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Based on the survey data of shadow education activities of junior middle school students in Dalian, China in 2020, this paper analyzes the socio-spatial differentiation of participation, activity spatial distribution and travel distance. It's found that: (1) The participation rate reaches 74.17%. In general, the higher socioeconomic status strata have more advantages both in participation rate and registered subjects' number. Spatially, though the suburban area has the lowest participation rate, the largest registered subjects' number per student is there. (2) Spatial agglomeration of shadow education activities is obvious, mainly gathering in commercial centers, around schools and residential areas and forming a relatively dispersed multi-core structure. The activities of the middle socioeconomic status strata are most widely distributed. (3) The average travel distance of shadow education is almost twice that of travel to school. The average distance goes up with the rise of social strata with the only exception of the highest stratum because of their enjoying of superior locations. Students in the suburban area have the longest travel distance due to their large number of travels to the urban core area. Also, students registered for more than one shadow education subjects' number have a much higher proportion of long-distance travel. [ABSTRACT FROM AUTHOR]

Patient travel distance to the hospital is a key metric of individual and social disadvantage and its impact on the management and outcomes following intervention for chronic limb-threatening ischemia (CLTI) is likely underestimated. We sought to evaluate the effect of travel distance on outcomes in patients undergoing first-time lower extremity revascularization at our institution. We retrospectively reviewed all consecutive patients undergoing first-time lower extremity revascularization, both endovascular and open, for CLTI from 2005 to 2014. Patients were stratified into 2 groups based on travel distance from home to hospital greater than or less than 30 miles. Outcomes included reintervention, major amputation, restenosis, primary patency, wound healing, length of stay, length of follow-up and mortality. Kaplan-Meier estimates were used to determine event rates. Logistic and cox regression was used to evaluate for an independent association between travel distance and these outcomes. Of the 1293 patients were identified, 38% traveled >30 miles. Patients with longer travel distances were younger (70 years vs 73 years; P =.001), more likely to undergo open revascularization (65% vs 41%; P <.001), and had similar Wound, Ischemia, foot Infection stages (P =.404). Longer distance travelled was associated with an increase in total hospital length of stay (9.6 days vs 8.6 days; P =.031) and shorter total duration of postoperative follow-up (2.1 years vs 3.0 years; P =.001). At 5 years, there was no definitive difference in the rate of restenosis (hzard ratio [HR], 1.3; 95% confidence interval [CI], 0.91-1.9; P =.155) or reintervention (HR, 1.4; 95% CI, 0.96-2.1; P =.065), but longer travel distance was associated with an increased rate of major amputation (HR, 2.1; 95% CI, 1.2-3.7; P =.011), and death (HR, 1.6; 95% CI, 1.2-2.2; P =.002). Longer travel distance was also associated with higher rate of nonhealing wounds (HR, 2.3; 95% CI, 1.5-3.5; P =.001). Longer patient travel distance was found to be associated with a lower likelihood of limb salvage and survival in patients undergoing first-time lower extremity revascularization for CLTI. Understanding and addressing the barriers to discharge, need for multidisciplinary follow-up, and appropriate postoperative wound care management will be key in improving outcomes at tertiary care regional specialty centers. [ABSTRACT FROM AUTHOR]

The travel behavior of subway passengers has shown systematic differences with the onset and progression of the COVID-19 pandemic. This study focused on subway stations in Xi'an and systematically analyzed the spatiotemporal features of the average travel distance of passengers (ATDP) during the peri- and post-COVID-19 periods. Using the gradient boost regression tree analysis framework, the study explored the nonlinear relationship between various built environment factors and changes in ATDP during pandemic periods. The results indicated that the distance to the city center, land-use mix, and road network density contributed significantly more than other variables in different periods. Furthermore, the study found that the ATDP in subway stations does not vary significantly based on the structural characteristics of the station network. These findings hold significant value for operational organizers seeking to comprehend the station-level changes in travel distances under the influence of public health crises, offering effective scientific data support for the rational development of operational plans to balance the distribution of operational capacities. [ABSTRACT FROM AUTHOR]

Recreational running, both on roads and in mountains, is one of the most practiced physical activities worldwide, and so, the motivations behind participating have been quite extensively described in the literature. However, the cultural and environmental motivations behind these athletes traveling to other countries or destinations to compete have not been properly addressed yet. The aim of this research is to analyze the motivations of sport tourists and to compare the motivations that cause mountain runners and city runners to compete. A cross-sectional study with a total of 244 athletes, divided into a group of city marathon runners (N = 118) and a group of mountain ultra-marathon runners (N = 126), was conducted. Athletes completed the Sports Tourism Motivation Scale (STMS), composed of 37 items and nine dimensions, through an online survey. Participants were asked questions related to their age, running experience, distance to events, numbers of nights in hotels and volunteering. The results showed that there were statistically significant differences in four out of the nine dimensions of the STMS between city and mountain runners' motivations and, likewise, statistical differences were found in some dimensions of the scale related to participants' sex, age, running experience, numbers of nights in a hotel, travel distance and volunteering. In conclusion, the reasons why runners participate in mountain and city running events are different; likewise, some sociodemographic variables should be taken into account when organizing such sporting events in a sustainable way, in order to provide organizers with the most suitable information and attract the most participants. [ABSTRACT FROM AUTHOR]

