Objective: This paper investigates the impact on emergency hospital services from initiation through recovery of a ransomware attack affecting the emergency department, intensive care unit and supporting laboratory services. Recovery strategies of paying ransom to the attackers with follow-on restoration and in-house full system restoration from backup are compared. Methods: A multi-unit, patient-based and resource-constrained discrete-event simulation model of a typical U.S. urban tertiary hospital is adapted to model the attack, its impacts, and tested recovery strategies. The model is used to quantify the hospital's resilience to cyberattack. Insights were gleaned from systematically designed numerical experiments. Results: While paying the ransom was found to result in some short-term gains assuming the perpetrators actually provide the decryption key as promised, in the longer term, the results of this study suggest that paying the ransom does not pay off. Rather, paying the ransom, when considered at the end of the event when services are fully restored, precluded significantly more patients from receiving critically needed care. Also noted was a lag in recovery for the intensive care unit as compared with the emergency department. Such a lag must be considered in preparedness plans. Conclusion: Vulnerability to cyberattacks is a major challenge to the healthcare system. This paper provides a methodology for assessing the resilience of a hospital to cyberattacks and analyzing the effects of different response strategies. The model showed that paying the ransom resulted in short-term gains but did not pay off in the longer term.

Drought and decrease in the level of lakes in recent years due to global warming and excessive use of water resources feeding lakes is of great importance and this research has provided a structure to investigate this issue. First, the information required for simulating lake drought is provided with strong references and necessary assumptions. Entity-Component-System (ECS) structure has been used for simulation which can consider assumptions flexibly in simulation. Three major users (i.e., Industry, agriculture, and Domestic users) consume water from ground water and surface water (i.e., streams, rivers and lakes). Lake Mead has been considered for simulation, and the information necessary to investigate its drought has also been provided. The results are presented in the form of scenario-based design and optimal strategy selection. For optimal strategy selection a deep reinforcement algorithm is developed to select the best set of strategies among all possible projects. These results can provide a better view of how to plan to prevent lake drought.

Purpose: The ability to replicate global supply chain (SC) structures is important for maintaining and improving the operations of global SCs. This structure, while known to specific manufacturers and key suppliers, is not generally published and may not be totally transparent to all stakeholders. This paper presents a methodology for replicating the structure of global SCs with limited, publicly available data. Design/methodology/approach: The proposed SC replication method decomposes the multi-echelon SC into a set of duo-echelon models, each focused on a single commodity, which are reconstituted for a complete representation of the SC for improved computational efficiency. Flows of raw materials, middle products (product components) and end-products for each duo-echelon model are obtained from a developed stacked machine learning method using only publicly available information. The duo-echelon models are integrated into a final multi-echelon, multi-commodity SC representation. Findings: The method was applied to a case study of lithium-ion battery production. The findings underscore the model’s capability to capture complex trade relationships and global SC dynamics. Further, the method outperformed numerous other approaches. Originality/value: This paper proposes a novel approach to estimating global SC structures, including complexities from their multi-commodity and multi-echelon nature, using publicly available data.

1. Ports are critical nodes in global supply chains, enabling the movement of goods, materials and sources of energy, such as crude oil and liquid natural gas. The operation of ports is essential f...