96 research outputs found
Operations research in passenger railway transportation
In this paper, we give an overview of state-of-the-art OperationsResearch models and techniques used in passenger railwaytransportation. For each planning phase (strategic, tactical andoperational), we describe the planning problems arising there anddiscuss some models and algorithms to solve them. We do not onlyconsider classical, well-known topics such as timetabling, rollingstock scheduling and crew scheduling, but we also discuss somerecently developed topics as shunting and reliability oftimetables.Finally, we focus on several practical aspects for each of theseproblems at the largest Dutch railway operator, NS Reizigers.passenger railway transportation;operation research;planning problems
Shunting of Passenger Train Units in a Railway Station
In this paper we introduce the problem of shunting passenger trainunits in a railway station. Shunting occurs whenever train units aretemporarily not necessary to operate a given timetable. We discussseveral aspects of this problem and focus on two subproblems. Wepropose mathematical models for these subproblems together with asolution method based on column generation. Furthermore, a newefficient and speedy solution technique for pricing problems in columngeneration algorithms is introduced. Finally, we present computationalresults based on real life instances from Netherlands Railways.logistics;column generation;railway optimization;real world application
Differences between physicians in the likelihood of referral and acceptance of elderly patients for dialysis-influence of age and comorbidity
BACKGROUND: Incidence of dialysis in elderly patients in the Netherlands is low compared to other countries. This study aims to assess the impact of patients' age and comorbidity on the likelihood of referral and acceptance of patients for dialysis and whether this is affected by physician characteristics. METHODS: A vignette study was performed among 209 primary care physicians, 162 non-nephrology specialists and 20 nephrologists working in the north of the Netherlands. Physicians were offered six vignettes concerning case-reports of patients with end-stage renal disease (ESRD) and varying comorbidities or circumstances and asked about the likelihood of referral/acceptance of the patient in the given circumstances. RESULTS: The likelihood of referral within groups of physicians varied widely, especially within the group of primary care physicians and non-nephrology specialists, but was not affected by characteristics of physicians. The likelihood of referral or acceptance of patients for dialysis depended on the patient's age, and type and severity of comorbidity. In general, primary care physicians and non-nephrology specialists were less likely to refer than nephrologists were to accept. Differences within and between groups of physicians were larger for 80- than for 65-year-old patients, and for patients with less severe shortness of breath and cognitive impairments and more severe diabetes and social impairments. Hardly any differences were found for patients with cancer. CONCLUSION: Patients' age and comorbidities affect the likelihood of referral. Differences between groups of physicians suggest that there is insufficient agreement on the extent to which these factors should affect the referral/acceptance of patients for dialysis. These findings underline the need for more research into circumstances under which patients might benefit from dialysis. Guidelines should be developed to improve the referral of elderly and less healthy patients
Shunting of Passenger Train Units in a Railway Station
In this paper we introduce the problem of shunting passenger train
units in a railway station. Shunting occurs whenever train units are
temporarily not necessary to operate a given timetable. We discuss
several aspects of this problem and focus on two subproblems. We
propose mathematical models for these subproblems together with a
solution method based on column generation. Furthermore, a new
efficient and speedy solution technique for pricing problems in column
generation algorithms is introduced. Finally, we present computational
results based on real life instances from Netherlands Railways
Solution Approaches for Vehicle and Crew Scheduling with Electric Buses
The use of electric buses is expected to rise due to its environmental benefits. However, electric vehicles are less exible than conventional diesel buses due to their limited driving range and longer recharging times. Therefore, scheduling electric vehicles adds further operational dificulties. Additionally, various labor regulations challenge public transport companies to find a cost-effcient crew schedule. Vehicle and crew scheduling problems essentially define the cost of operations. In practice, these two problems are often solved sequentially. In this paper, we introduce the integrated electric vehicle and crew scheduling problem (E-VCSP). Given a set of timetabled trips and recharging stations, the E-VCSP is concerned with finding vehicle and crew schedules that cover the timetabled trips and satisfy operational constraints, such as limited driving range of electric vehicles and labor regulations for the crew while minimizing total operational cost. An adaptive large neighborhood search that utilizes branch-and-price heuristics is proposed to tackle the E-VCSP. The proposed method is tested on real-life instances from public transport companies in Denmark and Sweden that contain up to 1,109 timetabled trips. The heuristic approach provides evidence of improving efficiency of transport systems when the electric vehicle and crew scheduling aspects are considered simultaneously. By comparing to the traditional sequential approach, the heuristic finds improvements in the range of 1.17-4.37% on average. A sensitivity analysis of the electric bus technology is carried out to indicate its implications for the crew schedule and the total operational cost. The analysis shows that the operational cost decreases with increasing driving range (120 to 250 kilometers) of electric vehicles