Given the growing environmental impact of tourism, understanding how information influences tourists’ sustainable choices is essential. This study focuses on the relatively under-researched area of how information on carbon emissions and travel distance affects tourists’ environmentally friendly choices at destinations across various time intervals. Hypothetical dichotomous questions were employed in three online surveys with 991 participants. T-tests were used to compare the effects of carbon emissions and distance information over eight, five, three, and one-hour intervals. The results indicate that both carbon emissions and distance information positively influence preferences for environmentally friendly behaviour. Additionally, more available time can lead to less environmentally friendly choices. These findings offer valuable insights for policymakers and tourism stakeholders aiming to foster sustainable practices in the industry. [ABSTRACT FROM AUTHOR]

Background: Delegation of clinical tasks from physiotherapists to physiotherapy support workers is common yet varies considerably in musculoskeletal outpatient physiotherapy services, leading to variation in patient care. This study aimed to explore patients' preferences and estimate specific trade-offs patients are willing to make in treatment choices when treated in musculoskeletal outpatient physiotherapy services. Methods: A discrete choice experiment was conducted using an efficient design with 16 choice scenarios, divided into two blocks. Adult patients with musculoskeletal conditions recruited from a physiotherapy service completed a cross-sectional, online questionnaire. Choice data analyses were conducted using a multinomial logit model. The marginal rate of substitution for waiting time to first follow-up physiotherapy appointment and distance from the physiotherapy clinic was calculated and a probability model was built to estimate the probability of choosing between two distinct physiotherapy service options under different scenarios. Results: 382 patient questionnaires were completed; 302 participants were treated by physiotherapists and 80 by physiotherapists and support workers. There was a significant preference to be seen by a physiotherapist, have more follow-up treatments, to wait less time for the first follow-up appointment, to be seen one-to-one, to see the same clinician, to travel a shorter distance to get to the clinic and to go to clinics with ample parking. Participants treated by support workers did not have a significant preference to be seen by a physiotherapist and it was more likely that they would choose to be seen by a support worker for clinic scenarios where the characteristics of the physiotherapy service were as good or better. Conclusions: Findings highlight that patients treated by support workers are likely to choose to be treated by support workers again if the other service characteristics are as good or better compared to a service where treatment is provided only by physiotherapists. Findings have implications for the design of physiotherapy services to enhance patient experience when patients are treated by support workers. The findings will contribute to the development of "best practice" recommendations to guide physiotherapists in delegating clinical work to physiotherapy support workers for patients with musculoskeletal conditions. [ABSTRACT FROM AUTHOR]

The ecologically valuable and unique natural and cultural landscapes of protected areas are popular nature tourism destinations. From a spatial perspective, travellers visit protected areas by moving from their place of origin to the destination for a temporary stay. This paper analyses the travel distances of day visitors and overnight guests to German national parks and biosphere reserves. National parks position themselves as both regional and national destinations. In contrast, biosphere reserve tourism is more regionally concentrated due to the proximity of biosphere reserves to urban centres, which are the primary places of origin for visitors. On average, visitors travel 278.6 km by car to visit a national park, taking 172.1 minutes (02:52 hours). Opting for public transport increases the average travel distance to 312.5 km, with a travel time of 284.5 minutes (04:43 hours). Visitors to German biosphere reserves travel 208.7 km by car, requiring 134.7 minutes (02:15 hours). When using public transport to visit biosphere reserves, the average distance increases to 234.0 km, with a travel time of 239.1 minutes (03:59 hours). The automated, GIS-supported distance analyses offer an innovative approach for assessing nature tourism catchment areas and the accessibility of protected areas, serving as a basis for effective spatial planning, development, and regional marketing. [ABSTRACT FROM AUTHOR]

