Search Results (13)

Developing policy instruments related to urban freight, such as congestion pricing, urban consolidation schemes, and off-hours delivery, requires an understanding of the distribution of shipment delivery times. Furthermore, agent-based urban freight simulators use relevant information (shipment delivery time distribution or vehicle tour start time distribution) as input to simulate tour generation. However, studies focusing on shipment delivery time-period selection modeling are very limited. In this study, we propose a method using GPS trajectory data from the Tokyo Metropolitan Area to estimate a shipment delivery time-period selection model based on pseudo-shipment records inferred from GPS data. The results indicate that shipment distance, size, and destination attributes can explain the delivery times of goods. Moreover, we demonstrate the practicality of the model by comparing the simulation result with the observed data for three areas with distinct characteristics, concluding that the model could be applied to urban freight simulation models for accurately reproducing spatial heterogeneity in shipment delivery time periods. This study contributes to promoting smart city development and management by proposing a method to use big data to better understand deliveries and support the development of relevant advanced city logistics solutions. Full article

Background: Due to the remarkable growth in online retail sales in New Zealand, a large number of parcels are needed to be delivered to consumers’ doorsteps. Home deliveries in major New Zealand cities (e.g., Christchurch) typically occur between 9 a.m. and 6 p.m. on weekdays, when many home delivery attempts fail. This leads to adverse effects, such as vehicular traffic in residential areas and greater air pollution per parcel delivered. However, home deliveries outside of typical business hours (i.e., before 9 a.m. and after 5 p.m.) might be worthwhile to help subside the above issues. Therefore, this study investigated consumers’ preferences for receiving home deliveries during various times, such as early morning, morning, afternoon, late afternoon, and evening. Methods: The data used in this study were obtained via an online survey of 355 residents of Christchurch city. Non-parametric tests, namely the Friedman test, Wilcoxon signed-rank test, and ordinal logistic regression, were carried out to examine consumer preferences for the above time slots. Results: The results showed that consumers preferred the late afternoon (3 p.m. to 6 p.m.) time slot the most for receiving home deliveries. Conclusion: It appeared that the off-peak delivery option is less likely to draw the desired consumer patronage and is thus less likely to assist in lowering the number of unsuccessful home deliveries, the transportation costs incurred by service providers, traffic congestion, and pollution in urban areas. Full article

This study evaluated the association between off-hour deliveries and the risk of severe maternal morbidity (SMM). Data regarding Korean deliveries between 2005 and 2019 obtained from the National Health Insurance Service were used. SMM was evaluated using an algorithm developed by the United States Centers for Disease Control and Prevention. Modified Poisson regression analyses were conducted to investigate the association between off-hour deliveries and SMM, with stratification by hospital region and the number of beds. Approximately 32.7% of the 3,076,448 nulliparous women in this study delivered during off-hours, including 2.6% who experienced SMM. Patients who delivered at night had the highest risk of SMM (weekday nights, adjusted risk ratio (aRR): 1.41, 95% confidence interval (CI): 1.38–1.44; weekend nights, OR: 1.40, 95% CI: 1.34–1.46). The SMM of night deliveries was higher at hospitals located in small cities and those with 100–499 beds (weekend night: small cities, aRR: 1.49, 95% CI: 1.40–1.59; 100–499 beds, aRR: 1.83, 95% CI: 1.67–2.01; weekday night: small cities, aRR: 1.46, 95% CI: 1.42–1.51; 100–499 beds, aRR: 1.70, 95% CI: 1.62–1.79). Therefore, nighttime deliveries are associated with a higher risk of SMM, especially at hospitals located in small cities and those with 100–499 beds. Full article

