Advanced Low-Floor Vehicle (ALFV) Specification Research

This report details the results of research on market comparison, operational cost efficiencies, and prototype tests conducted on a novel design for an Advanced Low Floor Vehicle (ALFV), flex-route transit bus. Section I describes how the need for such a bus arises from a combination of diminishing transit funding from the federal government and demographic and transportation factors. Section II describes the unique features of this bus design that render it suitable for rural and urban operation, including improved transit passenger and wheelchair accessibility, reduced maintenance, structural design features, safety provisions, and the technical specifications of this design. Section III details the potential differences in capital and operational costs of procuring and operating this bus in a fleet. Potential cost reductions due to the long-life vehicle concept, maneuverability, operational savings (from APTA Bus Roadeo tests), and reserve fleet savings are explored. Section IV refers to the Federal Transit Administration (FTA) new model bus tests (“Altoona Testing”). However, at the this time, the Altoona Bus Test Report for these tests is not yet released by the bus manufacturer, Ride Solution, Inc., as is its right under the Bus Testing Regulation. The report must be released to the public before this bus can be purchased by a transit agency using FTA funds. In addition to the standard Altoona Bus Test, additional research was conducted to determine the turning ability, suspension travel, ramp travel index, field of view for the driver, compliance to Americans with Disabilities Act (ADA) requirements, and timed assessment of wheelchair securement. Section IV also presents the results of these tests. Section V presents results from a market comparison that included the buses in this mid-size category that were tested at Altoona and are expected to be available for FTA grantees to purchase. The specifications and performance of the ALFV bus are compared with these buses. Section VI presents a flex-route utilization plan, and Section VII provides the results from a survey of transit professionals about their interest in the features of this bus design. Section VIII gives Ride Solution’s experience in developing the concept for ALFV. Conclusions of this report are presented in Section IX, followed by the references and appendices

Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo