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This study presents first descriptive statistics on the usage behavior relating to discounted tickets for public transportation as part of an initiative of the German Federal Government in 2022. During a three-month period, 103 psychiatric outpatients of the University Clinic - Charité Berlin provided self-reported data by completing a survey. In general results suggested a high usage rate of the so-called "9-Euro-ticket" of 89,3%. Due to its purchase, 37,9% (N=39) of the participants felt motivated to explore unknown places. Furthermore, approximately one third of the sample (34,9%; n=36) reported an increase of social contacts as a result of their ticket usage. A higher influence of costs on participants' activity levels was associated with an increase in main symptoms. Higher age was correlated with a decrease of patients' core symptoms due to their activity. Results indicate a high usage of reduced-price tickets for subsidized public transport by the patients concerned., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The field of spatial analysis in traffic crash studies can often enhance predictive performance by addressing the inherent spatial dependence and heterogeneity in crash data. This research introduces the Geographical Support Vector Regression (GSVR) framework, which incorporates generated distance matrices, to assess spatial variations and evaluate the influence of a wide range of factors, including traffic, infrastructure, socio-demographic, travel demand, and land use, on the incidence of total and fatal-or-serious injury (FSI) crashes across Greater Melbourne's zones. Utilizing data from the Melbourne Activity-Based Model (MABM), the study examines 50 indicators related to peak hour traffic and various commuting modes, offering a detailed analysis of the multifaceted factors affecting road safety. The study shows that active transportation modes such as walking and cycling emerge as significant indicators, reflecting a disparity in safety that heightens the vulnerability of these road users. In contrast, car commuting, while a consistent factor in crash risks, has a comparatively lower impact, pointing to an inherent imbalance in the road environment. This could be interpreted as an unequal distribution of risk and safety measures among different types of road users, where the infrastructure and policies may not adequately address the needs and vulnerabilities of pedestrians and cyclists compared to those of car drivers. Public transportation generally offers safer travel, yet associated risks near train stations and tram stops in city center areas cannot be overlooked. Tram stops profoundly affect total crashes in these areas, while intersection counts more significantly impact FSI crashes in the broader metropolitan area. The study also uncovers the contrasting roles of land use mix in influencing FSI versus total crashes. The proposed framework presents an approach for dynamically extracting distance matrices of varying sizes tailored to the specific dataset, providing a fresh method to incorporate spatial impacts into the development of machine learning models. Additionally, the framework extends a feature selection technique to enhance machine learning models that typically lack comprehensive feature selection capabilities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: Population mobility significantly contributes to the spread and prevalence of infectious diseases, posing a serious threat to public health safety and sustainable development across the globe. Understanding the impact of population mobility on the prevention and control of infectious diseases holds profound significance., Methods: In this study, we collected the data on the incidence of notifiable infectious diseases in mainland China from 2013 to 2019, and analyzed the characteristics of notifiable infectious diseases, as well as their correlation with transportation passenger traffic., Results: Among 29 common notifiable infectious diseases, the incidence rate of intestinal diseases per 100,000 people was the highest (256.35 cases), while the mortality rate was the lowest (0.017 cases). The mortality rate per 100,000 people due to sexually transmitted and bloodborne diseases was the highest (1.154 cases). A significant linear correlation was noted between commercial passenger traffic and the number of cases of tuberculosis (r = 0.83, P = 0.022), hepatitis A (r = 0.87, P = 0.012), bacillary and amebic dysentery (r = 0.90, P = 0.006), typhoid/paratyphoid (r = 0.94, P = 0.002), leptospirosis (r = 0.90, P = 0.005), AIDS(r=-0.90, P = 0.006), gonorrhea (r=-0.79, P = 0.035) and scarlet fever (r=-0.85, P = 0.016). A significant linear correlation was noted between public transportation passenger traffic and the number of cases of measles (r = 0.94, P = 0.002), hepatitis A (r = 0.96, P = 0.001), parasitic and vector-borne diseases (r = 0.96, P = 0.001), brucellosis (r = 0.95, P = 0.001), leptospirosis (r = 0.88, P = 0.008), other infectious diarrhea (r = 0.86, P = 0.013) and gonorrhea (r = 0.84, P = 0.018)., Conclusion: The results of this study indicated that transportation passenger traffic significantly affected the incidence of infectious diseases, and reasonable management of passenger traffic was a potentially important means of prevention and control of infectious diseases., (© 2024. The Author(s).)

With the implementation of sustainable development objectives in developing countries, urban planning, land use regulation, and urban mobility policies are expected to help reduce inequalities in access to urban facilities. Urban transport policies are also expected to encourage travel by non-motorised modes and public transport. These are considered to be the sustainable modes of urban transport. In this paper, we investigate how inequality of urban facilities impacts trips made by sustainable modes in the city of Santiago de Chile. We use a Poisson regression model and its geographical extension, the geographically weighted Poisson regression model (GWPR). The results suggest that the inequality of urban facilities impacts trips made by sustainable modes. The variables with the highest relevance are the spatial distribution of mixed land use, the spatial distribution of urban services related to transport infrastructure, primary and secondary education, as well as the spatial distribution of demographic variables related to people's life cycle., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Urrutia-Mosquera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The rapid economic development and accelerating urbanization have led to a significant mismatch between the urban bus network allocation and the population flow. Therefore, this paper investigates this challenge by exploring the intricate relationship between the population flow dynamics, traffic congestion conditions, and the efficient allocation of bus resources. In response, two key indexes were introduced based on spatial matching patterns to assess the urban bus network: the Population-Bus Match Index evaluates the matching degree between supply and demand, and the Population-Congestion Match Index evaluates the matching degree between utilization and saturation. Additionally, two distinct optimization strategies have been proposed to enhance the urban bus network. The first optimization strategy considers the bus network's current status, while the second aspires to an idealized scenario. Subsequently, the potential contributions of each bus station in reducing CO2 emission reduction after implementing the two optimization strategies are quantified. Utilizing a case study focused on Harbin, the proposed methods are validated. The findings unveil a substantial misalignment between supply and demand within the bus network during peak periods, with nearly half of the bus stations experiencing a disparity between utilization and saturation. Comparative experiments across different optimization strategies reveal that the second optimization strategy significantly outperforms the first, but the first optimization strategy has a higher degree of CO2 emission reduction contribution. The results of this study provide decision-makers with an environmentally oriented vantage point for the discerning selection of optimization strategies and leave valuable insights for urban areas confronting transportation challenges., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gao, Liu. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The objective of this study is to examine the feasibility of using survey data to identify factors that predict commute mode choice., Design: The study design is cross-sectional., Setting: Survey data from the Finnish Public Sector study (2020) were used., Participants: 42 574 public sector employees, of whom 10 983 were selected for the final sample. These included employees with 5 km or less commuting distances and those working full-time onsite or partly remotely. The mean age was 46 (SD 11) years, and 84% were women., Primary Outcomes: Commute by (1) bike or foot (an active mode) during summer and winter weather and (2) by car (a passive mode) during summer and winter weather., Methods: Using logistic Lasso (least-absolute-shrinkage-and-selection-operator) regression, we developed and tested a prediction model for short commutes of 5 km or less to identify the characteristics of employees most likely to commute actively during summer and winter weather and passively during summer and winter weather., Results: All models had a good predictive ability with a C-index of 0.82, 0.77, 0.72 and 0.71. Cycling and walking during summer weather were predicted by shorter commutes, higher physical activity, lower body mass index (BMI), female sex and higher team psychological safety. Predictors of cycling and walking during winter weather were shorter commute length, higher physical activity, lower BMI and higher age. Commuting by car during summer weather was predicted by longer journey length, higher BMI, lower physical activity, male sex and having children 7-18 years old living at home. Predictors of driving during winter weather were almost identical, but the male sex was replaced by having a spouse., Conclusions: We identified the correlates of active and passive commute choice in different weather conditions with eight variables. This information can be used to develop and target interventions to promote sustainable and healthy commuting modes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Introduction: Long-duration commuting is widely recognized for its significant influence on health. However, while research has traditionally focused on direct impacts, there remains a critical need to explore the nonlinear dynamics of this relationship. This study aims to deepen our understanding of how behavioral preferences and built environments contribute to these complex interactions., Methods: This study was conducted in Jinan, China's most congested city, using data from the "Jinan Residents Commuting Survey" of 1,755 participants aged 19 to 59. We applied Generalized Propensity Score Matching (GPSM) to explore the nonlinear effects of commuting time on self-rated health, adjusting for participants' sociodemographic characteristics. Variables related to active commuting, physical activity, and perceived built environment were also examined for their potential moderating effects., Results: Commuting for less than 21 minutes enhances health, but negative effects intensify and peak at 60 minutes. Heterogeneity analysis reveals that women and older adults, especially those with higher incomes, are more susceptible to long commutes, experiencing a delayed onset of adverse effects. While active commuting offers health benefits, it may exacerbate health issues if prolonged. Conversely, regular physical activity consistently improves health outcomes related to commuting. Additionally, factors like residential greenery and walkability help alleviate commuting-related stress, improving the overall commuting-health dynamic., Discussion: This study clarifies the commuting-health relationship by identifying key time thresholds and the positive effects of active commuting and physical activity on mitigating longer commute impacts. The findings inform healthier commuting behaviors and offer practical guidelines for urban planning and policy-making to enhance commuter well-being., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Qiu, Li, Cui, Du, Xing, Cui and Xinyu.)