Effectiveness of endosponge therapy for the management of presacral abscesses following rectal surgery
Cellular mechanisms in basic and clinical gastroenterology and hepatolog
Inter- and Intra-Observer Variability and the Effect of Experience in Cine-MRI for Adhesion Detection
Cine-MRI for adhesion detection is a promising novel modality that can help the large group of patients developing pain after abdominal surgery. Few studies into its diagnostic accuracy are available, and none address observer variability. This retrospective study explores the inter- and intra-observer variability, diagnostic accuracy, and the effect of experience. A total of 15 observers with a variety of experience reviewed 61 sagittal cine-MRI slices, placing box annotations with a confidence score at locations suspect for adhesions. Five observers reviewed the slices again one year later. Inter- and intra-observer variability are quantified using Fleiss’ (inter) and Cohen’s (intra) κ and percentage agreement. Diagnostic accuracy is quantified with receiver operating characteristic (ROC) analysis based on a consensus standard. Inter-observer Fleiss’ κ values range from 0.04 to 0.34, showing poor to fair agreement. High general and cine-MRI experience led to significantly (p < 0.001) better agreement among observers. The intra-observer results show Cohen’s κ values between 0.37 and 0.53 for all observers, except one with a low κ of −0.11. Group AUC scores lie between 0.66 and 0.72, with individual observers reaching 0.78. This study confirms that cine-MRI can diagnose adhesions, with respect to a radiologist consensus panel and shows that experience improves reading cine-MRI. Observers without specific experience adapt to this modality quickly after a short online tutorial. Observer agreement is fair at best and area under the receiver operating characteristic curve (AUC) scores leave room for improvement. Consistently interpreting this novel modality needs further research, for instance, by developing reporting guidelines or artificial intelligence-based methods.</p
Colourful coexistence of red and green picocyanobacteria in lakes and seas
Hutchinson's paradox of the plankton inspired many studies on the mechanisms of species coexistence. Recent laboratory experiments showed that partitioning of white light allows stable coexistence of red and green picocyanobacteria. Here, we investigate to what extent these laboratory findings can be extrapolated to natural waters. We predict from a parameterized competition model that the underwater light colour of lakes and seas provides ample opportunities for coexistence of red and green phytoplankton species. To test this prediction, we sampled picocyanobacteria of 70 aquatic ecosystems, ranging from clear blue oceans to turbid brown peat lakes. As predicted, red picocyanobacteria dominated in clear waters, whereas green picocyanobacteria dominated in turbid waters. We found widespread coexistence of red and green picocyanobacteria in waters of intermediate turbidity. These field data support the hypothesis that niche differentiation along the light spectrum promotes phytoplankton biodiversity, thus providing a colourful solution to the paradox of the plankton
Diagnostic value of radiological staging and surveillance for T1 colorectal carcinomas: a multicenter cohort study
Background: The role of radiological staging and surveillance imaging is under debate for T1 colorectal cancer (CRC) as the risk of distant metastases is low and imaging may lead to the detection of incidental findings. Objective: The aim of this study was to evaluate the yield of radiological staging and surveillance imaging for T1 CRC. Methods: In this retrospective multicenter cohort study, all patients of 10 Dutch hospitals with histologically proven T1 CRC who underwent radiological staging in the period 2000-2014 were included. Clinical characteristics, pathological, endoscopic, surgical and imaging reports at baseline and during follow-up were recorded and analyzed. Patients were classified as high-risk T1 CRC if at least one of the histological risk factors (lymphovascular invasion, poor tumor differentiation, deep submucosal invasion or positive resection margins) was present and as low-risk when all risk factors were absent. Results: Of the 628 included patients, 3 (0.5%) had synchronous distant metastases, 13 (2.1%) malignant incidental findings and 129 (20.5%) benign incidental findings at baseline staging. Radiological surveillance was performed among 336 (53.5%) patients. The 5-year cumulative incidence of distant recurrence, malignant and benign incidental findings were 2.4% (95% confidence interval (CI): 1.1%-5.4%), 2.5% (95% CI: 0.6%-10.4%) and 18.3% (95% CI: 13.4%-24.7%), respectively. No distant metastatic events occurred among low-risk T1 CRC patients. Conclusion: The risk of synchronous distant metastases and distant recurrence in T1 CRC is low, while there is a substantial risk of detecting incidental findings. Radiological staging seems unnecessary prior to local excision of suspected T1 CRC and after local excision of low-risk T1 CRC. Radiological surveillance should not be performed in patients with low-risk T1 CRC.Cellular mechanisms in basic and clinical gastroenterology and hepatolog
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