Summary: Background: Delays in obstetric care are associated with adverse maternal outcomes, while long-distance travel for delivery is associated with high neonatal mortality and increased maternal morbidity. Distance and travel time are key components of geographic accessibility to health services and important risk indicators for maternal and neonatal care. This study evaluated whether the Brazilian Unified Health System (SUS) has been geographically accessible in providing hospital childbirth services, over time. Methods: Geographic accessibility to hospital deliveries in Brazil was mapped over two biennia (2010–2011 and 2018–2019), spanning a 10-year period, using national aggregated data from SUS Hospital Admissions Authorizations. Travel flows, distances, and times between women's municipalities of residence and hospitals were estimated. Findings: A total of 6,930,944 hospital deliveries were analyzed. Overall, 25.4% (n = 1,759,306) of pregnant women traveled outside their municipalities to give birth in SUS hospitals, increasing from 23.6% (n = 843,501) in 2010–2011 to 27.3% (n = 915,805) in 2018–2019. Distance and travel time rose by 31.1% (54.0 km–70.8 km) and 33.6% (63.1–84.3 min), respectively. Women experiencing maternal and/or neonatal death traveled longer distances and times. Regional disparities were evident: the Northeast had the highest proportion of women traveling (35.6%; n = 817,499), and the North had the lowest (16.0%; n = 138,295). Women in the North faced the longest travel distances (97.5–133.4 km) and times (1,012–1,850 min), while those in the Southeast and South experienced the shortest distances (37.2–55.9 km and 41.2–54.8 km, respectively) and times (38–52 min and 41–52 min). Interpretation: The results highlight regional disparities in maternal health service access within the SUS, which may affect maternal and neonatal outcomes. Targeted public health measures are needed to improve the availability of service, particularly in the North and Northeast regions, where access issues are most severe. Funding: Fundação Oswaldo Cruz; CNPq; FAPERJ.

The taxi travel distance distribution can be used to forecast the origin and destination (OD) distribution of taxis and private cars. Most of the existing studies on taxi trip distributions have summarized a "low–high–low" trend and approached zero at both ends; however, they failed to explain the reason for this distance distribution. The key indicators and parameters identified by various researchers using big data for the same city and year typically differ, especially in terms of the mode and mean values of distance and time. This study uses New York yellow and green taxi data (a total of 417,018,811 data points) from 2017 to 2022, as well as data from China, to obtain a general law of the taxi travel distance distribution through an analysis of the relative distance and relative frequency. The travel mode was 0.54 times the relative distance, while the data tended towards zero at 2.0 times the relative distance. We verified the reliability of the research method based on reference and survey data. The results reveal the formation mechanism of the taxi travel distance distribution characteristics, which follow an exponential distribution. These laws can be used in the context of urban planning and transportation research. We propose a taxi form distance clustering method based on the k-means approach, chosen for its effectiveness on large datasets, interpretability, and alignment with our research objectives. This method provides visual results for the travel distance and accurate information for urban transportation planning and taxi services. The practical implications for policymakers, urban planners, and taxi services are discussed, demonstrating how the identified travel distance distribution laws can influence urban planning and taxi service optimization. Finally, the problems of data collection, cleaning, and processing are identified from the perspective of data statistics and analysis. [ABSTRACT FROM AUTHOR]

Asthma, one of the most common chronic diseases of adults and children, is an important public health concern. The cause of asthma is thought to be a combination of genetic and environmental factors, and a growing body of research has investigated the possible geographic and contextual factors that contribute to asthma prevalence. However, few studies have incorporated geographic and environmental variables into their designs, despite evidence that geography is associated with asthma exacerbation. Additionally, studies of asthma exacerbations among adults are limited. The situation regarding asthma is particularly concerning in North Central Texas (NCT) compared to the national context. In light of this, we analyzed the geographic variation of approximately 12,000 adult patients hospitalized for asthma in the North Central Texas Region, and their association with built environmental features such as land use types, dwelling characteristics, exposure to traffic parameters at the Census Block Group (CBG) level, and pollutant concentrations in the relevant counties for the year 2014. We applied the Hierarchical Linear Model (HLM), and our analysis indicates that there are significant health disparities in the region. We found that the adult asthma hospitalization rate is significantly higher in low-income, low-education neighborhoods with a significant Black population. Furthermore, factors such as increased travel distance to work and substandard dwelling conditions have been found to trigger an increase in hospital visits for asthma patients. Conversely, the presence of greenspace in the surrounding area has been found to help reduce the frequency of asthma-related hospital visits. It is worth noting that both indoor and outdoor environmental quality contribute to adult asthma hospitalizations. Overall, our study highlights the importance of considering geographic and environmental factors in understanding the prevalence and exacerbation of asthma. Our findings suggest that targeted interventions, such as improving indoor and outdoor environmental quality and increasing access to greenspace, may help reduce the burden of asthma in high-risk communities. [ABSTRACT FROM AUTHOR]