Aim: Mental health issues in adolescence contribute to various disease burdens later in life and are associated with violence, crime, and suicide. Activities such as sleep, diet, exercise, and time spent using electronic devices are related to declining mental health. However, few studies have examined the association between commuting times to school and mental health. This study tested the hypothesis that high school students' long commuting times are associated with poor mental health., Method: A cross-sectional study was conducted between October and December 2022 among 2067 students at two private high schools. Survey items included participant information (sex, grade, school), commuting time, mental health status (Patient Health Questionnaire 9 [PHQ-9]: depressive symptoms, and Generalized Anxiety Disorder 7 [GAD-7]: anxiety symptoms), lifestyle factors, and sleep-related factors., Results: Data from 1899 high school students were analyzed. The prevalence of depressive and anxiety symptoms was 17.3% and 19.0%, respectively. A commuting time of ≥1 h was significantly associated with depressive symptoms (adjusted odds ratio: 1.60 [95% confidence interval]: 1.14-2.24) and anxiety symptoms (adjusted odds ratio: 1.51 [95% confidence interval]: 1.09-2.10). Sex, grade, use of ≥8 h/day of electronic devices, and chronotype were significantly associated with depressive symptoms, while sex, grade, use of ≥8 h/day of electronic devices, and insomnia were significantly associated with anxiety symptoms., Conclusion: It is suggested that long commuting times are associated with poor mental health in high school students. Parents and schools should consider commuting time when advising students on school selection to maintain their mental health., (© 2024 The Author(s). Psychiatry and Clinical Neurosciences © 2024 Japanese Society of Psychiatry and Neurology.)

Urban arterial and collector roads, while interconnected within the urban transportation network, serve distinct purposes, leading to different driving risk profiles. Investigating these differences using advanced methods is of paramount significance. This study aims to achieve this by primarily collecting and processing relevant vehicle trajectory data alongside driver-vehicle-road-environment data. A comprehensive risk assessment matrix is constructed to assess driving risks, incorporating multiple conflict and traffic flow indicators with statistically temporal stability. The Entropy weight-TOPSIS method and the K-means algorithm are employed to determine the risk scores and levels of the target arterial and collector roads. Using risk levels as the outcome variables and multi-scale features as the explanatory variables, random parameters models with heterogeneity in means and variances are developed to identify the determinants of driving risks at different levels. Likelihood ratio tests and comparisons of out-of-sample and within-sample prediction are conducted. Results reveal significant statistical differences in the risk profiles between arterial and collector roads. The marginal effects of significant parameters are then calculated separately for arterial and collector roads, indicating that several factors have different impacts on the probability of risk levels for arterial and collector roads, such as the number of movable elements in road landscape pictures, the standard deviation of the vehicle's lateral acceleration, the average standard deviation of speed for all vehicles on the road segment, and the number of one-way lanes on the road segment. Some practical implications are provided based on the findings. Future research can be implemented by expanding the collected data to different regions and cities over longer periods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Active commuting (AC) to and from work is associated with numerous health benefits, through increased physical activity. This study examined whether occupation types and part-time work, by sex, were associated with AC in a population-based sample of Canadian workers., Data and Methods: Cross-sectional public use microdata files from the 2006 (n=363,048), 2011 (n=370,672), and 2016 (n=362,310) Census of Population were examined. Multinomial logistic regression models were used to estimate the odds of cycling, walking, and using public transit, relative to using a private motorized vehicle, by occupation and sex. Time trends in mode share were also analyzed., Results: In 2016, commuting by private motorized vehicle and cycling were more common among males, while public transit and walking were more common among females. Occupations in art, culture, recreation, and sport were associated with the greatest odds of cycling (odds ratio [OR]=3.02, 99% confidence interval [CI]: 2.65 to 3.39), while those in trades, transportation, natural resources, and manufacturing had the lowest odds of cycling (OR=0.47, 99% CI: 0.44 to 0.51) and walking (OR=0.36, 99% CI: 0.33 to 0.38). Since 2006, relative declines of 1% and 8% in the proportion of workers commuting by driving and walking, respectively, were observed (absolute change of -1% each). Relative increases of 14% and 12% were observed for cycling and public transit, respectively (absolute changes of less than 1% and 1.5%, respectively)., Interpretation: This study found that sex and occupation are important correlates of AC among Canadian workers. Further research aimed at understanding occupational barriers and facilitators may inform future AC interventions.

Purpose: The aim of the study was to identify settings associated with SARS-CoV-2 transmission throughout the COVID-19 pandemic in France., Methods: Cases with recent SARS-CoV-2 infection were matched with controls (4:1 ratio) on age, sex, region, population size, and calendar week. Odds ratios for SARS-CoV-2 infection were estimated for nine periods in models adjusting for socio-demographic characteristics, health status, COVID-19 vaccine, and past infection., Results: Between October 27, 2020 and October 2, 2022, 175,688 cases were matched with 43,922 controls. An increased risk of infection was documented throughout the study for open-space offices compared to offices without open space (OR range across the nine periods: 1.12 to 1.57) and long-distance trains (1.25 to 1.88), and during most of the study for convenience stores (OR range in the periods with increased risk: 1.15 to 1.44), take-away delivery (1.07 to 1.28), car-pooling with relatives (1.09 to 1.68), taxis (1.08 to 1.89), airplanes (1.20 to 1.78), concerts (1.31 to 2.09) and night-clubs (1.45 to 2.95). No increase in transmission was associated with short-distance shared transport, car-pooling booked over platforms, markets, supermarkets and malls, hairdressers, museums, movie theatres, outdoor sports, and swimming pools. The increased risk of infection in bars and restaurants was no longer present in restaurants after reopening in June 2021. It persisted in bars only among those aged under 40 years., Conclusion: Closed settings in which people are less likely to wear masks were most affected by SARS-CoV-2 transmission and should be the focus of air quality improvement., Clinicaltrials: GOV (03/09/2022): NCT04607941., (© 2024. The Author(s).)

