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Background: Direct oral anticoagulants (DOACs) are rapidly replacing warfarin for therapeutic anticoagulation; however, many DOACs are irreversible and may complicate bleeding in emergent situations such as hip fracture. In this setting, there is a lack of clear guidelines for the timing of surgery. The purpose of this study was to evaluate the current practices of Canadian orthopedic surgeons who manage patients with hip fracture receiving anticoagulation. Methods: In January-March 2018, we administered a purpose-specific cross-sectional survey to all currently practising orthopedic surgeons in Canada who had performed hip fracture surgery in 2017. The survey evaluated approaches to decision-making and timing of surgery in patients with hip fracture receiving anticoagulation. Results: A total of 280 surgeons representing a mix of academic and community practice, seniority and fellowship training responded. Nearly one-quarter of respondents (66 [23.4%]) were members of the Canadian Orthopaedic Trauma Society (COTS). Almost three-quarters (206 [73.6%]) felt that adequate clinical guidelines for patients with hip fracture receiving anticoagulation did not exist, and 177 (61.9%) indicated that anesthesiology or internal medicine had a greater influence on the timing of surgery than the attending surgeon. A total of 117/273 respondents (42.9%) indicated that patients taking warfarin should have immediate surgery (with or without reversal), compared to 63/270 (23.3%) for patients taking a DOAC (p < 0.001). Members of COTS were more likely than nonmembers to advocate for immediate surgery in all patients (p < 0.05). Conclusion: There is wide variability in Canada in the management of patients with hip fracture receiving anticoagulation. Improved multidisciplinary communication, prospectively evaluated treatment guidelines and focus on knowledge translation may add clarity to this issue. Level of evidence: IV. Contexte : Les anticoagulants oraux directs (AOD) prennent rapidement la place de la warfarine en anticoagulotherapie; or, de nombreux AOD sont irreversibles et peuvent compliquer une hemorragie en cas d'incident comme une fracture de la hanche. Dans ce contexte, il n'y a pas de recommandations claires pour choisir le moment de l'operation. Cette etude avait pour but d'evaluer les pratiques actuelles des chirurgiens orthopedistes canadiens qui traitent des patients avec fracture de la hanche sous anticoagulotherapie. Methodes : De janvier a mars 2018, nous avons realise un sondage transversal cible aupres des chirurgiens orthopedistes en exercice au Canada qui avaient opere des hanches fracturees en 2017. Ce sondage a servi a evaluer leurs approches concernant la prise de decision et le moment choisi pour operer les patients avec fracture de la hanche sous anticoagulotherapie. Resultats : Au total, 280 chirurgiens representant une multitude de cliniques universitaires et communautaires, de niveaux d'anciennete et de surspecialites ont participe. Pres du quart des repondants (66 [23,4 %]) etaient membres de la Canadian Orthopaedic Trauma Society (COTS). Pres des trois quarts (206 [73,6 %]) consideraient qu'il n'y avait pas de directives cliniques adequates pour les cas de fracture de la hanche sous anticoagulotherapie, et 177 (61,9 %) ont indique que l'anesthesie ou la medecine interne avait une plus grande influence que le chirurgien traitant sur le moment choisi pour operer. Selon 117 repondants sur 273 (42,9 %), les patients prenant de la warfarine devraient etre operes sans delai (avec ou sans reversibilite), comparativement a 63 sur 270 (23,3 %) pour les patients prenant des AOD (p < 0,001). Les membres de la COTS etaient plus susceptibles que les autres de preconiser une operation immediate chez tous les patients (p < 0,05). Conclusion : Au Canada, la prise en charge des patients avec fracture de la hanche sous anticoagulotherapie varie considerablement. Le fait d'ameliorer la communication transdisciplinaire, d'evaluer prospectivement les directives sur les traitements et de tabler sur l'application des connaissances pourrait clarifier la question. Niveau de preuve : IV., Warfarin, a vitamin K antagonist, was first used in humans in the mid-20th century. It has since become commonly used worldwide for therapeutic anticoagulation of atrial fibrillation, thrombosis and valvular [...]