The operation of the subway system necessitates a comprehensive understanding of passenger flow characteristics at station locations, as well as a keen awareness of the average travel distances at these stations. Moreover, the travel distances at the station level bear a direct relationship with the built environment composed of land use characteristics within the station's catchment area. To this end, we selected the land use features within an 800 m radius of the station (land use area, distribution of points of interest, and the surrounding living environment) as the influencing factors, with the travel distances at peak hours on the subway network in Xi'an as the research subject. An improved SSA-XGBOOST-SHAP interpretable machine learning framework was established. The research findings demonstrate that the proposed enhanced model outperforms traditional machine learning or linear regression methods in terms of R-squared, MAE, and RMSE. Furthermore, the distance from the city center, road network density, the number of public transit routes, and the land use mix have a pronounced influence on travel distances, reflecting the significant impact that mature built environments can have on passenger attraction. Additionally, the analysis reveals a notable nonlinear relationship and threshold effect between the built environment variables comprising land use and the travel distances during peak hours. The research results provide data-driven support for operational strategy management and line capacity optimization, as well as theoretical underpinnings for enhancing the efficiency and sustainability of the entire subway system. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between travel distance and postoperative length of stay (LOS) and discharge disposition among veterans undergoing surgical aortic valve replacement (SAVR). Data Sources/Study Setting: We performed a retrospective cohort study of patients undergoing SAVR, with or without coronary artery bypass grafting (CABG) at VA Boston Healthcare (January 1, 2005–December 31, 2015). Study Design: Postoperative LOS and discharge disposition were compared for SAVR patients based on travel distance to the facility: <100 miles or ≥100 miles. Multivariable regression was performed to ascertain factors associated with LOS and home discharge. Data Collection/Extraction Methods: Data were collected via chart review. All patients undergoing SAVR at our institution who primarily resided within the defined region were included. Principal Findings: Of 597 patients studied, 327 patients underwent isolated SAVR; 270 patients underwent SAVR/CABG. Overall median (IQR) distance between the patient's residence and the hospital was 49.95 miles (27.41–129.94 miles); 190 patients (32%) resided further than 100 miles away. There were no differences in the proportion of patients with diabetes, hypertension, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, atrial fibrillation, or prior myocardial infarction between groups. Overall LOS (IQR) was 9 (7–13) days and did not differ between groups (p = 0.18). The proportion of patients discharged home was higher among patients who resided more than 100 miles from the hospital (71% vs. 58%, p = 0.01). On multivariable analysis, residing further than 100 miles from the hospital was independently associated with home discharge (OR = 1.64, 95% CI: 1.09–2.48). Travel distance was not associated with LOS. Conclusions: Based on our institutional experience, potential concerns of longer hospital stay or discharge to other inpatient facilities for geographically distanced patients undergoing SAVR do not appear supported. Continued examination of the drivers underlying the marked shift of veterans to the private sector appears warranted. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate handling and transport variables as potential causes of disturbed behaviour in response to seeing a person on an overhead observation platform during pre-slaughter in batches of females and castrated males composed of pure or crossed Bos Taurus animals (Aberdeen Angus, Red Angus, Hereford and Charolais) with a maximum of 37.5% Bos indicus, and maturity at slaughter varying from zero to eight teeth, coming from pasture and confined systems. For the batches of castrated males, the independent variables included the distance covered on the trip, and the handling and facilities on the farms. For the female batches, the variables were travel time and waiting time prior to unloading. For both sexes, the presence of horns in the batches and the load density were included in the regression equations. Disturbed behaviour, the result of factors related to animal handling and transportation, is detrimental to satisfactory results in production systems. It is up to the managers in the production chain to seek alternatives in order to minimise inappropriate behaviour, which is one determinant of loss. Handling and transport are determining factors in the behaviour of beef cattle during the pre-slaughter period. [ABSTRACT FROM AUTHOR]

This study examined the consumption demands of short-, medium-, and long-haul tourists in Taiwan, considering the effects of tourism attractiveness, generational cohorts, and nationalities on tourism consumption demand. We employed an Almost Ideal Demand System model to estimate the expenditures and price elasticities based on tourism expenditure data of 3018 visitors to Taiwan. The results indicated that varying degrees of price elasticity were observed among short-, medium-, and long-haul tourists. Long-haul tourists exhibited the highest elasticity in terms of shopping prices and expenditure. The factors influencing tourists' attraction to Taiwan were identified as the geographical convenience of their travel and their nationalities, which, in turn, affected their consumption demands. Thus, based on tourists' relevant characteristics to implement targeted marketing strategies.

ObjectivesPrior research identified a significant decline in the number of abortions in Louisiana at the onset of the COVID-19 pandemic, as well as increases in second-trimester abortions and decreases in medication abortions. This study examines how service disruptions in particular areas of the state disparately affected access to abortion care based on geography.Study designWe collected monthly service data from Louisiana's abortion clinics (January 2018-May 2020) and conducted mystery client calls to determine whether clinics were scheduling appointments at pandemic onset (April-May 2020). We used segmented regression to assess whether service disruptions modified the main pandemic effects on the number, timing, and type of abortions using stratified models and interaction terms. Additionally, we calculated the median distance that Louisiana residents traveled to the clinic where they obtained care.ResultsFor residents whose closest clinic was consistently scheduling appointments at the onset of the pandemic, the number of monthly abortions did not change (IRR = 1.07, 95% CI: 0.84-1.36). For those whose closest clinic services were disrupted, the number of monthly abortions decreased by 46% (IRR = 0.54, 95% CI: 0.45-0.65). Similarly, increases in second-trimester abortions and decreases in medication abortions were concentrated in areas where residents experienced service disruptions (AOR = 2.25, 95% CI: 1.21-4.56 and AOR = 0.59, 95% CI: 0.29-0.87, respectively) and were not seen elsewhere in the state.ConclusionChanges in the number, timing and type of abortions were concentrated among residents in particular areas of Louisiana. The early stages of the COVID-19 pandemic exacerbated geographic disparities in access to abortion care.ImplicationsDisruptions in services at the beginning of the COVID-19 pandemic in Louisiana meaningfully affected pregnant people's ability to obtain an abortion at their nearest clinic. These findings reinforce the importance of developing mechanisms to support pregnant people during emergency situations when traveling to a nearby clinic is no longer possible.