A reasonable land use development around subway stations can balance the utilization rates of the subway system during peak and off-peak hours, thereby enhancing its service levels and operational efficiency. Analyzing the temporal distribution patterns of passenger flow and their influencing factors is crucial for determining the optimum ratio of each land use type surrounding metro stations. Thus, this paper employs principal component analysis (PCA) at first to investigate the temporal distribution of metro ridership, and identify their main patterns and factor loadings. Then, using geographically weighted regression, the study examines the spatial dependencies between the main component proportions and influencing factors, focusing on Xi'an subway stations. The results indicate that the temporal distribution of passenger flow can be decomposed into three principal components: the first representing commuting characteristics, and the second and third representing regulating functions. The overall distribution is a composite of these components in varying proportions. Residential and educational land uses primarily drive morning and evening peak flows, with residential land use in the city center and peripheral areas having a more pronounced effect compared to transitional areas. Conversely, commercial & office, healthcare, and recreational & park land mitigate peak flows and increase off-peak flows. External hub enhances passenger flow throughout the day, while industrial land use has negligible impact., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 DAI et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Health co-benefits are a key potential advantage of transport decarbonisation policy. However, health effects will occur in the context of existing transport-health inequities and decarbonisation policies will themselves affect inequities. This research examines the effects of national decarbonisation pathways for transport on population health, health inequity, and health-system costs in Aotearoa New Zealand., Methods: We modelled the health, health-system, and environmental impacts of two pathways to net zero for transport developed by the New Zealand Climate Change Commission using a proportional multistate lifetable model. The behaviour pathway emphasises a mixed approach, including reduced driving, increased cycling and use of public transport, and light vehicle electrification, and the technology pathway focuses on vehicle electrification. We used data from transport, environmental, population health, and health-care sources to populate the model. We simulated changes in health effects through the pathways of physical activity, air pollution (PM 2·5 and NO 2 ), and injury for the Aotearoa New Zealand population from 2018 to 2050. We modelled impacts for Māori (the Indigenous People of Aotearoa) and non-Māori. For each pathway to net zero, we calculated changes in overall health-adjusted life-years (HALYs), age-standardised HALYs, and rate ratios for Māori and non-Māori. We also calculated changes in health-system costs and transport greenhouse gas emissions. 95% uncertainty intervals (95% UIs) were derived for all model outputs by use of a Monte Carlo simulation., Findings: Both pathways show improvements in population health, reductions in health-system costs, and reduced lifecycle greenhouse gas emissions compared with baseline, although health gains were substantially larger in the behaviour pathway. For example, an extra 2100 HALYs (95% UI 1500-3100) were gained in the behaviour scenario compared with baseline. Health gains were 20-30% larger for Māori than non-Māori in both pathways, although more HALYs were gained by Māori in the behaviour pathway. For the cohort aged 0-4 years in 2018, healthy life expectancy differences between Māori and non-Māori reduced by 0·5% in the behaviour pathway over their lifetime. HALYs gained by Māori and non-Māori were altered substantially depending on assumptions about the equity of the implemented pathway., Interpretation: Decarbonising transport might improve overall population health, save the health system money, and reduce health inequities between Māori and non-Māori. Pathways that increase physical activity have a larger effect on population health than those that rely on low-emission vehicles. The effects on inequity between Māori and non-Māori are larger in the behaviour pathway than in the technology pathway but dependent on how equitably policies supporting decarbonisation are implemented., Funding: Health Research Council of New Zealand and University of Otago., Competing Interests: Declaration of interests CS, MM, RG, LC, RJ, and AM report salary support from Health Research Council for this research. AM, RG, and LC also report salary support from the University of Otago for this research. MM reports directors fees from the Institute of Environmental Science and Research. AW reports a contract from WHO and air fares and accommodation to attend the Korean Society for Preventive Medicine Conference 2023. RJ reports grants from Ngā Pae o te Māramatanga and co-directorship of the research network Climate Health Aotearoa. He Pou a Rangi/Climate Change Commission has no role in the research., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The study explored the association between maternal transport modes and childhood mortalities in Nigeria., Method: Utilizing data and definitions from the 2018 Nigeria Demographic and Health Survey report, the ten-year early mortality rates of the five childhood mortalities and the percentage of live births in the 5 years before the survey, transported by eight identified means of transportation, were statistically correlated for each of Nigeria's 36 states and the federal capital territory (FCT) in the R environment at a significance level of α < 0.05., Results: In the spatial distribution of the five childhood mortalities, a notable north-south dichotomy was observed, contrasting with the spatial spread of maternal transport modes. The five childhood mortalities exhibited a significant, moderately positive correlation with transportation by Private Car or Truck, while their associations with Public Transport or Bus and Walking were notably moderate but negative., Conclusion for Practice: While the use of private cars or trucks should be encouraged as a means of maternal transport, public transport should be better organized to provide efficient services to women who need such services for maternal and child healthcare. Additionally, steps should be taken to reduce travel distances to health facilities to manageable distances for mothers., (© 2024. The Author(s).)

Background: Most evidence on transport use and mortality has focused on the commute to work. This study aims to fill a gap by assessing relationships between public transport use and mortality among older adults., Methods: Data come from a cohort of 10,186 individuals aged 50 or older who participated in the English Longitudinal Study of Ageing (ELSA), with survey data linked to mortality records over 16 years (2002-2018). We assessed a binary measure of public transport use and frequency of use from 'every day or nearly every day' to 'never'. Cox proportional-hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for associations between public transport use and mortality. Analyses were adjusted for a range of covariates including socio-demographic factors, chronic disease, and self-reported problems with daily living activities., Results: Overall, 3371 participants (33.1%) died within the study period. Mortality was lower among public transport users (21.3%) compared with non-users (64.2%). Adjusted analyses found that users had 34% lower mortality than non-users (HR 0.66 (95% CI 0.61;0.71)). Adjusted analyses showed similar association sizes across frequencies of public transport use, with those using public transport every day or nearly every day having 41% lower mortality than never users (HR 0.59 (0.49;0.71)). Associations were similar among those with and without a longstanding illness., Conclusion: The use of public transport among older adults is linked to lower levels of mortality. Reductions in provision of public transport services could be detrimental to both transportation and population health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Although commuting time is an extension of working hours, few studies have examined the relationship between commuting time and insomnia symptoms in relation to working time. Thus, this study investigated the relationship between commuting time and working time and their link to sleep disturbance., Methods: This study included employees with ≥35 weekly working hours (n = 30,458) using data from the Sixth Korean Working Conditions Survey conducted in Korea between October 2020 and April 2021. The association between commuting time (≤60, 61-120, and >120 minutes) and insomnia symptoms based on working hours (35-40, 41-52, and >52 h/wk) or shift work was investigated using survey-weighted logistic regression analysis., Results: Long commuting time (>120 min/d) combined with >52 working hours/week (OR: 7.88, 95% CI: 2.51-24.71) or combined with 41-52 h/wk (OR: 3.64, 95% CI: 2.15-6.14) was associated with a higher risk of insomnia symptoms compared with the reference group (working hours: 35-40 h/wk; daily commuting time: ≤60 minutes), after controlling for sex, age, socioeconomic factors, and work-related factors. Among shift workers, those with daily commuting time ≤60 minutes (OR: 1.71, 95% CI: 1.39-2.09), 61-120 minutes (OR: 2.63, 95% CI: 1.21-5.74), and >120 minutes (OR: 5.16, 95% CI: 2.14-12.44) had higher odds of insomnia symptoms than nonshift workers with ≤60 minutes daily commuting time., Conclusion: Long working hours and shift work are associated with greater risk of insomnia symptoms., Competing Interests: Declaration of conflicts of interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Many municipalities in rural areas of Korea are facing population decline due to the aging population phenomenon. This study examined the relationship between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure in older aged adults., Methods: The 2021 Korea Community Health Survey (KCHS) data were used. Municipalities were classified as those not facing population decline, those at risk, and those facing population decline based on the Population Decline Index. The association between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure was examined cross-sectionally using a multi-level logistic regression analysis. Satisfaction with available public transportation was concomitantly examined as it is related to accessing healthcare services., Results: Of the 58,568 individuals aged 65 years or above analyzed, 27,471 (46.9%) adults were residing in municipalities without population decline, 4,640 (7.9%) adults in municipalities at risk of population decline, and 26,457 (45.2%) in municipalities with population decline. Individuals living in municipalities with population decline were more likely to be dissatisfied with nearby healthcare infrastructure (OR 1.76, 95% CI 1.41-2.20). Similar tendencies were found for public transportation infrastructure (OR 1.67, 95% CI 1.38-2.03)., Conclusions: Individuals residing in municipalities with declining populations are more likely to report dissatisfaction with nearby healthcare infrastructure and public transportation. These findings emphasize the importance of providing adequate medical infrastructure to reduce potential health-related disparities., (© 2024. The Author(s).)

Food insecurity is pervasive in Allegheny County, as one in five residents experiences food insecurity. Food insecurity is linked to chronic health conditions like heart disease and hypertension and disproportionately affects women in the United States, particularly women who are head of household. There are multiple dimensions used to measure regional disparities in food accessibility. Prior research has examined the linkages between food access and food insecurity, and this study aims to explore further the relationship between equitable access to sustainable and affordable food sources. This study examines food outlets in Allegheny County to determine if there is a significant relationship between food outlet availability and food insecurity. Both the presence and accessibility of these food outlets were examined. To measure accessibility, the walking distance to the nearest public transportation stop was calculated for each public transportation stop. The minimum distance to each food outlet was compared to food insecurity rates on a census tract level. Results showed that communities without grocery stores had lower access to healthy and affordable food sources. Also, communities with a higher proportion of female-headed households experienced greater food insecurity, regardless of access to food outlets. There was no statistically significant relationship between the distance from public transportation stops to grocery stores and rates of food insecurity overall and in low-income communities. However, communities with inaccessible grocery stores, either absent in the census tract or without close public transport stops, did have even greater average rates of food insecurity if there was an above-average proportion of female-headed households. Based on these findings, it is evident there exist structural elements of the built environment that correspond with disproportionate rates of food insecurity experienced by communities with households that are predominately female headed. In addition to resource support for these marginalized groups, we suggest that sole reliance on distance as an indicator of food insecurity can be misleading. There should be a greater focus on walkability aggregated on a household or individual level within the community instead of physical distance alone at a general scale.

