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Dickerson AE, Stapleton T, Bloss J, Géinas I, Harries P, Choi M, Margot-Cattin I, Mazer B, Patomella AH, Swanepoel L, Van Niekerk L, Unsworth C, Vrkljan B. A Systematic Review of Effective Interventions and Strategies to Support the Transition of Older Adults From Driving to Driving Retirement/Cessation. Innov Aging 2024; 8:igae054. [PMID: 38948542 PMCID: PMC11212369 DOI: 10.1093/geroni/igae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Indexed: 07/02/2024] Open
Abstract
Background and Objectives In most western countries, older adults depend on private cars for transportation and do not proactively plan for driving cessation. The objective of this review was to examine current research studies outlining effective interventions and strategies to assist older adults during their transition from driver to driving retirement or cessation. Research Design and Methods A search was completed across 9 databases using key words and MeSH terms for drivers, cessation of driving, and older adult drivers. Eligibility screening of 9,807 titles and abstracts, followed by a detailed screening of 206 papers, was completed using the Covidence platform. Twelve papers were selected for full-text screen and data extraction, comprising 3 papers with evidence-based intervention programs and 9 papers with evidence-informed strategies. Results Three papers met the research criteria of a controlled study for programs that support and facilitate driving cessation for older adults. Nine additional studies were exploratory or descriptive, which outlined strategies that could support older drivers, their families, and/or healthcare professionals during this transition. Driving retirement programs/toolkits are also presented. Discussion and Implications The driver retirement programs had promising results, but there were methodological weaknesses within the studies. Strategies extracted contributed to 6 themes: Reluctance and avoidance of the topic, multiple stakeholder involvement is important, taking proactive approach is critical, refocus the process away from assessment to proactive planning, collaborative approach to enable "ownership" of the decision is needed, and engage in planning alternative transportation should be the end result. Meeting the transportation needs of older adults will be essential to support aging in place, out-of-home mobility, and participation, particularly in developed countries where there is such a high dependency on private motor vehicles.
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Affiliation(s)
- Anne E Dickerson
- Department of Occupational Therapy, East Carolina University, Greenville, North Carolina, USA
| | - Tadhg Stapleton
- Discipline of Occupational Therapy, Trinity College, Dublin, Ireland
| | - Jamie Bloss
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Isabelle Géinas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - Priscilla Harries
- Graduate Research School and Researcher Development, Kingston University, London, UK
| | - Moon Choi
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Isabel Margot-Cattin
- Department of Occupational Therapy, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Barbara Mazer
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - Ann-Helen Patomella
- Division of Occupational Therapy, Department of Neurobiology, Karolinska Institutet, Huddinge, Sweden
| | - Lizette Swanepoel
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lana Van Niekerk
- Division Occupational Therapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Carolyn A Unsworth
- Institute of Health and Wellbeing, Federation University, Churchill, Victoria, Australia
| | - Brenda Vrkljan
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Xiang W, Zhang Y, Pan X, Liu X, Xu G. Analysis of coping capacities and cognitive biases of novice drivers-A questionnaire-based study. PLoS One 2024; 19:e0297763. [PMID: 38363741 PMCID: PMC10871514 DOI: 10.1371/journal.pone.0297763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/06/2024] [Indexed: 02/18/2024] Open
Abstract
Coping capacity is a key aspect of driver-vehicle interaction when drivers observe and make decisions, and is of great importance for drivers. However, different drivers have different self-cognition and assess their driving abilities differently, especially for novice drivers. Based on questionnaire data, this study has investigated the coping capacities of drivers in both static environments and dynamic environments. With the ANOVA analysis method and the structural equation model (SEM), this study has verified the effects of gender and driving factors (driving years, driving frequency, driving time) on drivers' coping capacities based on drivers' self-assessment scores and mutual assessment scores. Drivers' self-assessment scores show significant effects of all factors on drivers' coping capacities, and drivers' mutual assessment scores show significant effects of all factors, excluding driving time, on drivers' coping capacities. Also, it has been found that all drivers in the driving year group have cognitive biases. It seems that first-year drivers are always overconfident with their driving skills, while drivers with a driving experience of more than three years usually score driving skills of themselves and other drivers most conservatively. With increased exposure to various traffic conditions, experienced drivers are more aware of their limitations in dealing with complex traffic situations, while novice drivers do not know their lack of capability to properly respond to any unexpected situation they could encounter.
