Crew Rostering for the High Speed Train

At the time of writing we entered the final stage of implementing the crew rostering system Harmony CDR to facilitate the planning of catering crews on board of the Thalys, the High Speed Train connecting Paris, Cologne, Brussels, Amsterdam, and Geneva. Harmony CDR optimally supports the creation of crew rosters in two ways. Firstly, Harmony CDR contains a powerful algorithm to automatically generate a set of rosters, which is especially developed for this specific situation. As the user has some control over the objectives of the algorithm, several scenarios can be studied before a set of rosters is adopted. An important feature of the automatic roster generator is that it respects requirements, directives, and requests stemming from legal, union, and/or company regulations and/or from individual crew. Secondly, Harmony CDR provides user-interface data manipulation at various levels of detail. The user interface enables the planner to easily obtain many different views on the planning data and to manipulate the planning manually. So again, the planner gets optimal support from the system while he or she is still in control. Also, violating a requirement, directive, or request is detected and displayed, but can be accepted by the planner. In this paper we describe the crew rostering problem for the catering crews of the High Speed Train and the Harmony CDR solution in more detail.decision support systems;railways;crew rostering

Crew Rostering for the High Speed Train

At the time of writing we entered the final stage of implementing the crew rostering system Harmony CDR to facilitate the planning of catering crews on board of the Thalys, the High Speed Train connecting Paris, Cologne, Brussels, Amsterdam, and Geneva. Harmony CDR optimally supports the creation of crew rosters in two ways. Firstly, Harmony CDR contains a powerful algorithm to automatically generate a set of rosters, which is especially developed for this specific situation. As the user has some control over the objectives of the algorithm, several scenarios can be studied before a set of rosters is adopted. An important feature of the automatic roster generator is that it respects requirements, directives, and requests stemming from legal, union, and/or company regulations and/or from individual crew. Secondly, Harmony CDR provides user-interface data manipulation at various levels of detail. The user interface enables the planner to easily obtain many different views on the planning data and to manipulate the planning manually. So again, the planner gets optimal support from the system while he or she is still in control. Also, violating a requirement, directive, or request is detected and displayed, but can be accepted by the planner. In this paper we describe the crew rostering problem for the catering crews of the High Speed Train and the Harmony CDR solution in more detail

Acute Ankle Sprains in Primary Care

Of all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur during sport, of which 43,000 seek for medical care. The latest statistics in the Netherlands show that general practitioners (GPs) see around 125,000 patients with an ankle sprain each year, with an incidence of eight per thousand patients per year. In the Netherlands, currently there are three clinical guidelines which deal with the diagnosis and treatment of acute lateral ankle injuries. These guidelines roughly correspond with each other and recommend conventional treatment as the primary treatment modality of choice. Conventional treatment consists of early mobilizing, early weight bearing (as much as the pain will allow) combined with (or without) the use of an external support, e.g. tape, brace or bandage. Acute lateral ankle ligaments injuries are treated in various ways. However, before being able to evaluate the eff ectiveness of therapeutic interventions, we need insight into the course of recovery after an acute lateral ankle injury. Benefi cial eff ects or complications of diff erent treatments may be considered against the background of this clinical course. In addition, the identifi cation of relevant subgroups of patients with better or worse prognosis is also important. This may guide management decisions, give directions for future research, and is helpful when informing patients about the clinical course of their injury. Therefore, we performed a systematic review to provide an overview of the literature evaluating the clinical course of conventionally treated acute lateral ankle sprains in adults, and possible prognostic factors for incomplete recovery of this injury

Associations between work-related factors and specific disorders of the shoulder - A systematic review of

Objective: Our aim was to provide a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the occurrence of specific shoulder disorders in occupational populations. Methods: A systematic review of the literature was conducted on the associations between type of work, physical load factors, and psychosocial aspects at work, on the one hand, and the occurrence of tendinitis of the biceps tendon, rotator cuff tears, subacromial impingement syndrome (SIS), and suprascapular nerve compression, on the other hand. Associations between work factors and shoulder disorders were expressed in quantitative measures as odds ratio (OR) or relative risk (RR). Results: The occurrence of SIS was associated with force requirements >10% maximal voluntary contraction (MVC), lifting >20 kg >10 times/day, and high-level of hand force >1 hour/day (OR 2.8-4.2). Repetitive movements of the shoulder, repetitive motion of the hand/wrist >2 hours/day, hand-arm vibration, and working with hand above shoulder level showed an association with SIS (OR 1.04-4.7) as did upper-arm flexion ≥45° ≥15% of time (OR 2.43) and duty cycle of forceful exertions ≥9% time or duty cycle of forceful pinch >0% of time (OR 2.66). High psychosocial job demand was also associated with SIS (OR 1.5-3.19). Jobs in the fish processing industry had the highest risk for both tendinitis of the biceps tendon as well as S

The Association Between Training Load and Injury Risk in Elite Youth Soccer Players: a Systematic Review and Best Evidence Synthesis

Background: Injury risk in elite youth soccer players is high. Implementing an optimal training load is of utmost importance to reduce the risk of injuries. Objective: To conduct a systematic review and best evidence synthesis to explore the effects of internal and external training load on injury

What is the clinical course of transient synovitis in children: A systematic review of the literature