Background: Achieving a higher level of accessibility and equity to community healthcare services has become a major concern for health service delivery from the perspectives of health planners and policy makers in China., Methods: In this study, we introduced a comprehensive door-to-door (D2D) model, integrating it with the open OD API results for precise computation of accessibility to community hospitals over different transport modes. For the D2D public transit mode, we computed the temporal variation and standard deviation of accessibility at different times of the day. Additionally, accessibility values for D2D riding mode, D2D driving mode, and simple driving mode were also computed for comparison. Moreover, we introduced Lorenz curve and Gini index to assess the differences in equity of community healthcare across different times and transport modes., Results: The D2D public transit mode exhibits noticeable fluctuations in accessibility and equity based on the time of day. Accessibility and equity were notably influenced by traffic flow between 8 AM and 11 AM, while during the period from 12 PM to 10 PM, the open hours of community hospitals became a more significant determinant in Nanjing. The moments with the most equitable and inequitable overall spatial layouts were 10 AM and 10 PM, respectively. Among the four transport modes, the traditional simple driving mode exhibited the smallest equity index, with a Gini value of only 0.243. In contrast, the D2D riding mode, while widely preferred for accessing community healthcare services, had the highest Gini value, reaching 0.472., Conclusion: The proposed method combined the D2D model with the open OD API results is effective for accessibility computation of real transport modes. Spatial accessibility and equity of community healthcare experience significant fluctuations influenced by time variations. The transportation mode is also a significant factor affecting accessibility and equity level. These results are helpful to both planners and scholars that aim to build comprehensive spatial accessibility and equity models and optimize the location of public service facilities from the perspective of different temporal scales and a multi-mode transport system., Competing Interests: QL was employed by Anhui Mobile Communication Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ni, Wang, Li, Chen and Long.)

Background: Despite accounting for more than half of new Human Immunodeficiency Virus diagnoses in the United States, the South has fewer than 30% of all pre-exposure prophylaxis users. Pre-exposure prophylaxis access geospatial analyses have focused on drive time but analyses along public transit routes have not been evaluated. Given the proximity to pharmacists and pharmacies, involvement in pre-exposure prophylaxis services may increase access and uptake of this preventative health need., Objective: The objectives were to compare the rate of pre-exposure prophylaxis uptake between Georgia counties with and without public transit, to assess the geospatial accessibility of services along public transit, and to evaluate the potential impact of expanding pre-exposure prophylaxis services to community pharmacies., Methods: Pre-exposure prophylaxis uptake rates between counties with and without public transit were compared using the Mann-Whitney U test. Geospatial analysis was performed using ArcGIS Pro and Geoda. The Pearson correlation coefficient was used to determine the relationship between pre-exposure prophylaxis uptake rates and population and county characteristics. Spatial analysis was completed to uncover predictors for pre-exposure prophylaxis uptake rates. Increased access to pre-exposure prophylaxis along public transit was calculated by reporting the number of counties that would experience at least a 50% increase in pre-exposure prophylaxis access through community pharmacies., Results: Pre-exposure prophylaxis uptake is significantly higher in Georgia counties with versus without public transit (P < 0.001). Pre-exposure prophylaxis rate is positively correlated with the accessibility of community pharmacies and pre-exposure prophylaxis clinics along fixed-route public transit (R 2  = 0.524). Among pre-exposure prophylaxis clinics, 44% are inaccessible by public transit alone. Community pharmacies are significantly more widely distributed and accessible along public transit routes than pre-exposure prophylaxis clinics., Conclusion: Transportation remains a barrier to accessing pre-exposure prophylaxis. Georgia community pharmacies along public transit may serve as a solution to pre-exposure prophylaxis care access barriers., Competing Interests: Disclosure The authors declare no relevant conflicts of interest or financial relationships., (Copyright © 2024 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: As a complementary means to urban public transit systems, public bike-sharing provides a green and active mode of sustainable mobility, while reducing carbon-dioxide emissions and promoting health. There has been increasing interest in factors affecting bike-sharing usage, but little is known about the effect of ambient air pollution., Method: To assess the short-term impact of daily exposure to multiple air pollutants (PM 2.5 , PM 10 , NO 2 , and O 3 ) on the public bike-sharing system (PBS) usage in Seoul, South Korea (2018-2021), we applied a quasi-Poisson generalized linear model combined with a distributed lag nonlinear model (DLNM). The model was adjusted for day of the week, holiday, temperature, relative humidity, and long-term trend. We also conducted stratification analyses to examine the potential effect modification by age group, seasonality, and COVID-19., Results: We found that there was a negative association between daily ambient air pollution and the PBS usage level at a single lag day 1 (i.e., air quality a day before the event) across all four pollutants. Our results suggest that days with high levels of air pollutants (at 95th percentile) are associated with a 0.91% (0.86% to 0.96%) for PM 2.5 , 0.89% (0.85% to 0.94%) for PM 10 , 0.87% (0.82% to 0.91%) for O 3 , and 0.92% (0.87% to 0.98%) for NO 2 , reduction in cycling behavior in the next day compared to days with low levels of pollutants (at 25th percentile). No evidence of effect modification was found by seasonality, age nor the COVID-19 pandemic for any of the four pollutants., Conclusions: Our findings suggest that high concentrations of ambient air pollution are associated with decreased rates of PBS usage on the subsequent day regardless of the type of air pollutant measured., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study investigated the associations of occupational physical activity and active transport with depressive symptoms, stratified by income range, among Brazilian working adults., Study Design: This cross-sectional study drew on data from the 2019 Brazilian National Health Survey., Methods: We used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms in working adults aged 18-65 years, with physical activities (occupational physical activity and active transport) self-reported through a specially developed questionnaire. Crude and adjusted logistic regression models were fitted., Results: Individuals at the highest level of occupational physical activity (odds ratio [OR] 1.35; 95% confidence interval [95% CI] 1.19-1.53) and at the moderate level of active transport to work (OR 1.66; 95% CI 1.24-2.22) returned increased odds of depressive symptoms as compared with those who were inactive in these domains. Stratified by income group, light active transport to work (OR 0.57; 95% CI 0.34-0.95) in the lower income group (Range 1) was associated with lower odds of depressive symptoms. On the other hand, individuals at the highest level of active transport to work returned higher odds of depressive symptoms in the low- and intermediate-income groups, Ranges 3 and 4 (OR 1.92; 95% CI 1.22-3.00 and OR 2.91; 95% CI 1.71-4.95, respectively)., Conclusion: Our results suggest that occupational physical activity and active transport may be a risk factor for depressive symptoms. They also point to differences in this relationship by income range. Further studies are needed to pursue the analysis of how specific domains of physical activity contribute to depressive symptoms., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Public transport priority systems such as Bus Rapid Transit (BRT) and Buses with High Level of Service (BHLS) are top-rated solutions to mobility in low-income and middle-income cities. There is scientific agreement that the safety performance level of these systems depends on their functional, operational, and infrastructure characteristics. However, there needs to be more evidence on how the different characteristics of bus corridors might influence safety. This paper aims to shed some light on this area by structuring a multivariate negative binomial model comparing crash risk on arterial roads, BRT, and BHLS corridors in Bogotá, Colombia. The analyzed infrastructure includes 712.1 km of arterial roads with standard bus service, 194.1 km of BRT network, and 135.6 km of BHLS network. The study considered crashes from 2015 to 2018 -fatalities, injuries, and property damage only- and 30 operational and infrastructure variables grouped into six classes -exposure, road design, infrastructure, public means of transport, and land use. A multicriteria process was applied for model selection, including the structure and predictive power based on [i] Akaike information criteria, [ii] K-fold cross-validation, and [iii] model parsimony. Relevant findings suggest that in terms of observed and expected accident rates and their relationship with the magnitude of exposure -logarithm of average annual traffic volumes at the peak hour (LOG&#95;AAPHT) and the percentage of motorcycles, cars, buses, and trucks- the greatest risk of fatalities, injuries, and property damage occurs in the BHLS network. BRT network provides lower crash rates in less severe collisions while increasing injuries and fatalities. When comparing the BHLS network and the standard design of arterial roads, BHLS infrastructure, despite increasing mobility benefits, provides the lowest safety performance among the three analyzed networks. Individual factors of the study could also contribute to designing safer roads related to signalized intersection density and curvature. These findings support the unique characteristics and traffic dynamics present in the context of Bogotá that could inform and guide decisions of corresponding authorities in other highly dense urban areas from developing countries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: People with disabilities have higher rates of physical inactivity than people without. Active travel (e.g., walking/wheeling to nearby destinations or transit) is a recommended approach to increasing total physical activity (PA) but limited research has examined active travel among people with disabilities., Objective: To describe active travel among a nationally representative sample of people with disabilities, analyze variation between sub-groups, and examine factors associated with active travel., Methods: Using the 2017 National Household Travel Survey, our cross-sectional analysis summarized counts and duration of walking/wheeling trips for people with four different types of disabilities. We examined which factors were associated with doing any active travel and the duration of active travel, using zero inflated negative binomial regression models., Results: Our analysis identified that 14.55% of people with disabilities took a mean of 2.56 (95%CI = 2.42-2.69) walking/wheeling trips per day. Compared to non-active travelers, a higher proportion of active travelers were low-income, lived alone, had no-vehicle, and were Black or Hispanic. For active travelers, daily walking minutes, on average, were 46.41 (95%CI = 40.25-52.57) among people who used ambulatory devices, 41.55 (95%CI = 24.61-58.49) among people who were blind/low-vision, 39.93 (95%CI = 35.41-44.45) among people who used no device, and 29.58 (95%CI = 23.53-35.64) among people who used chair devices. Our analysis identified individual, household, and community factors associated with the likelihood and duration of walking/wheeling for travel and variation across disability types., Conclusions: Understanding the multiple identities of active travelers with disabilities can inform walking/wheeling intervention strategies. Infrastructure improvements that support less reliance on automobiles could increase active travel among people with disabilities., Competing Interests: Declaration of competing interest The authors have indicated that they have no potential conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Prior investigators have examined the relationship between neighborhood public transportation access and physical activity among adolescents, but research is lacking on the association with obesity in this age group. This study examines the association between neighborhood public transportation access and adolescent BMI using a national sample. Methods: We used cross-sectional data from the Family Life, Activity, Sun, Health, and Eating study, a national survey (2014) that assessed physical activity and diet, among adolescents (aged 12-17 years, N  = 1737) and their parents. We ran crude and adjusted linear regression models to test the association between neighborhood-level public transportation access (less prevalent and prevalent) and individual participant-level BMI z -scores. Results: The analytic sample included 336 adolescents (50% female; 69% had healthy weight; 28% had overweight or obesity). Adjusted models showed a positive relationship between high public transportation access and adolescent z -BMI ( b  = 0.25, confidence interval [95% CI]: -0.01 to 0.50). In stratified analyses, high public transportation access was associated with higher z -BMI for high school students ( b  = 0.57, 95% CI: 0.23-0.91), males ( b  = 0.48, 95% CI: 0.09-0.87), and adolescents in households with an income below $99,999 (0.29, 95% CI: 0.02-0.56). Conclusion: Neighborhood public transportation access is associated with adolescent BMI, but the direction of this association varies across urban adolescent demographic subgroups. Further research is needed to clarify the relationships between individual and social-environmental factors that impact public transportation access and its association with adolescent BMI.