Specific environmental characteristics can encourage active leisure travel and increase physical activity. However, existing environment-travel studies tend to ignore the differences in environmental characteristics associated with route choice and travel distance, of which the latter could be more important for health benefits, since longer trips are associated with increased exercise. Additionally, the most recent studies focus on leisure walking and leisure cycling, and activities such as hiking, climbing, and running are examined less frequently. This study, therefore, compares the similarities and differences of the environmental factors associated with route selection and travel distance through non-parametric tests and Cox proportional hazard models. The results show that two intersecting sets of environmental elements relate to both the route chosen and the distance traveled. Land use diversity and varied topography are appealing for both leisure trips and trip length. In addition, the differences in environmental characteristics among specific leisure travels may be attributed to variations in physical activity requirements, preferences for landscape viewing, and/or sensitivity to crowding. Therefore, conclusions drawn without considering the different types of leisure travel could be skewed. Whether particular surroundings may effectively increase physical activity remains uncertain. A more holistic perspective could be beneficial when studying the connection between the environment, active travel, and health. [ABSTRACT FROM AUTHOR]

Third Places (TPs), defined by Oldenburg in suburban American context are social informal gathering spaces, except home and workplace. Major literature focused on how TPs create social capital and cohesion within communities, largely benefitting socially, psychologically and even economically. Over the years, the TP concept is contested to globally transform from its initial theme of communitarianism to present dominant forms of neo-liberal consumerism. This posed significant threat to the inherent idea of affordable sociability rooted in characteristic plainness and neutral ground of TP. Moreover, exploring the spatial patterns and the influence of geographical variations on the nature of TP across urban landscapes is largely understudied. This study thus aimed to develop a consolidated understanding of the spatial dynamics of TPs in Indian context. The paper presented a city level, empirical based quantitative study based on online questionnaire survey. Commercial TPs are found to be most preferred. Research findings showed that the types of TP significantly affect the individual’s preferred travel distance. Also, one’s behavioural attributes as a whole significantly affect the catchment of the TPs, influenced by spatial variations. Hotspot analysis demonstrated three significant spatial concentrations across the city based on distance-based clustering. It showed heterogenous agglomerating tendencies of TP. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Railway Science & Engineering is the property of Journal of Railway Science & Engineering Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tourism & Rural Development Studies / Turisztikai és Vidékfejlesztési Tanulmányok is the property of CampInvest Kft. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Odontogenic infections (OI) are a preventable disease commonly managed in a tertiary hospital setting. Prevention of severe infections and hospitalisation relies on timely access to primary dental care. This study outlines the pre-hospital treatment of patients presenting to hospital with OIs and the association between travel distance from the patients' residence to a tertiary hospital oral and maxillofacial surgical (OMS) unit. Methods: This study analysed patients who initially presented hospital with an OI. Patient demographics, pre-hospital treatment, and clinical markers of severity were recorded. The travel distance from the patient's residence to the hospital was recorded in kilometers, along with any inter-hospital transfer via road/air ambulance. Results: Two hundred twenty-seven patients were included in this study, 17.2% required an inter-hospital transfer. Of these patients, 70.3% had prior treatment before hospitalisation, and antibiotics without source control was the most frequent treatment (83.1%). The mean travel distance for patients with more severe markers of infection significantly greater than patients with minor infections (p = <.001). Patients who required an inter-hospital transfer accounted for most cases with airway compromise requiring ICU admission. Conclusion: This study found that most patients presenting to hospital with an OI had received antibiotics alone as treatment before hospitalisation. The travel distance from a tertiary hospital with OMS services had a significant correlation to more severe infections. This has important public health implications for the allocation of preventative dental services, and patient access to OMS services. [ABSTRACT FROM AUTHOR]

Background/purpose: Patients with advanced cancer sometimes travel to locations that have the treatment that they need. We explored the prognostic factors of survival in patients with advanced lung cancer who travel long distances in Taiwan. Methods: We obtained data from the National Taiwan University Hospital (NTUH) Integrated Medical Database. Patients who received a diagnosis of stage IV lung cancer from 2010 to 2019 and were treated in NTUH and its Hsinchu and Yunlin branches were enrolled. Factors associated with survival were analyzed using a Cox hazard regression model. Results: In total, 6178 patients with stage IV lung cancer were enrolled. Young age, female sex, smaller primary tumor size, better performance, and non-squamous cell non–small cell histology were independently associated with longer survival. Treatment in medical centers and long travel distances (>50 km) were associated with longer survival in the univariate analysis but not in the multivariate analysis (hazard ratio [HR]: 1.04, p = 0.361; HR: 0.99, p = 0.775, respectively). Participation in clinical trials was associated with longer survival in the univariate (HR: 0.53, p

