In the aftermath of a large disaster, the routing of vehicles carrying critical supplies can greatly impact the arrival times to those in need. Since it is critical that the deliveries are both fast and fair to those being served, it is not clear that the classic cost-minimizing routing problems properly reflect the priorities relevant in disaster relief. In this paper, we take the first steps in developing new methodologies for these problems. We focus specifically on two alternative objective functions for the TSP and VRP: one that minimizes the maximum arrival time (minmax) and one that minimizes the average arrival time (minavg). To demonstrate the potential impact of using these new objective functions, we bound the worst case performance of optimal TSP solutions with respect to these new variants and extend these bounds to include multiple vehicles and vehicle capacity. Similarly, we examine the potential increase in routing costs that result from using these alternate objectives. We present solution approaches for these two variants of the TSP and VRP which are based on well known insertion and local search techniques. These are used in a series of computational experiments to help identify the types of instances where TSP and VRP solutions can be significantly different from optimal minmax and minavg solutions.

Several forms of exercise appear to be safe interventions for clinicians to use when treating this population and offer benefits such as improved quality of life, strength, body mass index, and mental health and decreased pain and lymphatic swelling. Additional research should be conducted to further examine the efficacy and safety of nontraditional forms of exercise in the treatment of BCRL.

A significant redistribution of cholesterol in lipoproteins following ingestion of large doses of D,L-alpha tocopherol (vitamin E) is documented. In persons with decreased high-density lipoprotein (HDL) cholesterol a complex response occurs, which includes cholesterol redistribution in favor of the HDL fraction, with decreases in very-low-density lipoprotein (VLDL) levels and total triglycerides. The response was studied in five persons with average cholestrol distributions and five persons with cholesterol distributions associated with high risk of coronary heart disease. The mean elevation of the HDL cholesterol concentration in the former group was 168% of the initial value, while the latter group experienced post-therapy levels 375% of initial levels.

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The occurrence of a compound nevus in an ovarian benign cystic teratoma is presented. This appears to be the first report of this lesion in the ovary without coincident melanoma. The case illustrates a probable origin for ovarian melanoma and raises a question concerning the origin of the melanocyte.