Driver fatigue is a major cause of road crashes. However, there is limited knowledge regarding the potential consequences of driver fatigue in taxi (conventional and app-based), ride-hailing, and ridesharing services. Driver fatigue is likely to be significantly exacerbated in this population due to the multi-task characteristics of their jobs; thus, conducting a comprehensive study on driver fatigue in these transportation sectors is of utmost importance. This systematic review summarises the current state of knowledge about the causes and consequences of driver fatigue. We also suggested some potential control mechanisms for driver fatigue in taxi and ride-hailing services along a fatigue risk trajectory. We included studies published prior to September 2022 in three databases (Web of Science, Scopus, and PubMed) using a predefined search strategy. Eligible studies were critically appraised using the Joanna Briggs Institute (JBI) critical appraisal checklists. A total of 18 studies met our eligibility criteria as scoped from the 414 initially identified studies. Eight contributing factors to driver fatigue were revealed including long working hours, short rest breaks, limited driving experience, job demand, poor sleep, algorithmic management, traffic congestion, and additional workload. Furthermore, our review identified risk factors for driver fatigue in taxi and ride-hailing services, including road safety, work pressure and driver's health, optimism bias, job precariousness, and lack of additional benefits. Findings to date suggest that driver fatigue in taxi and ride-hailing industries is as serious as, or more serious than, in other transportation sectors. Understanding the working conditions of these drivers is critical to establish effective policies and practices for reducing crash-related driver fatigue. [ABSTRACT FROM AUTHOR]

This study proposes a methodology for the calibration of microscopic traffic flow simulation models by enabling simultaneous selection of traffic links and associated parameters. The analyst selects any number and combination of links and model parameters for calibration. Most calibration methods consider the entire network and use ad hoc approaches without enabling a specific selection of location and associated parameters. In practice, only a subset of links and parameters is used for calibration based on several factors such as expert knowledge of the system or constraints imposed by local governance. In this study, the calibration problem for the simultaneous selection of links and parameters was formulated using a mathematical programming approach. The proposed methodology is capable of calibrating model parameters considering multiple time periods and performance measures simultaneously. Traffic volume and speed are the performance measures used in this study, and the methodology is developed without considering the characteristics of a specific traffic flow model. A genetic algorithm was implemented to find a solution to the proposed mathematical program. In the experiments, two traffic models were calibrated: the first set of experiments included selection of links only, while all associated parameters were considered for calibration. The second set of experiments considered simultaneous selection of links and parameters. The implications of these experiments indicate that the models were calibrated successfully subject to selection of a minimum number of links. As expected, the more links and parameters that are used for calibration, the more time it takes to find a solution, but the overall results are better. All parameter values were reasonable and within constraints after successful calibration., Author(s): Alexander Paz (corresponding author) [1]; Kul Shrestha [2]; Cristian Arteaga [3]; Douglas Baker [4] 1. Introduction Microscopic traffic flow simulation is increasingly being used to analyze complex scenarios for [...]

Numerous studies have established strong connections between air traffic and economic growth at the regional level. However, without consideration of individual airports' immediate vicinities, this aggregate view can lead to an overly simplistic conclusion about the role of airports in their urban environment. The impact of airports on local economic development is evaluated through a case study of Brisbane Airport by using primary data sourced from semi-structured interviews and a survey. The results demonstrate that the role of airports as transport hubs is not the dominant mechanism that drives industries to locate in airport areas. Rather, the local urban context is a dominant driver for development in and around airports. Based on the survey and interview results, urbanization economies have the highest significance on the landside industrial location decision, with a mean of 3.53 in terms of importance level. The findings provide a reference for policymakers regarding investment in airport expansion or construction, as well as a refinement of the understanding of the local economic impact of airports. [ABSTRACT FROM AUTHOR]