Introduction: The COVID-19 pandemic resulted in unprecedented changes to healthcare services. Non-emergent, out-patient care was either discontinued, greatly reduced, or switched to telehealth during the first wave of the pandemic. Here, we describe an American Burn Association (ABA) verified Burn Center’s experience with telehealth services during and after the COVID-19 emergency. Material and methods: In this retrospective study, all patients who underwent out-patient care at a large academic hospital’s ABA Burn Center between March 2018 and March 2023 were identified from the electronic medical record system. Descriptive analysis was carried out to delineate trends in outpatient in-person and telehealth services during the COVID-19 pandemic. The travel distance saved from the introduction of telehealth was determined. Results: During the study period, 3471 patients underwent a total of 7444 out-patient visits for burn care. There were no telehealth visits prior to the onset of the COVID-19 pandemic. In the first year of the COVID-19 pandemic, 14.9% of all out-patient visits were conducted with telehealth. This decreased to 8.3% and 6.8% of all out-patient care in the second and third years of the pandemic, respectively. The average round trip travel distance saved was 123 miles (2.8–––2312 miles). No complications were reported specific to receiving telehealth care. Conclusions: Telehealth is a feasible option for out-patient burn care in selected patients and reduces travel for patients. Further studies are needed to assess patient and clinician satisfaction, clinical outcomes, and the economic impact of telehealth utilization to help guide appropriateness of use.

The impact of the built environment and weather conditions on travel behavior has been widely studied. However, limited studies have focused on better understanding such effects in medium-sized cities with bus-oriented transit systems, particularly from a separate perspective of travelers’ origins and destinations. We took Weinan, China, as a representative of second-tier cities in developing countries that concentrate on bus-oriented development strategies. New evidence of feature importance and nonlinear effects of crucial factors were revealed by an interpretable machine learning-based approach combining XGBoost and Shapley Additive Explanation (SHAP) with multi-source data. Most key factors were critical at both origins and destinations, such as the density of residential and commercial facilities. However, several important factors, such as road density and boarding time, had strong imbalanced effects on travel behavior. These findings provide novel insights and empirical implications to support urban planning strategies in medium-sized cities.

Patients with advanced cancer sometimes travel to locations that have the treatment that they need. We explored the prognostic factors of survival in patients with advanced lung cancer who travel long distances in Taiwan. We obtained data from the National Taiwan University Hospital (NTUH) Integrated Medical Database. Patients who received a diagnosis of stage IV lung cancer from 2010 to 2019 and were treated in NTUH and its Hsinchu and Yunlin branches were enrolled. Factors associated with survival were analyzed using a Cox hazard regression model. In total, 6178 patients with stage IV lung cancer were enrolled. Young age, female sex, smaller primary tumor size, better performance, and non-squamous cell non–small cell histology were independently associated with longer survival. Treatment in medical centers and long travel distances (>50 km) were associated with longer survival in the univariate analysis but not in the multivariate analysis (hazard ratio [HR]: 1.04, p = 0.361; HR: 0.99, p = 0.775, respectively). Participation in clinical trials was associated with longer survival in the univariate (HR: 0.53, p < 0.001) and multivariate analyses (HR: 0.62, p < 0.001). For the 1144 patients in the Hsinchu area, enrolment in clinical trials was an independent prognostic factor (HR: 0.72, p = 0.040), whereas treatment in medical centers was not (HR: 0.95, p = 0.635). Long travel distances and treatment in medical centers were not independently associated with survival for patients with advanced lung cancer. Enrolment in clinical trials was an independent prognostic factor. [ABSTRACT FROM AUTHOR]

Background: The overall cost of managing chronic diseases is a significant barrier to accessing complete and timely healthcare, especially in rural and geographically isolated areas. This cost disparity becomes more pronounced in the case of children and more so in under-resourced regions of the world. In the era of COVID-19, as the need for physical distancing increased, there was a transition in approach to healthcare provision to telemedicine consultations. This study evaluates the cost saving using teleconsultations in a paediatric nephrology clinic. Methods: This prospective cohort study was conducted at AIIMS Jodhpur, a tertiary care centre in western Rajasthan from March 2021 to October 2022. All consecutive paediatric (29 days–18 years) patients attending telemedicine services for kidney-related illness were enrolled. Basic demographic details were collected. Cost analysis was done after 6 months, regarding perceived cost savings for the patient and family by using telehealth for follow-up during 6 months starting from enrolment. Results: A total of 112 patients were enrolled; 266 teleconsultations attended; 109 patients who could be followed up saved INR 457,900 during 6 months of follow-up. The average cost saving was INR − 1577/patient/visit. Patients saved 4.99% of the family income (median 2.16% (IQR 0.66–5.5)). The highest expenditure per visit was incurred for food and transport. The median distance from the residence to the clinic was 122.5 km (IQR 30–250). Over the 6-month study period, patients saved a travel distance of 83,274 km (743 km/patient). Conclusions: The use of telemedicine as a follow-up method helps save significant costs and distances travelled by patients. A higher-resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