Background and Objectives: ACS presents an acute manifestation of coronary artery disease and its treatment is based on timely interventional diagnostics and PCI. It has been known that the treatment and the outcomes are not the same for all the patients with ACS during the working day, depending on the availability of the procedures and staff. The aim of the study was to explore the differences in clinical characteristics and outcomes in patients admitted for ACS during on- and off-hours. Materials and Methods: The retrospective study included 1873 consecutive ACS patients admitted to a tertiary, university hospital that underwent coronary angiography and intervention. On-hours were defined from Monday to Friday from 07:30 h to 14:30 h, while the rest was considered off-hours. Results: There were more males in the off-hours group (on-hours 475 (56%) vs. off-hours 635 (62%); p = 0.011), while previous MI was more frequent in the on-hours group (on 250 (30%) vs. off 148 (14%); p < 0.001). NSTEMI was more frequent during on-hours (on 164 (19%) vs. off 55 (5%); p < 0.001), while STEMI was more frequent during off-hours (on 585 (69%) vs. off 952 (93%); p < 0.001). Patients admitted during on-hours had more multivessel disease (MVD) (on 485 (57%) vs. off 489 (48%); p = 0.006), as well as multivessel PCI (on 187 (22%) vs. off 171 (16%); p = 0.002), while radial access was preferred in off-hours patients (on 692 (82%) vs. off 883 (86%); p = 0.004). Left main PCI was performed with similar frequency in both groups (on 37 (4%) vs. off 35 (3%); p = 0.203). Death occurred with similar frequency in both groups (on 17 (2.0%) vs. off 26 (2.54%); p = 0.404), while major adverse cardio-cerebral events (MACCEs) were more frequent in the on-hours group (on 105 (12.4%) vs. off 70 (6.8%); p = 0.039) probably due to the more frequent repeated PCI (on 49 (5.8%) vs. off 27 (2.6%); p = 0.035). Conclusions: Patients admitted for ACS during working hours in a tertiary hospital present with more complex CAD, have more demanding interventions, and experience more MACCEs during follow-up mostly due to myocardial infarctions and repeated procedures. Full article

Background: Esophageal food impactions (EFI) often precede a diagnosis of eosinophilic esophagitis (EOE). Current guidelines suggest obtaining esophageal biopsies upon suspicion of EOE, treating with proton pump inhibitor (PPI), and repeating esophagogastroduodenoscopy (EGD). This study was conducted to determine provider practice patterns with these mentioned recommendations at the time of EFI. Methods: In this retrospective study, key outcomes were the proportion of patients who had EOE mucosal biopsies, EOE diagnosis, PPI initiation, and recommendations and completions of repeat EGD. Differences in outcomes among age, sex, race, off-hours time of procedure, and trainee involvement were examined. EOE diagnosis predictors were explored with logistic regression. Results: Twenty-nine percent of the patients had esophageal biopsies taken at the time of index EGD (iEGD). Sixteen patients were diagnosed with EOE at the time of index EFI, while fourteen patients were diagnosed on subsequent EGDs. Among those diagnosed with EOE at iEGD, 94% were placed on PPI. Of patients with confirmed EOE on index biopsy, 63% of patients were recommended repeat EGD, of which 50% completed it within 90 days. Older age was protective of EOE diagnosis while no GERD history and endoscopist suspicion of EOE predicted diagnosis of EOE. Conclusions: Endoscopists uncommonly take biopsies at the time of EFI, which may delay diagnosis and treatment of EOE. Full article

Promoting good primate welfare outside of daylight hours is an important task. The responsibility to provide a complex environment and environmental enrichment is an essential element of primate wellbeing programs that should be approached from a 24-h perspective and planned according to the species and individual needs, including giving animals the ability to interact with and control their environment during hours when animal care staff are not present. One must be aware, however, that their needs may differ at night-time from their care needs during the day when staff are present. Assessing welfare and providing enrichment during times when staff are not on hand can be achieved through the use of a variety of technologies, such as night-view cameras, animal-centred technologies, and data loggers. This paper will address the relevant topics concerning the care and welfare of primates during off-hours, and the use of related technologies to facilitate and assess wellbeing at these times. Full article

Door-to-balloon (DTB) time significantly affects the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). The effects of temporal differences in emergency department (ED) arrival time on DTB time and on different segments of DTB time remain inconclusive. Therefore, we performed a retrospective study in a tertiary hospital between January 2013 and December 2021 and investigated the relationship between a patient’s arrival time and both their DTB time and different segments of their DTB time. Of 732 STEMI patients, 327 arrived during the daytime (08:01–16:00), 268 during the evening (16:01–24:00), and 137 at night (00:01–08:00). Significantly higher odds of delay in DTB time were observed during the nighttime (adjusted odds ratio (aOR): 2.87; 95% confidence interval (CI): 1.50–5.51, p = 0.002) than during the daytime. This delay was mainly attributed to a delay in cardiac catheterization laboratory (cath lab) activation-to-arrival time (aOR: 6.25; 95% CI: 3.75–10.40, p < 0.001), particularly during the 00:00–04:00 time range. Age, sex, triage level, and whether patients arrived during the COVID-19 pandemic also had independent effects on different segments of DTB time. Further studies are required to investigate the root causes of delay in DTB time and to develop specific strategies for improvement. Full article