Objectives: The objective of the present study was to model the effects of a reduced number of treatment centres for acute type A aortic dissection on preclinical transportation distance and time. We examined whether treatment in selected centres in Germany would be implementable with respect to time to treatment., Methods: For our transportation model, the number of aortic dissections and respective mean annual volume were collected from the annual quality reports (2015-2017) of all German cardiac surgery centres (n = 76). For each German postal code, the fastest and shortest routes to the nearest centre were calculated using Google Maps. Furthermore, we analysed data from the German Federal Statistical Office from January 2005 to December 2015 to identify all surgically treated patients with acute type A aortic dissection (n = 14 102) and examined the relationship between in-hospital mortality and mean annual volume of medical centres., Results: Our simulation showed a median transportation distance of 27.13 km and transportation time of 35.78 min for 76 centres. Doubling the transportation time (70 min) would allow providing appropriate care with only 12 medical centres. Therefore, a mean annual volume of >25 should be obtained. High mean annual volume was associated with significantly lower in-hospital mortality rates (P < 0.001). A significantly lower mortality rate of 14% was observed (P < 0.001) if a mean annual volume of 30 was achieved., Conclusions: Operationalizing the volume-outcome relationship with fewer but larger medical centres results in lower mortality, which outweighs the disadvantage of longer transportation time., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background: Active transport- for example walking and bicycling to travel from place to place- may improve physical fitness and health and mitigate climate change if it replaces motorised transport. The aim of this study is to analyse the active transport behaviour of adults living in Germany, to investigate differences among population groups and to determine whether climate protection is a frequent motive for this behaviour., Methods: This study uses self-reported data of 4,971 adults who participated in a national health survey (German Health Update 2021), which was conducted as a telephone survey from July to December 2021. Associations between active transport behaviour and corresponding motives with sociodemographic and health-related variables were analysed using logistic regression models., Results: Of the adult population, 83% use active transport at least once a week. The frequency and duration of walking per week are significantly higher than those for bicycling (walking 214 min/week; bicycling 57 min/week). Those with a lower education level are less likely to practise active transport than those with a higher education level. Furthermore, women are less likely to use a bicycle for transport than men. Among those practising active transport, the most frequently mentioned motive is "is good for health" (84%) followed by "to be physically active" (74%) and "is good for the climate/environment" (68%). Women and frequent bicyclists (at least 4 days/week) mention climate protection as a motive more often than men and those bicycling occasionally., Conclusions: The improvement of active transport, especially among people with lower education and women (for bicycling), may benefit from better insights into motives and barriers. Climate protection is an important motivator for practising active transport within the adult population living in Germany and should therefore have greater emphasis in behavioural change programmes., (© 2024. The Author(s).)

The occupational health burden and mechanisms that link gig work to health are understudied. We described injury and assault prevalence among food delivery gig workers in New York City (NYC) and assessed the effect of job dependence on injury and assault through work-related mechanisms and across transportation modes (electric bike and moped versus car). Data were collected through a 2022 survey commissioned by the NYC Department of Consumer and Worker Protection among delivery gig workers between October and December 2021 in NYC. We used modified Poisson regression models to estimate the adjusted prevalence rate ratio associations between job dependence and injury and assault. Of 1650 respondents, 66.9% reported that food delivery gig work was their main or only job (i.e., fully dependent). About 21.9% and 20.8% of respondents reported being injured and assaulted, respectively. Injury and assault were more than twice as prevalent among two-wheeled drivers, in comparison to car users. Fully dependent respondents had a 1.61 (95% confidence interval (CI) 1.20, 2.16) and a 1.36 (95% CI 1.03, 1.80) times greater prevalence of injury and assault, respectively, than partially dependent respondents after adjusting for age, sex, race and ethnicity, language, employment length, transportation mode, and weekly work hours. These findings suggest that fully dependent food delivery gig workers, especially two-wheeled riders, are highly vulnerable to the negative consequences of working conditions under algorithmic management by the platforms. Improvements to food delivery gig worker health and safety are urgently needed, and company narratives surrounding worker autonomy and flexibility need to be revisited., (© 2024. The Author(s).)

Objectives: Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships., Methods: This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the likelihood of a companionship tie among senior center members (N = 42)., Results: Members had an average of 2 companionships with one another (M = 2.2, SD = 2.7). Companionships were more likely for members with greater life-space mobility (p = .009), who attended the senior center more frequently (p = .004), with automobile ownership in their households (p = .034), and who were not transportation cost-burdened (i.e., spent less than 15% of their income on transportation, p = .005). Demographic characteristics, limitations on instrumental activities of daily living, and being at risk for depression were not significantly associated with the likelihood of companionships., Discussion: These findings extend previous knowledge of the role of life-space mobility and transportation in supporting general social participation for older adults to include the importance of transportation and mobility for having companions within a senior center., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Road traffic crashes (RTCs) are significantly high in Nigeria with serious social and health consequences. While existing studies on RTCs have mainly focused on the effect of socio-economic, environmental, human and mechanical factors to address the high rates, the relationship between road transport fares and RTCs has been glossed over in literature. Thus, this study examines the influence of road transport fares and other covariates on RTCs. Data on RTCs and the predictors between 2017 and 2022 were obtained from the records of the National Bureau of Statistics and the Federal Road Safety Corps. Spatial statistical techniques were used for the data analysis. RTCs vary across the country, and Northern Nigeria is the hot spot. Results from the spatial analysis show that road transport fares, population density, and illiteracy rate are significant predictors of RTCs. The study recommends striking a balance between fare affordability, the quality of service provided, and the implementation of effective transportation strategies.

