A bi-criterion sequence-dependent scheduling problem with order deliveries.

The manufacturing sector faces unprecedented challenges, including intense competition, a surge in product varieties, heightened customization demands, and shorter product life cycles. These challenges underscore the critical need to optimize manufacturing systems. Among the most enduring and complex challenges within this domain is production scheduling. In practical scenarios, setup time is whenever a machine transitions from processing one product to another. Job scheduling with setup times or associated costs has garnered significant attention in both manufacturing and service environments, prompting extensive research efforts. While previous studies on customer order scheduling primarily focused on orders or jobs to be processed across multiple machines, they often overlooked the crucial factor of setup time. This study addresses a sequence-dependent bi-criterion scheduling problem, incorporating order delivery considerations. The primary objective is to minimize the linear combination of the makespan and the sum of weighted completion times of each order. To tackle this intricate challenge, we propose pertinent dominance rules and a lower bound, which are integral components of a branch-and-bound methodology employed to obtain an exact solution. Additionally, we introduce a heuristic approach tailored to the problem's unique characteristics, along with three refined variants designed to yield high-quality approximate solutions. Subsequently, these three refined approaches serve as seeds to generate three distinct populations or chromosomes, each independently employed in a genetic algorithm to yield a robust approximate solution. Ultimately, we meticulously assess the efficacy of each proposed algorithm through comprehensive simulation trials.

Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan.

BACKGROUND: Vagus nerve stimulation (VNS) is used as an add-on treatment for epilepsy. This study aimed to use Taiwanese nationwide registry data to analyze the therapeutic effects of VNS in children with refractory epilepsy (RE) and try to explore predictive factors of VNS treatment effectiveness. METHODS: This retrospective study collected data from December 2007 to December 2014. Patient variables included gender, age, VNS implantation date, epilepsy duration, seizure frequency, seizure type, etiology, and antiepileptic drug (AED) history. We divided patients into three groups: Group I as seizure frequency >80 times per month, Group II as seizure frequency 24-80 times per month, and Group III as seizure frequency <24 times per month. Multivariate regression analysis was performed to determine predictors of seizure frequency reduction after VNS treatment. RESULTS: A total of 80 patients were included in this study. Three or more AED types were prescribed for 61 (77.1%) patients. Seizure frequency decreased significantly at 12 and 24 months after VNS treatment. The mean seizure reduction rates were 44.6% and 50.1% at 12 and 24 months after VNS treatment, with the difference between them reaching statistical significance (p = 0.001). In multivariate linear regression, high seizure frequency (Group I) was a positive predictor of seizure frequency reduction (p < 0.001). The most common complication was coughing (eight patients, 10%) and no patient had early withdrawal or premature termination of VNS use due to complications. CONCLUSION: VNS is an effective palliative treatment for children with RE for different seizure types. Seizure reduction rate at 24 months after VNS was better than at 12 months after VNS. High seizure frequency can be regarded as a positive predictor for seizure frequency reduction in children with RE treated with VNS.

Parenting stress in parents of children with refractory epilepsy before and after vagus nerve stimulation implantation.

OBJECTIVES: The purpose of this study was to evaluate parenting stress in parents of children with refractory epilepsy before and after their children received vagus nerve stimulation (VNS) implantation. METHODS: Parents of children with refractory epilepsy completed the Parenting Stress Index (PSI) under a psychologist's assessment before and at least 12 months after their children received VNS implantation. The PSI questionnaire measures parenting stress in two domains; a parent domain with seven subscales, and a child domain with six. Age, gender, epilepsy comorbidity, VNS implantation date, seizure frequency, and anticonvulsant history before and after VNS implantation were obtained from reviews of medical charts. RESULTS: In total, 30 parents completed the first and follow-up PSI questionnaires. Seventeen of their children (56.7%) were boys. The children aged from 1 to 12 years (7.43 ± 3.59 years, mean ± SD). After VNS implantation, the mean total parenting stress scores decreased from 282.1 ± 38.0 to 272.4 ± 42.9. A significant decrease was found on the spouse subscale of the parent domain. For the parents of boys, the mean total parenting stress scores decreased significantly. The mean total parenting stress scores also decreased significantly for parents of epileptic children without autism and who did not taper off the number of different anticonvulsants used after VNS. CONCLUSIONS: VNS is an advisable choice to treat refractory epilepsy. Our study showed that 12 months or more after VNS implantation, seizure frequency and parenting stress typically decreased. However, in some special cases the parenting stress may increase, and external help may be required to support these patients and their parents.

Modeling the Pulse Signal by Wave-Shape Function and Analyzing by Synchrosqueezing Transform.

We apply the recently developed adaptive non-harmonic model based on the wave-shape function, as well as the time-frequency analysis tool called synchrosqueezing transform (SST) to model and analyze oscillatory physiological signals. To demonstrate how the model and algorithm work, we apply them to study the pulse wave signal. By extracting features called the spectral pulse signature, and based on functional regression, we characterize the hemodynamics from the radial pulse wave signals recorded by the sphygmomanometer. Analysis results suggest the potential of the proposed signal processing approach to extract health-related hemodynamics features.