Primates living in fragmented and degraded forest environments face multiple challenges such as the reduced availability of food resources. We used the group scan method to study the diet and travel distance of endangered golden monkeys (Cercopithecus mitis kandti) inhabiting exotic pine plantations (Pinus patula) outside their native forests in the highly fragmented Gishwati-Mukura landscape, Rwanda, from July to August 2018. We found that golden monkeys consumed parts of at least 17 plant species. Notably, their diet consisted largely of pinecones and needles and differed from the frugi-/folivorous diet of other golden monkeys inhabiting patches of native vegetation. We also found that the mean hourly travel distance of the population inhabiting the pine plantation is longer than that of their counterparts who live in native forests. The dietary flexibility in studied groups indicates their adaptability to non-native forests. The high intake of pine might be representative of availability, rather than preference, given its ubiquitous presence in these plantations and the lack of alternative, native plant food resources. The differences in travel patterns are potentially due to the more scattered availability of native food resources, and higher disturbance in pine forests compared to native forests. Future studies are needed to determine the long-term sustainability or probability of persistence of golden monkeys in exotic pine plantations to inform conservation management outside protected areas. [ABSTRACT FROM AUTHOR]

Objective: Cormack–Joly–Seber (CJS) mark–recapture analysis was used to estimate the effect of travel distance and fuel costs on angling party persistence (i.e., survival = probability of remaining in the Lake Trout Salvelinus namaycush fishery from year‐to‐year) and visitation (i.e., detection = probability of detection at the access point) over a 14‐year period (2006–2019) for the Lake Trout recreational fishery in Lake Opeongo, Ontario, Canada. Methods: Boat identification numbers, positioned near the bow and present by law, were used as "tags" in the CJS analysis. Complete trip creel interviews at the sole access point provided information on trip characteristics. Result: The long‐term mark–recapture analysis of individual angling parties showed travel distance had a significant negative effect on party persistence among years and visitation within years. The distance effect was strongest for visitation, with visitation having a more negative relationship with distance than persistence. Persistence in the Lake Trout fishery was insensitive to fuel costs while the fuel cost covariate had a small though significant and negative effect on visitation. Time‐varying CJS models were ranked low with little model weight indicating the distance effect estimated for Lake Opeongo was a general phenomenon and not year dependent. Conclusion: Cormack–Joly–Seber mark–recapture analysis cleanly separated effects of travel distance and fuel cost between visitation versus persistence for Lake Trout angling parties. Prior to this analysis, travel costs were typically associated with visiting a recreational fishery, while here we have shown that travel costs can be associated with persisting as anglers in a fishery independent of visitation patterns. Long‐term monitoring of angling parties provides unique insights into angling patterns that can aid in travel cost estimation. Impact statementWe followed individual Lake Trout angling parties for 14 years at a single access point fishery. Our findings showed greater travel costs primarily resulted in reduced visitation within years, with a smaller negative effect on persistence as anglers among years. Visitation to a fishery and persistence as anglers in a fishery are different features of travel costs. [ABSTRACT FROM AUTHOR]

Purpose: Despite lack of survival benefit, demand for contralateral prophylactic mastectomy (CPM) to treat unilateral breast cancer remains high. High uptake of CPM has been demonstrated in Midwestern rural women. Greater travel distance for surgical treatment is associated with CPM. Our objective was to examine the relationship between rurality and travel distance to surgery with CPM. Methods: Women diagnosed with stages I–III unilateral breast cancer between 2007 and 2017 were identified using the National Cancer Database. Logistic regression was used to model likelihood of CPM based on rurality, proximity to metropolitan centers, and travel distance. A multinomial logistic regression model compared factors associated with CPM with reconstruction versus other surgical options. Results: Both rurality (OR 1.10, 95% CI 1.06–1.15 for non-metro/rural vs. metro) and travel distance (OR 1.37, 95% CI 1.33–1.41 for those who traveled 50 + miles vs. < 30 miles) were independently associated with CPM. For women who traveled 30 + miles, odds of receiving CPM were highest for non-metro/rural women (OR 1.33 for 30–49 miles, OR 1.57 for 50 + miles; reference: metro women traveling < 30 miles). Non-metro/rural women who received reconstruction were more likely to undergo CPM regardless of travel distance (ORs 1.11–1.21). Both metro and metro-adjacent women who received reconstruction were more likely to undergo CPM only if they traveled 30 + miles (ORs 1.24–1.30). Conclusion: The impact of travel distance on likelihood of CPM varies by patient rurality and receipt of reconstruction. Further research is needed to understand how patient residence, travel burden, and geographic access to comprehensive cancer care services, including reconstruction, influence patient decisions regarding surgery. [ABSTRACT FROM AUTHOR]