Aim: To determine the extent to which level of active commute mode use is associated with self-rated health and work ability., Methods: The data were sourced from the Finnish Public Sector Study survey in 2020 ( n = 38,223). The associations between active commuting - assessed with the frequency of using active commute modes - and self-rated health and work ability were examined with negative binomial regression analyses. Passive commuting and low-to-moderate levels of active commuting were compared with active commuting, and the models were adjusted for sociodemographic factors, working time mode, and lifestyle risk factors. We also assessed separate associations between walking and cycling as a mode of commuting by additionally considering the commuting distance and the outcomes., Results: After adjustment, when using active commuters as a reference, passive commuters had a 1.23-fold (95% confidence intervals (CI) 1.19 to 1.29) risk of suboptimal self-rated health and a 1.18-fold (95% CI 1.13 to 1.22) risk of suboptimal work ability. More frequent and/or longer distance by foot and especially by bicycle, was positively associated with health and work ability. Never commuting by bicycle was associated with a 1.65-fold (95% CI 1.55 to 1.74) risk of suboptimal health and a 1.27-fold (95% CI 1.21 to 1.34) risk of suboptimal work ability when using high-dose bicycle commuting as a reference., Conclusions: Passive commuting was associated with suboptimal self-rated health and suboptimal work ability. Our results suggest that using active commute modes, particularly cycling, may be beneficial for employee health and work ability., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Traffic accidents on the road is an accident is a terrible accident that causes death, injury, and property damage. However, limited studies were addressed to investigate the prevalence of traffic accidents on the road and the contributing factors among drivers that help in developing strategies to cop-up the incidence within the research domain in Ethiopia, particularly in the study area., Objective: This study aimed to assess the prevalence of road traffic accidents and the contributing factors among drivers of public transportation in Mizan Aman town, Ethiopia., Methods: A community-based cross-sectional survey was employed among 376 drivers of public transportation. Every research subject was selected by using a simple random sampling technique. Semi-structured and open-ended questionnaires which comprised demographic characteristics, risky personal behaviors and lifestyles, driver's factors, vehicle condition, and environmental conditions were used to gather data. And then after, data was collected through interviewer-administered using KoBo Collect tools. Completed data were edited and cleaned in the Kobo collect toolbox and then exported for additional analysis to a statistical tool for social science statistics version 26. The descriptive statistics were displayed as figures, tables, and texts. Binary logistic regression was analyzed to identify the contributing factors. Statistically significant was decided with a p -value of ≤ 0.05., Results: The results showed that the prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was 17%. The study identified factors influencing traffic accidents on the roads including marital status (being single), employee condition (permanent), monthly income (1001-2500 Ethiopia Birr), alcohol use, vehicle maintenance (not), road type (non-asphalt), and weather conditions (being windy)., Conclusion: The overall prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was relatively low. Despite this, sociodemographic characteristics, driver factors, vehicle conditions, and environmental conditions [road type and weather conditions] were the predicting factors of traffic accidents in town. Therefore, reduction strategies should be the highest priority duty for concerned bodies like Mizan Aman town road and transport office, Bench Sheko zone transport and logistics office, and Southwest Ethiopia People Regional State (SWEPRS) transport bureau in the study area., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Endalew, Gibo, Belay, Zegeye, Ango and Ketema Astatke.)

The layout, scale and spatial form of urban employment centers are important guidelines for the rational layout of public service facilities such as urban transportation, medical care, and education. In this paper, we use Internet cell phone positioning data to identify the workplace and residence of users in the Beijing city area and obtain commuting data of the employed to measure the employment center system in Beijing. Firstly, the employment density distribution is generated using the data of the working places of the employed persons, and the employment centers are identified based on the employment density of Beijing. Then, we use the business registration data of employment centers to measure the industrial diversity within the employment centers by using the ecological Shannon Wiener Diversity Index, and combine the commuting links between employment centers and places of residence to measure the energy level of each employment center, analyze the hinterland and sphere of influence of each center, and finally using the industrial diversity index of employment centers and the average commuting time of employed persons, combined with the K-Means clustering algorithm, to classify the employment centers in Beijing. The employment center identification and classification method based on big data constructed in this study can help solve the limitations of the previous employment center system research in terms of center identification and commuting linkage measurement due to large spatial units and lack of commuting data to a certain extent. The study can provide reference for the regular understanding and technical analysis of employment centers and provide help for the employment multi-center system in Beijing in terms of quantifying the employment spatial structure, guiding the construction of multi-center system, and adjusting the land use rules., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wang, Cui. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Importance: Associations of domain-specific physical activity with stroke incidence and poststroke outcomes have not been extensively studied using long-term, population-based data., Objective: To investigate associations of leisure time, work time, transport, and household physical activity with stroke incidence and death or dependency in activities of daily living (ADL) 3 months after stroke., Design, Setting, and Participants: The prospective, population-based Interplay Between Genetic Susceptibility and External Factors (INTERGENE) cohort study was conducted among a random sample of individuals from an urban-rural area covering western Sweden; 3614 individuals aged 24 to 77 years were examined in 2001 to 2004, and 1394 individuals were reexamined in 2014 to 2016. The median (range) follow-up was 20.0 years (56 days to 21.9 years). Data were analyzed from September through October 2023., Exposure: Physical activity levels were self-reported for leisure time, work time, transportation, and household domains. The mean number of steps taken over a 6-day period was collected in a subgroup of participants using a sealed pedometer., Main Outcomes and Measures: Follow-up for stroke incidence and mortality rates continued until December 31, 2022. The composite outcome of death or ADL dependency was assessed at 3 months after stroke., Results: Among 3614 individuals (mean [SD] age, 51.4 [13.1] years; 1910 female [52.9%]); 269 individuals (7.4%) developed stroke, of whom 120 individuals (44.6%) were dead or ADL dependent at 3 months. Intermediate (adjusted hazard ratio [aHR], 0.54; 95% CI, 0.38-0.77) and high (aHR, 0.47; 95% CI, 0.31-0.73) levels of leisure time physical activity were associated with a reduced incidence of stroke compared with low levels, as was an intermediate level of physical activity in transportation (aHR, 0.69; 95% CI, 0.52-0.93). High levels of leisure time physical activity were also associated with a reduced risk of poststroke death or ADL dependency (adjusted odds ratio, 0.34; 95% CI, 0.16-0.71) compared with low levels. Work time and household physical activity were not associated with stroke incidence or stroke outcomes. In exploratory subgroup analyses, there were interactions between physical activity and smoking (current smoking or smoking in the past year associated with stroke risk only in participants with low or intermediate physical activity: aHR, 2.33; 95% CI, 1.72-3.15) and family history of stroke (first-degree relative with a history of stroke associated with stroke risk only in participants with low or intermediate physical activity: aHR, 1.73; 95% CI, 1.27-2.38)., Conclusions and Relevance: In this study, leisure time and transport-related physical activities were associated with a reduced risk of stroke. A high level of leisure time physical activity was also associated with a lower risk of death or ADL dependency 3 months after stroke.

Active mobility, encompassing walking and cycling for transportation, is a potential solution to health issues arising from inadequate physical activity in modern society. However, the extent of active mobility's impact on individual physical activity levels, and its association with health as mediated by physical activities, is not fully quantified. This study aims to clarify the direct relationship between active mobility usage and individual health, as well as the indirect relationship mediated by physical activity, with a focus on varying levels of physical activity intensity. Utilizing data from the 2017 U.S. National Household Travel Survey (NHTS), we employed Poisson regression to predict active mobility usage based on socio-demographic and household socio-economic characteristics. A Structural Equation Model (SEM) was then used to investigate the direct and indirect effects of active mobility on individual health, mediated by physical activity. We further segmented individuals according to their intensity of physical activity to examine how such effect differs between different levels of physical activity. The study demonstrates that active mobility usage positively correlates with both the amount and intensity of physical activity. The effect of active mobility on individual health includes a direct positive effect (29% for intensity, 67.7% for amount) and an indirect effect mediated by physical activity (71% for intensity, 32.3% for amount). Notably, the mediation effect of active mobility on health is more substantial in the context of vigorous physical activities compared to light or moderate activities. Our findings reveal a significant positive influence of active mobility on individual health, encompassing both direct and indirect effects mediated by physical activities. These results quantitatively underscore the health benefits of active mobility and suggest the importance of promoting active mobility as a strategy to improve public health., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: This study aimed to examine the association between transportation assistance and study visits, and explore differences by transportation modality., Study Design: This was a secondary analysis of prospective cohort study. We identified patients requesting transportation support for research ultrasound visits and identified controls (1:2 ratio) who did not request support matched for age, race, and insurance type. Conditional logistic regression examined the association between transportation support and mode of transportation with study visit attendance., Results: Transportation support was requested by 57/1,184 (4.8%) participants. Participants that requested transportation support were three times more likely to attend visits than their matched controls (adjusted odds ratio [aOR] = 3.16, 95% confidence interval [CI]: 1.76-5.68). Among visits with transportation support, those supported by a ridesharing service had five-fold higher odds of attendance than visits supported with taxi service (aOR = 5.06, 95% CI: 1.50-16.98)., Conclusion: Transportation support, especially a ridesharing service, is associated with improved attendance at research study visits in a sample of predominantly low-income, Black, pregnant participants. Implementing transportation support may be a promising strategy to improve engagement in research studies., Key Points: · Participants utilizing transportation assistance were more likely to attend study appointments.. · Participants using ridesharing had higher likelihood of attendance than those using taxi service.. · Transportation assistance may improve research engagement for historically marginalized people.., Competing Interests: E.B.C. received payment as part of Carter Expert Strategic Consulting. She is a volunteer Board Advisor for Affinia Healthcare and expert advisor for Mother Goose. The other authors did not report any potential conflicts of interest., (Thieme. All rights reserved.)