A novel model for exploring the correlation between patterns and prescriptions in clinical practice of traditional Chinese medicine for systemic lupus erythematosus.

OBJECTIVES: Traditional Chinese medicines in treating systemic lupus erythematosus are not uncommon. However, logic of pattern diagnosis and consensus on treating this disease is lacking. This study aimed to explore the correlation between the pattern diagnosis of and its corresponding prescription in systemic lupus erythematosus. DESIGN: Clinical data including patterns and prescriptions from the electronic medical records of lupus patients in a medical center were collected. Using a specific coding system (B-code) to encode the patterns and prescriptions provided a platform for data processing and statistics, and nonlinear canonical correlation analysis was employed to examine the correlation between them. RESULTS: In the 261 valid visits collected, a total of 46 patterns and 193 prescriptions were encoded into 57 B-codes. In our database, "Yin, Vacuity, Heat, and Dampness" were the most common B-codes (more than 90%) in both patterns and prescriptions. "Anemarrhena, Phellodendron, and Rehmannia Pill (Zhi-Bai-Di-Huang-Wan)" and "Miltiorrhizae Radix (Dan-Shen)" were the most frequently used formula (52%) and herb (48%), respectively. Water-rheum, kidney, and stasis were among the three most effective variable sets for correlating the patterns and prescriptions. CONCLUSION: By using B-code with nonlinear canonical correlation analysis, the clinical dataset can be examined to shed light on the logic of pattern differentiation and principle of treatment for a specific disease.

Effects of anti-Müllerian hormone and follicle stimulating hormone levels on in vitro fertilization pregnancy rate.

OBJECTIVES: To analyze the relationship between in vitro fertilization (IVF) pregnancy rate and basal serum hormone levels before patients begin an IVF course. MATERIALS AND METHODS: In this retrospective study, we analyzed patients with anti-Müllerian hormone (AMH) data and IVF data from January 2009 to October 2012. Pregnancy rates were calculated by AMH and follicle stimulating hormone quartiles and analyzed using the independent samples t test. Furthermore, patients were divided into three groups by age. The Chi-square test was used to assess the association between the parameters and IVF pregnancy rates. RESULTS: From the 910 IVF treatment courses, 377 (41.4%) clinical pregnancies resulted. The pregnant and nonpregnant groups differed significantly in age and FSH and AMH levels. The pregnancy rate was 53.3% for patients aged <32 years and 22.1% for patients aged >38 years. The pregnancy rate was 53.4% for patients with FSH levels <5.6 mIU/mL and 25.8% for patients with FSH levels >8.9 mIU/mL. The pregnancy rate was 56.8% for patients with AMH levels >4.0 ng/mL and 20.0% for patients with AMH levels <1.1 ng/mL. Furthermore, among patients aged <40 years, AMH and FSH were significantly associated with pregnancy rate. Higher pregnancy rates were found among the groups with higher AMH levels than in groups with lower AMH levels. CONCLUSION: For patients aged <40 years, basal serum AMH level and FSH level affected the IVF pregnancy rate, and patients with higher AMH levels had better pregnancy rates.

Using a questionnaire among patient, resident doctor and senior supervisor: Are their answers the same?

OBJECTIVES: This study aims to contribute to the development of objective diagnostic standards in Traditional Chinese Medicine (TCM), in order to improve the training of physicians. METHODS: We devised a questionnaire study to evaluate the accuracy of resident doctors' diagnostic skills by comparing their assessment of patients with those of their senior supervising physician and the patients themselves. We selected 39 patients with systemic lupus erythematosus (SLE) at Chang Gung Memorial Hospital, Taiwan, between November 1, 2008 and June 30, 2012, and had the resident doctors (R), their senior supervisor (S) and their patients (P) fill out questionnaires before treatment (V1), immediately after treatment (V5) and two months after treatment (V6), in order to record their assessments on the patients' condition. The R and S questionnaires covered subjective symptoms, tongue, and pulse, while the P questionnaires only included general symptoms. We then compared the assessment records to determine the level of agreement between them. RESULTS: The agreements of inquiry during the study for P and S were 0.78 (V1) to 0.84 (V6) and 0.87 (V1) to 0.94 (V6) for R and S, respectively, the agreements between R and S for tongue diagnosis and pulse diagnosis were 0.87 (V1) to 0.90 (V6) and 0.91 (V1) to 0.95 (V6), respectively. All the above agreements improved with time from V1 to V6. CONCLUSIONS: The results show that the patient input was feasible and effective and that the questionnaire method provided an objective assessment standard to determine how successfully the resident doctor was trained. Furthermore, it facilitated a training process that could help resident doctors improve their skills.