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Affiliation(s)
- Wang Xiang
- Hunan Key Laboratory of Smart Roadway and Cooperative Vehicle-Infrastructure Systems, Changsha University of Science and Technology, Changsha, Hunan, China
| | - Yonghe Zhang
- Hunan Key Laboratory of Smart Roadway and Cooperative Vehicle-Infrastructure Systems, Changsha University of Science and Technology, Changsha, Hunan, China
| | - Xin Pan
- State Grid Hunan Electric Power company Limited Economic & Technical Research Institute, Changsha, Hunan, China
- Hunan Key Laboratory of Energy Internet Supply-Demand and Operation, Changsha, Hunan, China
| | - Xuemei Liu
- Hunan Institute of Traffic Engineering, School of Traffic & Transportation Engineering, Hengyang, Hunan, China
| | - Guiqiu Xu
- GuangDong Architectural Design & Research Institute Company Limited, Guangzhou, Guangdong, China
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Peterson CM, Leslie A, Flannagan CA, Nelson TF. On the road to retirement: Predicting nighttime driving difficulty and cessation using self-reported health factors. JOURNAL OF TRANSPORT & HEALTH 2024; 34:101724. [PMID: 38855420 PMCID: PMC11160935 DOI: 10.1016/j.jth.2023.101724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Introduction Older drivers now expect to drive longer than previous cohorts and will make up about 25% of licensed U.S. drivers by 2050. Identifying early predictors of nighttime driving difficulty, a precursor to driving retirement, can inform screening procedures and timely linkage to interventions supporting driving or transitioning to driving cessation. Methods We examined self-reported physical and mental health baseline predictors of greater nighttime driving difficulty in five and ten years using weighted multivariate logistic analyses of 2261 drivers, aged 57 to 85, from the National Social Life, Health, and Aging Project (NSHAP). Transition matrix models describe probabilities of having greater, lesser, or the same nighttime driving difficulty after five years based on baseline driving conditions and the significant logistic model factors. We built a transition matrix tool that offers users the ability to calculate expected probabilities of change in nighttime driving difficulty based on the identified salient factors. Results Five-year predictors of greater nighttime driving difficulty included perceived poor physical health (OR = 3.75), limitations to activities of daily living (ADLs; OR = 1.97), and clinical levels of depressive and anxiety symptoms (OR = 1.63; OR = 1.71). Excellent physical health (OR = 0.52), mental health (OR = 0.60), and any frequency of physical activity compared to 'never' were protective (OR = 0.37-0.51). Physical health, walking pain, and limitations to ADLs were predictive at ten-years. Transition models showed physical health and anxiety were most indicative of greater nighttime driving difficulty at 5-years for those reporting no difficulty at baseline, but limitations to ADLs were more predictive otherwise. Conclusions Lay practitioners could capitalize on the use of self-report screening measures to identify older adults who may experience near-term nighttime driving difficulty. Earlier identification may better guide long-term driving retirement planning or engagement in appropriate health interventions. The transition matrix modeling tool is freely available to facilitate development and validation of related measures.
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Affiliation(s)
- Colleen M. Peterson
- Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Leslie
- Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA
| | | | - Toben F. Nelson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, USA
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Schlueter DA, Austerschmidt KL, Schulz P, Beblo T, Driessen M, Kreisel S, Toepper M. Overestimation of on-road driving performance is associated with reduced driving safety in older drivers. ACCIDENT; ANALYSIS AND PREVENTION 2023; 187:107086. [PMID: 37146403 DOI: 10.1016/j.aap.2023.107086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/24/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Older drivers often show less precise self-ratings with a tendency to overestimate themselves. It is unclear, however, how overestimators differ from underestimators or drivers with adequate self-ratings. METHODS 59 healthy older drivers participated in this on-road study. Besides standardized on-road driving assessment, the study protocol included the collection of neuropsychological and driving-related data as well as different self-ratings. Statistical analyses involved correlations between different subjective and objective ratings as well as statistical comparisons between drivers who overestimated and drivers who adequately rated their on-road driving performance (no drivers underestimated their performance). RESULTS Despite positive correlations between different self- and expert ratings, our results revealed that 25 % of the participants overestimated their on-road driving skills. Among other things, overestimators showed poorer on-road driving performances, more prospective near and minor at-fault accidents, poorer cognitive performances in specific driving-related domains and reduced annual mileage. DISCUSSION Our results suggest that older drivers who overestimate their driving skills show poorer performances within a broad range of skills that directly reflect or are closely related to driving safety. Against the background that an adequate self-assessment is required by German traffic regulations, our findings suggest that overestimators represent a risk group among the population of older drivers.
