ABSTRACT
Abstract: The global scientific community has intensified efforts to develop, test, and commercialize pharmaceutical products to deal with the COVID-19 pandemic. Trials for both antivirals and vaccines are in progress; candidates include existing repurposed drugs that were originally developed for other ailments. Once these are shown to be effective, their production will need to be ramped up rapidly to keep pace with the growing demand as the pandemic progresses. It is highly likely that the drugs will be in short supply in the interim, which leaves policymakers and medical personnel with the difficult task of determining how to allocate them. Under such conditions, mathematical models can provide valuable decision support. In particular, useful models can be derived from process integration techniques that deal with tight resource constraints. In this paper, a linear programming model is developed to determine the optimal allocation of COVID-19 drugs that minimizes patient fatalities, taking into account additional hospital capacity constraints. Two hypothetical case studies are solved to illustrate the computational capability of the model, which can generate an allocation plan with outcomes that are superior to simple ad hoc allocation.
ABSTRACT
The aims of this retrospective analysis were (i) to examine the trends of quality of life (QoL) scores and (ii) to identify the risk factors for QoL scores among 6908 dialysis patients entering dialysis between 1997 and 2002. The Spitzer QoL Index was the instrument used by the National Renal Registry of Malaysia to assess the QoL amongst dialysis patients. Demographic and biochemical data were analysed to identify risk factors for poor QoL. The median QoL-index score ranged between 9 and 10. Significant risk factors for poor QoL were female gender, age > 40, diabetes, cohort starting dialysis 2001-2002, haemodialysis modality, body mass index < 18.5, albumin < 30g/dL, cholesterol < 3.2 mmol/L, haemoglobin < 10 g/dL, diastolic blood pressure of > 90 mHg, iPTH < 100 pg/ml. The overall QoL of dialysis patients is satisfactory. The negative impact of diabetes and haemodialysis on QoL warrants further evaluation as each factor involves 50% and 90% of our dialysis population.
