Food supply chains are confronted with increased consumer demands on food quality and sustainability. When redesigning these the analysis of change environmental load new scenarios is as important efficiency responsiveness requirements. Simulation tools often used for supporting decision-making chain (re)design when logistic uncertainties in place, building their inherent modelling flexibility. Mostly, underlying assumption that product not influenced by or does influence design. Clearly,...

ABSTRACT Owing to its inherent modeling flexibility, simulation is often regarded as the proper means for supporting decision making on supply chain design. The ultimate success of simulation, however, determined by a combination analyst's skills, members' involvement, and capabilities tool. This should provide basis realistic model, which both transparent complete. need transparency especially strong chains they involve (semi)autonomous parties each having their own objectives. Mutual trust...

Background and Purpose— Today, treatment of acute stroke consists tissue-type plasminogen activator (tPA), admission to a unit, aspirin. Although tPA is the most effective, there substantial undertreatment. Centralized care may affect rate, timing, outcome thrombolysis compared decentralized in community hospitals. The present study aimed assess impact organizational models on proportion patients undergoing treatment. Methods— A prospective, multicenter, observational among 13 hospitals...

Safety stock and safety lead time are common measures used to cope with uncertainties in demand supply. Typically, these studied isolated instances, ignoring settings both The current literature largely neglects case study based contexts and, often, single product situations investigated which machine set-ups not considered. Based on the problems findings a study, we investigate effects of delivery performance multi-product setting. outcomes extensive simulation indicate that utilising...

Alteplase is widely used as an intravenous thrombolytic drug in acute ischemic stroke (AIS). Recently however, tenecteplase, a modified form of tissue plasminogen activator, has been shown to increase early recanalization rate and proven be non-inferior with similar safety profile compared alteplase. This study aims evaluate the cost-effectiveness 0.25 mg/kg tenecteplase versus 0.9 alteplase for thrombolysis AIS patients from Dutch healthcare payer perspective.A Markov decision-analytic...

This paper considers the development of multi-use simulation models for cost-effectiveness studies reperfusion treatments in acute ischemic stroke. The consistent and accurate a specific health domain allow cross-comparison interpretation findings. Furthermore, modelling efficiencies may benefit from exploiting system similarities. To explore requirements models, scoping review was performed to characterise analysis stroke treatments. Findings were used define mixed model structure covering...

In a drive-the-doctor (DD) paradigm, an interventionalist travels from comprehensive stroke centre (CSC) to primary centres (PSCs) perform endovascular thrombectomy (EVT) for acute ischaemic due large vessel occlusion (LVO). The DD paradigm may reduce time delays onset recanalisation. This study aimed analyse the cost-effectiveness of versus drip-and-ship (DS) where LVO patients are transferred PSCs CSC EVT in northern Netherlands. Economic evaluation was performed using simulation model...

A challenge in simulation modelling is to produce models that are transparent, is, facilitate stakeholders validating and understanding key decision variables, their workings, model output. In turn, stakeholder participation helpful exploiting domain knowledge for solution creation, acceptance. Unfortunately, many tend be less being influenced by the analyst's mental reference software libraries. this article, we consider issue somewhat more depth, reviewing a framework manufacturing...

Treatment with tissue plasminogen activator (tPA) is the most effective treatment in acute brain infarction. However, estimated worldwide rates are <10%, many barriers hampering broad implementation. Organization and resource-intense randomized controlled trials cannot address all potential simultaneously. Simulation, however, may provide an efficient research means for testing interventions aimed at resolving along care pathway.A simulation-based approach reflecting setup of a regional...

Abstract In this paper we investigate cross-training policies in a dual resource constraint (DRC) parallel job shop where new part types are frequently introduced into the system. Each type introduction induces need for workers to go through learning curve. A policy relates level of multi-functionality, pattern skill overlaps, and distribution skills among workers. Our results show that frequency needs be considered when selecting policy. The has impact on optimal cross-training, relative...

Traditionally, discrete event simulation is associated with system analysis due to its role as an operations research method. In this article, we consider a case study on the alternative use of for training industrial workers in new working procedures. Essentially, games are based players learning from model responses their decision-making. When stressing decision maker instead operations—as research—alternative demands set up and arise. Identifying such ways deal them helps exploit existing...

Various studies demonstrate better patient outcome and higher thrombolysis rates achieved by centralized stroke care compared to decentralized care, i.e. community hospitals. It remains largely unclear how improve rate in care. The aim of this simulation study was assess the impact previously identified success factors a central model on when implemented for decentral model.Based prospectively collected dataset 1084 ischemic patients, used replicate current practice estimate effect...

The batching of jobs in a manufacturing system is very common policy many industries. main reasons for are the avoidance setups and/or facilitation material handling. Good examples batch-wise production systems ovens that found aircraft industry and manufacture semiconductors. These often consist multiple machines different types range volumes products have to be handled. Building on earlier research industry, where process hardening synthetic parts was studied, we propose new heuristic...

We define a domain specific modelling framework for decision support in stroke.• Domain frameworks improve reuse and efficiency of studies.• the requirements conceptual framework.• propose an extended endovascular therapy.• illustrate use with real world example.

Centralisation of thrombolysis may offer substantial benefits. The aim this study was to assess short term costs and effects centralisation optimised care in a decentralised system.Using simulation modelling, three scenarios improve settings the North Netherlands were compared from perspective policy maker current care: (1) improving stroke at nine separate hospitals, (2) centralising treatment four, (3) two hospitals. Outcomes annual mean incremental per patient up with thrombolysis,...