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Affiliation(s)
- Daniel A Schlueter
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany; Bielefeld University, Department of Biopsychology and Cognitive Neuroscience, Universitätsstraße 25, D-33615 Bielefeld, Germany.
| | - Kim L Austerschmidt
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Philipp Schulz
- University Hospital OWL, Bielefeld University, Mara Hospital, Maraweg 21, D-33617 Bielefeld, Germany
| | - Thomas Beblo
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Martin Driessen
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Stefan Kreisel
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Max Toepper
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
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Rosenfeld M, Goverover Y, Weiss P. Self-awareness predicts fitness to drive among adults referred to occupational therapy evaluation. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1005025. [PMID: 36466937 PMCID: PMC9708717 DOI: 10.3389/fresc.2022.1005025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/26/2022] [Indexed: 09/10/2024]
Abstract
Background Driving is associated with independence, well-being, quality of life, and an active lifestyle. Driving requires cognitive, motor, and visual skills, including self-awareness and processing speed. This study examines whether driver self-awareness, motor processing speed, and cognitive processing speed can predict fitness to drive among individuals referred to occupational therapy evaluation due to concerns about their driving ability. Method In this cross-sectional study, 39 participants were referred to off- and on-road driving evaluation to determine their fitness to drive due to changes in health status, advanced age, license renewal requirement, or prior automobile accidents. A registered occupational therapist (OT) classified 23 of the participants as fit to drive and 16 as unfit to drive. Motor and cognitive processing speed were assessed by the Stationary Perception-Reaction Timer and the Color Trails Test, respectively. Driving self-awareness was assessed by comparing the DI and OT evaluations to the participants' estimation of their own on-road driving performance. Results The fit-to-drive participants had a better motor and cognitive processing speed than those unfit-to-drive. The unfit-to-drive group overestimated their driving ability, whereas the fit-to-drive group accurately or almost accurately estimated their driving ability. Driving self-awareness was a significant predictor of participants' fitness to drive. Conclusions This study demonstrates the importance of self-awareness for predicting fitness to drive among people at risk for compromised driving skills. Thus, driving self-awareness should be addressed as part of fitness-to-drive evaluations and interventions.
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Affiliation(s)
- Meirav Rosenfeld
- Department of Occupational Therapy, New York University, New York, NY, United States
| | - Yael Goverover
- Department of Occupational Therapy, New York University, New York, NY, United States
- Kessler Foundation, East Hanover, NJ, United States
| | - Penina Weiss
- Occupational Therapy Department, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
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Delphin-Combe F, Coste MH, Bachelet R, Llorens M, Gentil C, Giroux M, Paire-Ficout L, Ranchet M, Krolak-Salmon P. An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol. Front Neurol 2022; 13:901100. [PMID: 35923824 PMCID: PMC9339957 DOI: 10.3389/fneur.2022.901100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Older drivers face the prospect of having to adjust their driving habits because of health problems, which can include neurocognitive disorders. Self-awareness of driving difficulties and the interaction between individual with neurocognitive disorders and natural caregiver seem to be important levers for the implementation of adaptation strategies and for the subsequent voluntary cessation of driving when the cognitive disorders become too severe. This study aims to evaluate an educational program for patient/natural caregiver dyads who wish to implement self-regulation strategies in driving activity, and to improve self-awareness of driving ability. The ACCOMPAGNE program is based on seven group workshops, which target the dyad. The workshops deal with the impact of cognitive, sensory and iatrogenic disorders on driving. They tackle questions about responsibility, and about autonomy and social life. They also provide alternative solutions aimed at maintaining outward-looking activities even if driving is reduced or stopped. A randomized controlled trial is planned to evaluate the effectiveness of the program 2 months and 6 months after inclusion, and to compare this to the effectiveness of conventional approaches. The main outcome of this trial (i.e., the implementation of self-regulated driving strategies), will be measured based on scores on the “Current Self-Regulatory Practices” subscale of the Driver Perception and Practices Questionnaire. The Driving Habits Questionnaire will be used to measure secondary outcomes (indicators of driving changes; indicators of changes in mood, quality of life and caregiver burden; and self-awareness of driving abilities). Indicators will be collected for both patients and natural caregivers. This cognitive, social and psychological program should allow older individuals with cognitive disorders to drive more safely, and help to maintain the quality of life and mood of both patient and natural caregiver despite driving limitations. The patient's care path would be optimized, as he/she would become an actor in the process of giving up driving, which will, most certainly, be needed at some point in the progress of neurocognitive disorders. This process ranges from becoming aware of driving difficulties, to implementing self-regulation strategies, through to complete cessation of driving when necessary.Clinical trial registration numberNCT04493957.