Background: Transient synovitis of the hip (TS) is considered to be a self-limiting disease in childhood. However, because the etiology is unclear and some cases precede Legg-Perthes' disease, data on follow-up are important. Our aim was to summarize the knowledge on the clinical course of TS in children. Methods: The study design was a systematic review and a literature search was conducted in Medline and Embase. Studies describing short and/or long-term follow-up of TS in children were included. Case reports, reviews and studies describing traumatic hip pain were excluded. Study quality was scored and data extraction was performed. The main outcome measures were short-term and long-term clinical course, and recurrence of symptoms. Results: A total of 25 studies were included of which 14 were of high quality. At two-week follow-up, almost all children with TS were symptom free. Those with symptoms persisting for over one month were more prone to develop other hip pathology, such as Legg-Perthes' disease. The recurrence rate of TS ranged from 0-26.3%. At long-term follow-up, 0-10% of the children diagnosed with TS developed Legg-Perthes' disease. Hip pain after intensive physical effort and limited range of motion of the hip at long-term follow-up was reported in 12-28% and in 0-18% of the children, respectively.Conclusions: The majority of the studies indicate that children with TS recover within two weeks; recurrence was seen in 0-26% of the cases. Children with TS should be followed at least six months to increase the likelihood of not missing Legg-Perthes' disease

The impact of injury definitions on measures of injury occurrence in classical music students: a prospective cohort study

BACKGROUND: Multiple definitions are used to investigate injuries in musicians, resulting in a wide range of prevalence rates. The aim of this study is to establish the impact of different injury definitions on the prevalence of injuries and disability in classical music students. Moreover, the practical implications of using different injury definitions are considered. METHODS: A prospective cohort study among first-year classical music students was performed using bi-monthly questionnaires focusing on injuries. Three injury definitions were used: 1) all MSK complaints injury (any MSK complaint resulting in a VAS pain score > 0 in the past eight weeks), 2) medical attention injury (any MSK complaint that resulted in a student consulting a health provider in the past eight weeks), 3) time-loss injury (any MSK complaint t

Prevalence and development of hip and knee osteoarthritis according to American College of Rheumatology criteria in the CHECK cohort

_Background:_ We aimed to evaluate the prevalence of hip and knee osteoarthritis (HOA and KOA) according to American College of Rheumatology (ACR) criteria among participants with suspected early symptomatic osteoarthritis (OA) in the CHECK cohort. We also assessed whether participants not fulfilling ACR criteria at baseline develop ACR-defined OA at 2-year and/or 5-year follow up, and which baseline factors are associated with this development. _Methods:_ The CHECK cohort included 1002 subjects with first presentation of knee and/or hip complaints. The primary outcome was onset of HOA and/or KOA according to the ACR criteria, including the clinical classification criteria and the combined clinical and radiographic classification criteria at 2-year and/or 5-year follow up. _Results:_ Of the participants with hip complaints, 63% (n = 370) were classified as having HOA at baseline according to the ACR criteria. Of those not classified with HOA at baseline, 40% developed HOA according to the clinical or combined clinical/radiographic ACR criteria after 2 and/or 5 years. Up to 92% of participants (n = 829) with knee complaints were classified as having KOA at baseline; of those not classified with KOA at baseline, 55% developed KOA according to the clinical ACR criteria or the clinical/radiographic ACR criteria after 2 and/or 5 years. The following factors were associated with development of HOA: morning stiffness (OR 2.39; 95% CI 1.14-4.98), painful internal rotation (OR 2.53; 95% CI 1.23-5.19), hip flexion < 115° (OR 2.33; 95% CI 1.17-4.64) and erythrocyte sedimentation rate (ESR) < 20 mm/h (OR 2.94; 95% CI 1.13-7.61). No variables were associated with development o

Study protocol for a multicenter randomized controlled trial to compare the efficacy of end-ischemic dual hypothermic oxygenated machine perfusion with static cold storage in preventing non-anastomotic biliary strictures after transplantation of liver grafts donated after circulatory death: DHOPE-DCD trial

Background: The major concern in liver transplantation of grafts from donation after circulatory death (DCD) donors remains the high incidence of non-anastomotic biliary strictures (NAS). Machine perfusion has been proposed as an alternative strategy for organ preservation which reduces ischemia-reperfusion injury (IRI). Experimental studies have shown that dual hypothermic oxygenated machine perfusion (DHOPE) is associated with less IRI, improved hepatocellular function, and better preserved mitochondrial and endothelial function compared to conventional static cold storage (SCS). Moreover, DHOPE was safely applied with promising results in a recently performed phase-1 study. The aim of the current study is to determine the efficacy of DHOPE in reducing the incidence of NAS after DCD liver transplantation. Methods: This is an international multicenter randomized controlled trial. Adult patients (≥18 yrs. old) undergoing transplantation of a DCD donor liver (Maastricht category III) will be randomized between the intervention and control group. In the intervention group, livers will be subjected to two hours of end-ischemic DHOPE after SCS and before implantation. In the control group, livers will be subjected to care as usual with conventional SCS only. Primary outcome is the incidence of symptomatic NAS diagnosed by a blinded adjudication committee. In all patients, magnetic resonance cholangiography will be obtained at six months after transplantation. Discussion: DHOPE is associated with reduced IRI of the bile ducts. Whether reduced IRI of the bile ducts leads to lower incidence of NAS after DCD liver transplantation can only be examined in a randomized controlled trial. Trial registration: The trial was registered in Clinicaltrials.gov in September 2015 with the identifier NCT02584283