Predicting older-donor kidneys' post-transplant renal function using pre-transplant data

This paper provides a methodology for predicting post-transplant kidney function, that is, the 1-year post-transplant estimated Glomerular Filtration Rate (eGFR-1) for each donor-candidate pair. We apply customized machine-learning algorithms to pre-transplant donor and recipient data to determine the probability of achieving an eGFR-1 of at least 30 ml/min. This threshold was chosen because there is insufficient survival benefit if the kidney fails to generate an eGFR-1 ≥ 30 ml/min. For some donor-candidate pairs, the developed algorithm provides highly accurate predictions. For others, limitations of previous transplants' data results in noisier predictions. However, because the same kidney is offered to many candidates, we identify those pairs for whom the predictions are highly accurate. Out of 6977 discarded older-donor kidneys that were a match with at least one transplanted kidney, 5282 had one or more identified candidate, who were offered that kidney, did not accept any other offer, and would have had ≥80% chance of achieving eGFR-1 ≥ 30 ml/min, had the kidney been transplanted. We also show that transplants with ≥80% chance of achieving eGFR-1 ≥ 30 ml/min and that survive 1 year have higher 10-year death-censored graft survival probabilities than all older-donor transplants that survive 1 year (73.61% vs. 70.48%, respectively).     

Solving a selected class of location problems by exploiting problem structure: A decomposition approach

For many combinatorial optimization problems that are NP-hard, a number of special cases exist that can be solved in polynomial time. This paper addresses the issue of solving one such problem, the well-known m-median problem with mutual communication (MMMC), by exploiting polynomially solvable special cases of the problem. For MMMC, a dependency graph is defined that characterizes the structure of the interactions between decision variables. A Lagrangian decomposition scheme is proposed that partitions the problem into two or more subproblems, each having the same structure as the original problem, but with simpler dependency graphs. The dual problems are solved using subgradient or multiplier adjustment methods. An efficient method of adjusting the multiplier values is given. Computational results are reported that show the method to be quite effective. In addition, applications of the approach to other difficult location problems is discussed. © 1998 John Wiley & Sons, Inc. Naval Research Logistics 45: 791–815, 1998     

A critical look at the U.S. deceased‐donor organ procurement and utilization system

The U.S. system for procuring and utilizing deceased‐donor organs for transplantation has been studied and written about in many articles. The purpose of this paper is to examine the interactions between the elements that comprise this system, and point out improvement opportunities that may be affected through operations research/management techniques. The authors demonstrate the need for developing data‐driven and analytic tools. In fact, data is used to generate hypotheses and support claims throughout the paper. The paper also points out the need to fully leverage data that is available to researchers, and to seek data that is currently not deposited in a centralized archive.     

The applicability of acceptance sampling with respect to process stability and control

This article examines the applicability of acceptance sampling and the effectiveness of Deming's kp rule in relation to the degree of process stability achieved through statistical process control techniques. A discrete-event simulation model is used to characterize the correlation between the number of defective units in a randomly drawn sample versus in the remainder of a lot, in response to a number of system and control chart parameters. The model reveals that such correlation is typically present when special causes of variation affect the production process from time to time, even though the process is tightly monitored through statistical process control. Comparison of these results to an analogous mixed binomial scenario reveals that the mixed binomial model overstates the correlation in question if the state of the process is not necessarily constant during lot production. A generalization of the kp analysis is presented that incorporates the possibility of dependence between a sample and the unsampled portion of the lot. This analysis demonstrates that acceptance sampling is generally ineffective for lots generated by a process subject to statistical process control, despite the fact that the number of defectives in the sample and in the remainder of the lot are not strictly independent. © 1994 John Wiley & Sons, Inc.     

The effect of process adjustment error on X̄ chart design

The existing literature on economic design of X̄ process control charts generally assumes perfect process adjustment, such that the process mean is returned to an exactly centered “in control” state following any real or false alarm control chart signal. This paper presents a model which demonstrates the effects of imperfect process adjustment on the economically designed control chart parameters. The model demonstrates that the optimal control limit width depends fundamentally on the precision with which the process can be adjusted. The greater the process adjustment error, all else constant, the wider will be the optimal control limits, in order to alleviate the potential for process overcontrol and tampering effects. By endogenously modeling these effects, the new model helps to rectify the problem of poor statistical properties for which the economic design approach has been criticized. © 1999 John Wiley & Sons, Inc. Naval Research Logistics 46: 597–612, 1999     

The selection allocation problem

The Selection Allocation Problem (SAP) is a single period decision problem which involves selecting profit‐maximizing (or cost‐minimizing) activities from various distinct groups, and determining the volume of those activities. The activities in each group are selected subject to the availability of that group's resource, which is provided by either pooling or blending raw inputs from several potential sources. Imbedded in the decision process is the additional task of determining how much raw input is to be allocated to each group to form the resource for that group. Instances of this problem can be found in many different areas, such as in tool selection for flexible manufacturing systems, facility location, and funding for social services. Our goal in this paper is to identify and exploit special structures in the (SAP) and use those structures to develop an efficient solution procedure. © 1999 John Wiley & Sons, Inc. Naval Research Logistics 46: 707–725, 1999     

The determination of optimal base-stock inventory policy when the costs of under- and oversupply are uncertain

This article considers the determination of the optimal base-stock inventory policy for the newsboy inventory model when there is uncertainty about either or both of its basic cost inputs: either C_u, the marginal cost of an undersupply mistake, or C_o, the marginal cost of an oversupply mistake. Such uncertainties often arise in implementing the newsboy model, especially with respect to C_u, whose value depends mostly on the often-imponderable economic consequences of a lost sale or backorder. Given this uncertainty, we use decision theory to propose and analyze two measures of policy “goodness” and two base-stock selection criteria, which in combination provide four alternative “optimal” base-stock policies. Formulas and/or conditions defining each alternative policy are provided. Our empirical study indicates that the recommended policy can be quite sensitive to the measure/criterion chosen, and that the consequences of the wrong choice can be quite considerable.     

The ‘first’ surge: the repulse of the Easter Invasion in South Vietnam, 1972 – implications for Iraq and Afghanistan

In a military intervention, do surges work? I compare the failed ‘surge’ in Vietnam, the repulse of the Easter Invasion in 1972, as a means of assessing the more ambiguous surges in Iraq and Afghanistan. I identify four features of a surge for this analysis: the military dimensions and strategy of the surging forces, the military capabilities of the host forces, the political vitality and will of the host country, and the political commitment in the domestic politics of the intervener. I find that the last feature is the most critical; and, in all three surges, the American political commitment was lacking.     

Ireland: rebellion and counter-insurgency, 1848–1867

ABSTRACT

The period 1848 to 1867 witnessed what could be regarded as a very small-scale insurgency campaign in Ireland, waged by agrarian groups; the Whiteboys and Ribbonmen. 1848 and 1867 witnessed rebellions by the Young Irelanders and Fenians, which proved to be small-scale and of short duration but the British government had prepared for a nationwide counter-insurgency campaign. The government relied heavily on the militarised Irish Constabulary but in 1848 and 1867 troops were used in large numbers and there were concerns about how they could be best concentrated to meet the envisaged threat.