ease of use and result interpretation) and the willingness to pay for HIVST kits distributed through three distribution models, namely the community‐based, PLHIV network‐led and private practitioners models, in India. Methods This cross‐sectional study was implemented across 14 states in India between September 2021 and June 2022. All participants could choose between blood‐based or oral‐fluid‐based test kits. Participants were shown a test‐kit usage demonstration video, and pre‐ and post‐test counselling was provided for all. Participants were followed‐up after testing, and if reported reactive, were further supported for linkage to confirmatory testing and antiretroviral therapy (ART) initiation. Results Among the 90,605 participants found eligible, 88,080 (97%) accepted an HIVST kit. Among the 87,976 who reported using an HIVST kit, 45,207 (51%) preferred a blood‐based kit, and 42,120 (48%) reported testing for the first time. For future testing, 77,064 (88%) reported preferring HIVST over other HIV testing methods. Among those who used the kit, 83,308 (95%) found the kit easy to use, and 83,237 (95%) reported that the test results were easy to interpret. Among those who preferred HIVST for future use, 52,136 (69%) were willing to pay for the kit, with 35,854 (69%) of those willing to pay less than US$ 1.20. Only one instance of social harm was reported, with a participant reporting suicidal tendencies due to discord with their partner. Out of 328 participants (0.4%) who tested reactive with HIVST, 291 (89%) were linked to confirmatory testing; of these, 254 were confirmed HIV positive, and 216 (85%) successfully initiated ART. Conclusions Overall, we report that nearly all participants were willing to accept HIVST, found the test kits easy to use and interpret, and about two‐thirds were willing to pay for HIVST. Given the high levels of acceptance and the ability to reach a large proportion of first‐time testers, HIVST in India could contribute to achieving the UNAIDS first 95 and ending the HIV epidemic.

This paper deals with the vehicle routing problem involving simultaneous loading and unloading of goods with different temperature regimes. Existing modifications of the problem as well as current software products do not focus on the transport of goods with different temperature regimes. In this paper, restrictive conditions for the joint transportation of goods with multiple temperature regimes are determined, which can be used within various types of optimization algorithms that address vehicle routing problems. Considering the proposed conditions in these algorithms will increase the utilization of the vehicle payload, and load space while complying with the established mandatory rules for the transport of foodstuffs. This will reduce the number of journeys required to carry out the transport, thus resulting in savings in operating costs.