Background. The “weekend effect” has been associated with worse clinical outcomes. Our aim was to compare off-hours vs. regular-hours peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) in cardiogenic shock patients. Methods. We analyzed in-hospital and 90-day mortality among 147 consecutive patients treated with percutaneous VA-ECMO for medical reasons between July 1, 2013, and September 30, 2022, during regular-hours (weekdays 8:00 a.m.–10:00 p.m.) and off-hours (weekdays 10:01 p.m.–7:59 a.m., weekends, and holidays). Results. The median patient age was 56 years (interquartile range [IQR] 49–64 years) and 112 (72.6%) were men. The median lactate level was 9.6 mmol/L (IQR 6.2–14.8 mmol/L) and 136 patients (92.5%) had a Society for Cardiovascular Angiography and Interventions (SCAI) stage D or E. Cannulation was performed off-hours in 67 patients (45.6%). In-hospital mortality was similar in off-hours and regular hours (55.2% vs. 56.3%, p = 0.901), as was the 90-day mortality (58.2% vs. 57.5%, p = 0.963), length of hospital stay (31 days [IQR 16–65.8 days] vs. 32 days [IQR 18–63 days], p = 0.979), and VA-ECMO related complications (77.6% vs. 70.0%, p = 0.305). Conclusions. Off-hours and regular-hours percutaneous VA-ECMO implantation in cardiogenic shock of medical cause have similar results. Our results support well-designed 24/7 VA-ECMO implantation programs for cardiogenic shock patients. Full article

The mortality of stroke increases on weekends and during off-hour periods. We investigated the effect of off-hour admission on the outcomes of intracerebral hemorrhage (ICH) patients. We retrospectively analyzed a prospective cohort of ICH patients, admitted between January 2017 and December 2019 at the First Affiliated Hospital of Chongqing Medical University. Acute ICH within 72 h after onset with a baseline computed tomography and 3-month follow-up were included in our study. Multivariable logistic regression analysis was performed for calculating the odds ratios (OR) and 95% confidence interval (CI) for the outcome measurements. Of the 656 participants, 318 (48.5%) were admitted during on-hours, whereas 338 (51.5%) were admitted during off-hours. Patients with a poor outcome had a larger median baseline hematoma volume, of 27 mL (interquartile range 11.1–53.2 mL), and a lower median time from onset to imaging, of 2.8 h (interquartile range 1.4–9.6 h). Off-hour admission was significantly associated with a poor functional outcome at 3 months, after adjusting for cofounders (adjusted OR 2.17, 95% CI 1.35–3.47; p = 0.001). We found that patients admitted during off-hours had a higher risk of poor functional outcomes at 3 months than those admitted during working hours. Full article

This paper analyzes the amount of truck emissions and their variations according to changes in travel schedules or routes and the impact on human health represented by cases of Acute Respiratory Infections (ARI) due to PM_2.5 emissions in Medellín, Colombia. To accomplish this, information on each vehicle was collected, including model, year, type of fuel used, Euro, and engine power trucks. The commercial vehicles were equipped with GPS to obtain second-to-second speed, location, acceleration, and deceleration; the rest of the data were provided by the vehicles’ owners. All this information was used to estimate emissions with the HBEFA model. The main findings show a decrease of approximately 38% in emissions by changing the truck circulation schedule to off-hours and a generation of 2.35 annual cases of ARI if the amount of PM_2.5 increases 1 μg/m³. Moreover, this investigation proposes that the optimal inter-city speed for truck circulation is between 40 km/h and 50 km/h, and it is recommended that some cargo transport operations should be carried out during off-hours, especially at night. Full article

Pandemic-specific protocols require additional time to prepare medical staff and catheterization laboratories. Thus, we sought to investigate treatment delay and clinical outcomes in COVID-19 positive and negative patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) during on- and off-hours. All consecutive patients with STEMI treated with PCI between 1 March and 31 December 2020 were enrolled in the analysis. A propensity score match was used to compare COVID-19 positive and negative patients for on- and off-hours. The study group was comprised of 877 paired patients treated during regular hours (every day 7:00 a.m. to 16:59 p.m.) and 418 matched pairs with PCI performed during off-hours (every day 17:00 p.m. to 06:59 a.m.) (ORPKI Polish National Registry). No difference in periprocedural mortality was observed between the two groups (on-hours: COVID-19 negative vs. COVID-19 positive: 17 (1.9%) vs. 11 (1.3%); p = 0.3; off-hours: COVID-19 negative vs. COVID-19 positive: 4 (1.0%) vs. 7 (1.7%); p = 0.5). Additionally, a similar rate of periprocedural complications was reported. Patients diagnosed with COVID-19 were exposed to longer time from first medical contact to angiography (on-hours: 133.8 (±137.1) vs. 117.1 (±135.8) (min); p = 0.001) (off-hours: 148.1 (±201.6) vs. 112.2 (±138.7) (min); p = 0.003). However, there was no influence of COVID-19 diagnosis on mortality and the prevalence of other periprocedural complications irrespective of time of intervention. Full article