Background: Recent modifications to low-dose CT (LDCT)-based lung cancer screening guidelines increase the number of eligible individuals, particularly among racial and ethnic minorities. Because these populations disproportionately live in metropolitan areas, we analyzed the association between travel time and initial LDCT completion within an integrated, urban safety-net health care system., Methods: Using Esri's StreetMap Premium, OpenStreetMap, and the r5r package in R, we determined projected private vehicle and public transportation travel times between patient residence and the screening facility for LDCT ordered in March 2017 through December 2022 at Parkland Memorial Hospital in Dallas, Texas. We characterized associations between travel time and LDCT completion in univariable and multivariable analyses. We tested these associations in a simulation of 10,000 permutations of private vehicle and public transportation distribution., Results: A total of 2,287 patients were included in the analysis, of whom 1,553 (68%) completed the initial ordered LDCT. Mean age was 63 years, and 73% were underrepresented minorities. Median travel time from patient residence to the LDCT screening facility was 17 minutes by private vehicle and 67 minutes by public transportation. There was a small difference in travel time to the LDCT screening facility by public transportation for patients who completed LDCT versus those who did not (67 vs 66 min, respectively; P=.04) but no difference in travel time by private vehicle for these patients (17 min for both; P=.67). In multivariable analysis, LDCT completion was not associated with projected travel time to the LDCT facility by private vehicle (odds ratio, 1.01; 95% CI, 0.82-1.25) or public transportation (odds ratio, 1.14; 95% CI, 0.89-1.44). Similar results were noted across travel-type permutations. Black individuals were 29% less likely to complete LDCT screening compared with White individuals., Conclusions: In an urban population comprising predominantly underrepresented minorities, projected travel time is not associated with initial LDCT completion in an integrated health care system. Other reasons for differences in LDCT completion warrant investigation.

Background: Street greenery may have a profound effect on residents' active travel (AT), a mode of transportation involving walking and cycling. This study systematically reviewed the scientific evidence on the effects of street greenery on active travel., Methods: A comprehensive search was performed using keywords and references in PubMed, Web of Science, Scopus, and Cochrane Library. The review included studies that met the following criteria: (1) Study design: experimental studies, cross sectional studies, (2) Participants: individuals of all ages, (3) Exposure variables: street greenery, including street vegetation (e.g., trees, shrubs, and lawns), (4) Outcomes: active travel behaviors (walking, cycling), (5) Article type: peer-reviewed articles, (6) Search time window: from the inception of relevant electronic literature database until 21 June 2023, (7) Geographic scope: worldwide; (8) Language: articles in English., Results: Twenty-six cross-sectional studies met the inclusion criteria and were analyzed. These studies employed objective metrics for assessing street greenery and varied methodologies to measure AT, including 14 using subjective measurements (like self-reported surveys), 10 using objective data (such as mobile app analytics), and two studies combined both approaches. This review identifies a generally positive impact of street greenery on active travel in various aspects. However, the extent of this influence varies with factors such as temporal factors (weekdays vs. weekends), demographic segments (age and gender), proximity parameters (buffer distances), and green space quantification techniques. Street greenness promotes active travel by enhancing environmental esthetics, safety, and comfort, while also improving air quality, reducing noise, and fostering social interactions. In addition, the study suggests that variables like weather, seasonality, and cultural context may also correlate with the effectiveness of street greenery in encouraging active travel., Conclusion: Street greenery positively influences active travel, contributing to public health and environmental sustainability. However, the findings also indicate the need for more granular, experimental, and longitudinal studies to better understand this relationship and the underlying mechanisms. These insights are pivotal for urban planners and policymakers in optimizing green infrastructure to promote active transportation, taking into account local demographics, socio-economic factors, and urban design., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yu, Zhang, Dong and Shen.)

Purpose: Examine the risk for site-specific incident cancer across representative transport, rescue, and security industries., Methods: This Danish nationwide register-based study included all 302,789 workers from transport, rescue and security industries in 2001-2015 and 2,230,877 individuals aged 18-64 years from a total sample of the economically active population for comparison. We used Cox models to estimate the hazard ratios (HRs) of incident cancers. We categorized site-specific cancers by using population-attributable fraction (PAF) estimates from the previous literature., Results: During an average follow-up of 13.4 years, 22,116 incident cancer cases were recorded in these industries. Compared with the reference population, the age-adjusted cancer incidence with a high PAF was higher among men in seafaring (HR 1.28; 95% CI 1.14-1.43), and land transport (HR 1.32; 95% CI: 1.26-1.37), and among women in seafaring (HR 1.26; 95% CI: 1.01-1.57), land transport (HR 1.21; 95% CI: 1.12-1.32), aviation (HR 1.22; 95% CI: 1.05-1.41), and police force (HR 1.21; 95% CI: 1.04-1.40). Overall, tobacco and physical inactivity were the most significant risk factors of cancer., Conclusions: Regardless of considerable disparities in incident cancer attributable to modifiable risk factors across industries, the total incident cancer rate was elevated in all industries in both sexes., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Surplus dairy calves often arrive at veal and dairy-beef rearing facilities with health and blood metabolite level abnormalities, which can affect their welfare and performance, predisposing them to future health challenges. The objective of this randomized controlled trial was to investigate the effects of transport duration and age at the time of transport on blood parameters in surplus dairy calves following 6, 12, or 16 h of continuous road transportation. All surplus calves from 5 commercial dairy farms in Ontario were enrolled and examined daily before transport (n = 175). On the day of transportation, calves were weighed, blood sampled, and randomly assigned to 6, 12, or 16 h of transportation. Blood samples were then collected immediately after transportation, as well as 24, 48, and 72 h thereafter. Serum was analyzed at a provincial diagnostic laboratory for nonesterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), creatine kinase (CK), cholesterol, and haptoglobin. In addition, blood gas and electrolyte values were also assessed at the time of sample collection. Mixed models with repeated measures were used to assess the effects of transport duration, breed, sex, transfer of passive immunity status, weight before transportation, and age at transportation on blood parameters. Immediately following transportation, NEFA and BHBA were greater for calves transported for 12 h (Δ = 0.22 mmol/L NEFA, 95% CI = 0.15 to 0.30; Δ = 0.04 mmol/L BHBA, 95% CI = 0.02 to 0.06) and 16 h (Δ = 0.35 mmol/L NEFA, 95% CI = 0.27 to 0.42; Δ = 0.10 mmol/L BHBA, 95% CI = 0.08 to 0.11) compared with calves transported for 6 h. Glucose was lower immediately following transportation in calves transported for 16 h compared with 6 h (Δ = -15.54 mg/dL, 95% CI = -21.54 to -9.54). In addition, pH and HCO 3 - were lower in calves transported for 12 (Δ = -0.09 pH, 95% CI = -0.13 to -0.05; Δ = -1.59 mmol/L HCO 3 - , 95% CI = -2.61 to -0.56) and 16 h (Δ = -0.07 pH, 95% CI = -0.12 to -0.03; Δ = -1.95 mmol/L HCO 3 - , 95% CI = -2.95 to -0.95) compared with calves transported for 6 h. Calves transported between 15 and 19 d of age had a higher concentration of cholesterol and CK (Δ = 0.27 mmol/L cholesterol; 37.18 U/L CK) compared with 2- to 6-d-old calves, and calves 12 to 14 d old had greater reduction in HCO 3 - (Δ = -0.92 mmol/L) compared with 2- to 6-d-old calves. These findings show that transporting calves for long distances results in lower glucose concentration and suboptimal energy status, and that this effect varies based on the calf's age., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Transport-sharing systems are eco-friendly and the most promising services in smart urban environments, where the booming Internet of things (IoT) technologies play an important role in the smart infrastructure. Due to the imbalanced bike distribution, bikes and stalls in the docking stations could be unavailable when needed, leading to bad customer experiences. We develop a dynamic repositioning strategy for the management of bikes in this paper, which supports dispatchers to keep stations in service. Two open datasets are examined, and the exploratory data analysis presents that there is a significant difference of travel patterns between working and non-working days, where the former has an excess demand at rush hours and the latter is usually at a low demand. To evaluate the effect when the demand outstrips a station's capacity, we propose a non-linear scaling technique to transform demand patterns and perform the clustering analysis for each of five categories obtained from the sophisticated analysis of the dataset. Our repositioning strategy is developed according to the transformed demands. Compared with the previous work, numerical simulations reveal that our strategy has a better performance for high-demand stations, and thus can substantially reduce the repositioning cost, which brings benefit to bike-sharing operators for managing the city bike system.

