Travel pattern-based bus trip origin-destination estimation using smart card data.

Smart card data are widely used in generating the origin and destination (O-D) matrix for public transit, which contains important information for transportation planning and operation. However, the generation of the O-D matrix is limited by the smart card data information that includes the boarding (origin) information without the alighting (destination) information. To solve this problem, trip chain methods have been proposed, thereby greatly contributing in estimating the destination using the smart card data. Nevertheless, unlinked trips, that is, trips with unknown destinations, are a persisting issue. The purpose of this study is to develop a method for estimating the destination of unlinked trips, in which trip chain methods cannot be applied, using temporal travel patterns and historical boarding records of the passengers based on long-term smart card data. The passengers were clustered by k-means clustering, and the time-of-day travel patterns were estimated for each cluster using a Gaussian mixture model. The travel patterns were formulated to estimate the destination of the passengers from the smart card data. The proposed method was verified using the 2018 smart card data collected in Sejong City, South Korea. The existing trip chain method matched the destinations of 60.0% of the total trips, whereas the proposed method improved the matching to 74.9% by additionally matching the destinations of 37.2% of the unlinked trips.

FHL tendon transfer in diabetics for treatment of non-healing plantar heel ulcers.

BACKGROUND: In diabetics, although heel ulcers occurring after Achilles tendon lengthening for managing forefoot ulcers are rare, they are a very troublesome complication. The purpose of this study was to evaluate the results of FHL tendon transfer for management of a plantar heel ulcer as a sequelae of insufficiency of the Achilles tendon in diabetic patients. MATERIALS AND METHODS: Nine diabetic patients who underwent FHL tendon transfer for treatment of non-healing plantar heel ulcers due to insufficiency of the Achilles tendon for management of forefoot ulcers were treated between October 2005 and April 2007. All of the patients had undergone Achilles tendon lengthening with Hoke's triple hemisection method. The mean age was 55.9 +/- 9.7 years old. The average duration of a plantar heel ulcer was 11.9 +/- 3.8 months. The mean period of followup was 23.9 +/- 8.0 months. Between the occurrence of a heel ulcer and the FHL transfer, five of the patients underwent more than one attempt at direct Achilles tendon repair. The mean size of the wound was 1.2 +/- 0.6 cm2. We assessed the healing time of the heel plantar ulcers and recurrence rates during followup periods. The complication rate and walking ability was also evaluated. RESULTS: All of the plantar heel ulcers healed within 8 weeks after the operation and had not recurred as of the last followup. Two patients had recurrences of previous forefoot ulcers. One patient had a local infection in the FHL tendon transfer area. All of patients could walk without a brace or walking aid device after surgery. CONCLUSION: We believe that Achilles tendon reconstruction using an FHL transfer for non-healing plantar heel ulcers resulting from a triple Hoke lengthening of the Achilles tendon is a good treatment option for diabetic patients.

An anatomical study of Morton's interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML).

BACKGROUND: Using clinical and cadaver studies, we examined the relationship between the location of Morton interdigital neuromas and the surrounding structures, including the deep transverse metatarsal ligament (DTML), which has been suspected as a major causative factor in neuroma formation. METHODS: Seventeen fresh-frozen cadavers were evaluated to determine the relationship between the location of Morton interdigital neuromas and the DTML at two phases of the gait cycle with 60 degrees of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from the bifurcation of the common digital nerve in the foot to the anterior margin of the DTML and also measured the length of the DTML itself. Clinically, we checked the location of the Morton interdigital neuroma and its length during surgery in 32 feet. RESULTS: In the second and third webspace, the mean distance from the bifurcation of the common digital nerve of the foot to the anterior margin of the DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm and 14.6 mm in the heel-off position. The length of the second and third DTML averaged 12.8 mm and 10.6 mm. Clinically, all of the cases of Morton interdigital neuroma started at the bifurcation area of the common digital nerve, and the mean neuroma length was 7.5 mm (6 to 11). CONCLUSIONS: Morton interdigital neuromas were located more distally than the DTML in both the mid-stance and the heel-off stage during walking. The main lesion was located between the metatarsal head and the metatarsophalangeal joint and more distal than the DTML, questioning previous studies suggesting that the DTML is the major causative factor in development of Morton interdigital neuroma.