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Affiliation(s)
- Floriane Delphin-Combe
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
- *Correspondence: Floriane Delphin-Combe
| | - Marie-Hélène Coste
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Romain Bachelet
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Mélissa Llorens
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Claire Gentil
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Marion Giroux
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | | | - Maud Ranchet
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon, France
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Stinchcombe A, Hopper S, Mullen N, Bédard M. Canadian Older Adults' Perceptions of Transitioning from Driver to Non-Driver. Occup Ther Health Care 2021; 38:110-130. [PMID: 34156891 DOI: 10.1080/07380577.2021.1936338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/22/2021] [Indexed: 10/21/2022]
Abstract
Ceasing driving is associated with many negative outcomes. We examined the perceived impact of driving cessation among current older drivers. Transcripts from 92 interviews with participants from several locations across Canada were analyzed using inductive thematic analysis. We identified five themes: planning for mobility change, mobility supports and neighborhoods, financial security, fearing loss of control and independence, and coping and acceptance as a part of aging. Findings highlight diverse attitudes toward driving cessation, ranging from avoidance to acceptance, and emphasize the importance of tailored resources for drivers at various stages of behavior change.
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Affiliation(s)
- Arne Stinchcombe
- Department of Recreation and Leisure Studies, Brock University, St. Catharines, Canada
| | - Shawna Hopper
- Department of Recreation and Leisure Studies, Brock University, St. Catharines, Canada
| | - Nadia Mullen
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Canada
| | - Michel Bédard
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Canada
- Northern Ontario School of Medicine, Thunder Bay, Canada
- St. Joseph's Care Group, Thunder Bay, Canada
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Zafian T, Ryan A, Agrawal R, Samuel S, Knodler M. Using SHRP2 NDS data to examine infrastructure and other factors contributing to older driver crashes during left turns at signalized intersections. ACCIDENT; ANALYSIS AND PREVENTION 2021; 156:106141. [PMID: 33873135 DOI: 10.1016/j.aap.2021.106141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/24/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Drivers age 65 and over have higher rates of crashes and crash-related fatalities than other adult drivers and are especially over-represented in crashes during left turns at intersections. This research investigated the use of SHRP2 Naturalistic Driving Study (NDS) data to assess infrastructure and other factors contributing to left turn crashes at signalized intersections, and how to improve older driver safety during such turns. NDS data for trips involving signalized intersections and crash or near-crash events were obtained for two driver age groups: drivers age 65 and over (older drivers) and a sample of drivers age 30-49, along with NDS pre-screening and questionnaire data. Video scoring of all trips was performed to collect additional information on intersection and trip conditions. To identify the most influential factors of crash risk during left turns at signalized intersections, machine learning and regression models were used. The results found that in the obtained NDS dataset, there was a relatively small volume of crashes during left turns at signalized intersections. Further, model results found the statistically significant variables of crash risk for older drivers were associated more with health and cognitive factors rather than the infrastructure or design of the intersections. The results suggest that a study using only SHRP2 NDS data will not lead to definitive findings or recommendations for infrastructure changes to increase safety for older drivers at signalized intersections and during left turns. Moreover, the findings of this study indicates the need to consider other data sources and data collection methods to address this critical literature gap in older driver safety.
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Affiliation(s)
- Tracy Zafian
- UMass Transportation Center, University of Massachusetts Amherst, 214 Marston Hall, 130 Natural Resources Road, Amherst, MA, 01003, USA
| | - Alyssa Ryan
- Department of Civil & Environmental Engineering, University of Massachusetts Amherst, 34 Marston Hall, 130 Natural Resources Road, Amherst, MA, 01003, USA.
| | - Ravi Agrawal
- UMass Transportation Center, University of Massachusetts Amherst, 214 Marston Hall, 130 Natural Resources Road, Amherst, MA, 01003, USA
| | - Siby Samuel
- Department of Systems Design Engineering, University of Waterloo, Department of Systems Design Engineering, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Michael Knodler
- Department of Civil & Environmental Engineering, University of Massachusetts Amherst, 214 Marston Hall, 130 Natural Resources Road, Amherst, MA, 01003, USA
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