In most big cities, public transports are enclosed and crowded spaces. Therefore, they are considered as one of the most important triggers of COVID-19 spread. Most of the existing research related to the mobility of people and COVID-19 spread is focused on investigating highly frequented paths by analyzing data collected from mobile devices, which mainly refer to geo-positioning records. In contrast, this paper tackles the problem by studying mass mobility. The relations between daily mobility on public transport (subway or metro) in three big cities and mortality due to COVID-19 are investigated. Data collected for these purposes come from official sources, such as the web pages of the cities' local governments. To provide a systematic framework, we applied the IBM Foundational Methodology for Data Science to the epidemiological domain of this paper. Our analysis consists of moving averages with a moving window equal to seven days so as to avoid bias due to weekly tendencies. Among the main findings of this work are: a) New York City and Madrid show similar distribution on studied variables, which resemble a Gauss bell, in contrast to Mexico City, and b) Non-pharmaceutical interventions don't bring immediate results, and reductions to the number of deaths due to COVID are observed after a certain number of days. This paper yields partial evidence for assessing the effectiveness of public policies in mitigating the COVID-19 pandemic., Competing Interests: The authors have declared that no competing interests exist.

Many of our routines and activities are linked to our ability to move; be it commuting to work, shopping for groceries, or meeting friends. Yet, factors that limit the individuals' ability to fully realise their mobility needs will ultimately affect the opportunities they can have access to (e.g. cultural activities, professional interactions). One important aspect frequently overlooked in human mobility studies is how gender-centred issues can amplify other sources of mobility disadvantages (e.g. socioeconomic inequalities), unevenly affecting the pool of opportunities men and women have access to. In this work, we leverage on a combination of computational, statistical, and information-theoretical approaches to investigate the existence of systematic discrepancies in the mobility diversity (i.e. the diversity of travel destinations) of (1) men and women from different socioeconomic backgrounds, and (2) work and non-work travels. Our analysis is based on datasets containing multiple instances of large-scale, official, travel surveys carried out in three major metropolitan areas in South America: Medellín and Bogotá in Colombia, and São Paulo in Brazil. Our results indicate the presence of general discrepancies in the urban mobility diversities related to the gender and socioeconomic characteristics of the individuals. Lastly, this paper sheds new light on the possible origins of gender-level human mobility inequalities, contributing to the general understanding of disaggregated patterns in human mobility., Competing Interests: The authors have declared that no competing interests exist.

Background: Physical activity (PA) is associated with numerous health benefits among children and youth. However, few studies have examined how active transportation (AT) and device-based measures of PA vary within and between countries in sub-Saharan Africa., Purpose: This cross-sectional study sought to investigate the prevalence and correlates of AT and device-measured PA among children living in urban, peri-urban and rural areas in three African countries representing Eastern, Western and Southern regions of Africa., Methods: 3,205 participants (53.3% girls; 46.7% boys) aged 10-12 years were recruited in Kenya, Nigeria and Mozambique. Data were collected using a child questionnaire, a parent/guardian questionnaire and PiezoRx® pedometers. ANCOVA and binary logistic regression analyses were used to examine the correlates of AT and PA while controlling for gender, age, parent education and vehicle ownership., Results: Participants accumulated an average of 45.6±23.5 min/day of moderate-to-vigorous physical activity (MVPA) and 11,215±4,273 steps/day. Kenyan and Mozambican children were significantly more active than their Nigerian counterparts (p<0.001). Only 23% met the MVPA guidelines of 60 min/day. 65.1% of participants engaged in AT to school (and 67.8% for the trip back home) with no gender differences. Living in a rural area, lower parent education, lower vehicle ownership and higher motorcycle ownership were associated with higher odds of AT. Other correlates of AT were country-specific. Girls accumulated less daily MVPA than boys in all countries. MVPA was positively associated with living in less urbanized areas in Nigeria and Mozambique. In Kenya, lower parental education and AT were associated with higher MVPA. Nigerian children's daily MVPA decreased with age and the number of parent-perceived barriers to AT., Conclusions: Majority of children engaged in AT, but still failed to meet MVPA recommendations. Most correlates of AT and PA were country-specific, suggesting that strategies to encourage both behaviours should be informed by local evidence., Competing Interests: The authors have declared that no competing interests exist.

Since ride-hailing has become an important travel alternative in many cities worldwide, a fervent debate is underway on whether it competes with or complements public transport services. We use Uber trip data in six cities in the United States and Europe to identify the most attractive public transport alternative for each ride. We then address the following questions: (i) How does ride-hailing travel time and cost compare to the fastest public transport alternative? (ii) What proportion of ride-hailing trips do not have a viable public transport alternative? (iii) How does ride-hailing change overall service accessibility? (iv) What is the relation between demand share and relative competition between the two alternatives? Our findings suggest that the dichotomy-competing with or complementing-is false. Though the vast majority of ride-hailing trips have a viable public transport alternative, between 20% and 40% of them have no viable public transport alternative. The increased service accessibility attributed to the inclusion of ride-hailing is greater in our US cities than in their European counterparts. Demand split is directly related to the relative competitiveness of travel times i.e. when public transport travel times are competitive ride-hailing demand share is low and vice-versa., Competing Interests: SRD is employed by Uber. This does not alter our adherence to PLOS ONE policies on sharing data and materials. This research has not been commissioned by Uber to OC, RK and MY.

Real-time ride-sharing has become popular in recent years. However, the underlying optimization problem for this service is highly complex. One of the most critical challenges when solving the problem is solution quality and computation time, especially in large-scale problems where the number of received requests is huge. In this paper, we rely on an exact solving method to ensure the quality of the solution, while using AI-based techniques to limit the number of requests that we feed to the solver. More precisely, we propose a clustering method based on a new shareability function to put the most shareable trips inside separate clusters. Previous studies only consider Spatio-temporal dependencies to do clustering on the mobility service requests, which is not efficient in finding the shareable trips. Here, we define the shareability function to consider all the different sharing states for each pair of trips. Each cluster is then managed with a proposed heuristic framework in order to solve the matching problem inside each cluster. As the method favors sharing, we present the number of sharing constraints to allow the service to choose the number of shared trips. To validate our proposal, we employ the proposed method on the network of Lyon city in France, with half-million requests in the morning peak from 6 to 10 AM. The results demonstrate that the algorithm can provide high-quality solutions in a short time for large-scale problems. The proposed clustering method can also be used for different mobility service problems such as car-sharing, bike-sharing, etc., Competing Interests: The authors have declared that no competing interests exist.

COVID-19 outbreaks have had high mortality in low- and middle-income countries such as Ecuador. Human mobility is an important factor influencing the spread of diseases possibly leading to a high burden of disease at the country level. Drastic control measures, such as complete lockdown, are effective epidemic controls, yet in practice one hopes that a partial shutdown would suffice. It is an open problem to determine how much mobility can be allowed while controlling an outbreak. In this paper, we use statistical models to relate human mobility to the excess death in Ecuador while controlling for demographic factors. The mobility index provided by GRANDATA, based on mobile phone users, represents the change of number of out-of-home events with respect to a benchmark date (March 2nd, 2020). The study confirms the global trend that more men are dying than expected compared to women, and that people under 30 show less deaths than expected, particularly individuals younger than 20 with a death rate reduction between 22 and 27%. The weekly median mobility time series shows a sharp decrease in human mobility immediately after a national lockdown was declared on March 17, 2020 and a progressive increase towards the pre-lockdown level within two months. Relating median mobility to excess deaths shows a lag in its effect: first, a decrease in mobility in the previous two to three weeks decreases excess death and, more novel, we found an increase of mobility variability four weeks prior increases the number of excess deaths., (© 2022. The Author(s).)

Background: Structural factors limiting access to surgical care require elucidation. We hypothesize transportation time to hospitals with surgical capacity disproportionately burdens minority populations., Methods: We identified hospitals with surgical capacity within a 20-mile radius of our city center. Using geocoding, we estimated travel times from each census tract to the nearest facility by car or public bus., Results: For 143 tracts within the county, drive time was 13 ± 4 min and bus time was 33 ± 15 min. Only 41.2% of the population had a facility within 30 min by bus; access was further diminished for those with minority race/ethnicity and/or no insurance. Bus time was associated with percent minority population in a census tract: for each 10% increase in minority population there was a 4.3-min increase in bus time (p < 0.001) when controlling for socioeconomic status and other characteristics., Conclusions: Geographic information systems analysis has potential to identify communities with disproportionate burden to access surgical services., (Copyright © 2021 Elsevier Inc. All rights reserved.)