Therapeutic percutaneous coronary intervention (PCI) is the treatment of choice in acute myocardial infarction (AMI). If optimally performed, PCI reduces myocardial injury and improves the likelihood of a positive clinical outcome. Therefore, the equal quality of PCI throughout both day and night shifts is of paramount importance. Our aim was to compare urgent diagnostic and therapeutic coronary interventions performed during day and night shifts. We retrospectively analyzed the medical records of 144 patients who underwent coronary angiography for AMI over six months in a tertiary referral center working in 24/7 mode. The patients’ characteristics, procedural data and the operator’s experience in interventional cardiology were compared according to the time of intervention during a day shift (8 a.m. until 8 p.m., group A, n = 106) and night shift (from 8 p.m. until 8 a.m. next day, group B, n = 36). The baseline characteristics of the subjects of groups A and B were similar, except for a higher proportion of AMI without persistent ST-segment elevation (NSTEMI) in patients who underwent coronary angiography during regular working hours compared to off-hours (58% vs. 34%, p < 0.05). The average time of diagnostic coronary angiography was longer by about 5 min during the day shift (28.5 ± 12.2 vs. 23.8 ± 8.9 min, p < 0.05), while other procedural data, including the arterial access route, the number of catheters needed and the contrast-medium volume, were similar. The use of additional diagnostic tools for coronary lesion assessment (intracoronary ultrasound or fractional flow reserve measurement) was almost twice as frequent during regular working hours (15% vs. 8%). Urgent therapeutic PCI on the culprit artery was performed in 79% and 89% of group A and B patients, respectively. The groups did not differ in procedural characteristics regarding the total interventional session, including both diagnostic angiography and therapeutic PCI, such as total procedure duration, fluoroscopy time, radiation dose, stenting technique and total stent length. Coronary thrombectomy or rotational atherectomy were more frequently used in group A (27% vs. 15%, p = 0.16). The percentage of doctors with the least experience in interventional cardiology was, albeit insignificantly, lower during day shifts (31% vs. 42%). In conclusion, the majority of clinical and periprocedural characteristics appeared to be independent of intervention time, except for a longer duration of diagnostic coronary angiography during daytime. This finding could probably result from a higher proportion of NSTEMI patients frequently requiring additional angiographic projections and special techniques to properly identify the infarct-related artery during the day shift. Whether a tendency of less frequent use of additional tools at off-hours may also be due to a lower percentage of NSTEMI interventions at night, or whether this can be linked to lower availability of experienced operators, remains to be validated in a large study. The latter possibility, if confirmed, might encourage public health authorities and healthcare organizers to improve off-hours cathlab staffing with experienced interventionalists. Finally, additional obligatory training in special diagnostic and therapeutic invasive techniques might be advisable for the least experienced operators scheduled to work night shifts. Full article

This research aims to analyze the perception of logistics operators and retailers regarding freight deliveries in the city of São Paulo. Based on a survey applied to 100 logistics operators and 84 retailers, the data were analyzed by descriptive statistics and multiple correspondence analysis (MCA) was used to investigate the logistics efficiency of off-hours deliveries (OHD) and to indicate issues when carrying out OHD. From that sample, noise appears as the most critical issue of OHD for retailers. From the results, most logistics operators and retailers prefer to deliver cargo at night. The advantages of making OHD are the ability to check/store goods, the accuracy in the delivery schedule due to traffic conditions, and the ease of parking a vehicle to offload goods. Public authorities should improve the infrastructure to receive goods, including public lighting conditions and sidewalks. The correspondence analysis method showed that the level of customer service quality depends on the punctuality of the trucks and the ability to check and store goods. Furthermore, by highlighting the logistics efficiency and issues related to daytime and overnight deliveries by carriers and receivers, it can guide public polices and initiatives of other companies, an aspect that has been lacking in the literature. Full article