The Special Region of Yogyakarta is one of the most popular tourist destinations in Indonesia and offers a wide range of cultural wealth. Consequently, it is interesting to explore the many tourist attractions. A tour taking the optimal route can, of course, provide efficiency in terms of distance and travel time while also providing a quality experience to the traveler. Ignoring these factors can lead to a failed trip. To determine the optimal route, we spread a questionnaire to travelers (n = 507) and obtained their preferences when traveling to be used in designing the optimum route. We present two scenarios in this paper for comparison: the first is the common way tourists determine travel routes, and the second uses a genetic algorithm approach. We found that determining the optimal route of travel using methods of genetic algorithms can shorten the total travel distance of tourists by 68.8 kilometers (29.20%), reduce the travel time by 137.60 minutes (8.87%), and at the same time maintain tourist preferences during their tour. We also propose efforts to improve the optimization of cultural tourist travel routes, focusing on the travel aspects between tourist destinations and on the aspects of the tourist destination itself.

Changes in transportation trends can occur during and after COVID-19, such as travel distance, trip, and choice of transportation mode. The positive benefits from these changes in transportation trends should be maintained, to reduce disaster risk of environmental hazards from the CO2 emissions. Research on changes in mobility, trips, and CO2 emissions during and after COVID-19 in Indonesia is still very limited; whereas, changes in these transportation variables can be an inspiration for determining sustainable transportation policies in the future. This study aims to compare amid COVID-19 and post-COVID-19 transportation variables—travel distances, trips, and associated CO2 emissions. This research was conducted by giving questionnaires to 400 participants in Aceh Besar District. The questionnaire contains questions regarding the distance traveled, trips, fuel spent, and socio-economic characteristics. The CO2 emissions were calculated using IPCC (2006). The travel distance, trips, and transportation-related CO2 emissions during and after COVID-19 were compared respectively based on statistics. The results showed that there were significant differences in travel distances, trips, and transportation-related CO2 emissions between COVID-19 and the post-COVID-19 situation in the District of Aceh Besar. This article also presents several recommendations based on the data analysis results linked to literature studies about the sustainability of transportation as a result of COVID-19 situation; those are: providing quality public transportation, considering teleworking, providing solutions for workers who do not have access to online work, and paying attention to increasing use of private cars and car sharing post COVID-19.

The taxi travel distance distribution can be used to forecast the origin and destination (OD) distribution of taxis and private cars. Most of the existing studies on taxi trip distributions have summarized a “low–high–low” trend and approached zero at both ends; however, they failed to explain the reason for this distance distribution. The key indicators and parameters identified by various researchers using big data for the same city and year typically differ, especially in terms of the mode and mean values of distance and time. This study uses New York yellow and green taxi data (a total of 417,018,811 data points) from 2017 to 2022, as well as data from China, to obtain a general law of the taxi travel distance distribution through an analysis of the relative distance and relative frequency. The travel mode was 0.54 times the relative distance, while the data tended towards zero at 2.0 times the relative distance. We verified the reliability of the research method based on reference and survey data. The results reveal the formation mechanism of the taxi travel distance distribution characteristics, which follow an exponential distribution. These laws can be used in the context of urban planning and transportation research. We propose a taxi form distance clustering method based on the k-means approach, chosen for its effectiveness on large datasets, interpretability, and alignment with our research objectives. This method provides visual results for the travel distance and accurate information for urban transportation planning and taxi services. The practical implications for policymakers, urban planners, and taxi services are discussed, demonstrating how the identified travel distance distribution laws can influence urban planning and taxi service optimization. Finally, the problems of data collection, cleaning, and processing are identified from the perspective of data statistics and analysis.

The operation of the subway system necessitates a comprehensive understanding of passenger flow characteristics at station locations, as well as a keen awareness of the average travel distances at these stations. Moreover, the travel distances at the station level bear a direct relationship with the built environment composed of land use characteristics within the station’s catchment area. To this end, we selected the land use features within an 800 m radius of the station (land use area, distribution of points of interest, and the surrounding living environment) as the influencing factors, with the travel distances at peak hours on the subway network in Xi’an as the research subject. An improved SSA-XGBOOST-SHAP interpretable machine learning framework was established. The research findings demonstrate that the proposed enhanced model outperforms traditional machine learning or linear regression methods in terms of R-squared, MAE, and RMSE. Furthermore, the distance from the city center, road network density, the number of public transit routes, and the land use mix have a pronounced influence on travel distances, reflecting the significant impact that mature built environments can have on passenger attraction. Additionally, the analysis reveals a notable nonlinear relationship and threshold effect between the built environment variables comprising land use and the travel distances during peak hours. The research results provide data-driven support for operational strategy management and line capacity optimization, as well as theoretical underpinnings for enhancing the efficiency and sustainability of the entire subway system.

The utility factor (UF) of a plug-in hybrid electric vehicle (PHEV) refers to the ratio of miles traveled in electric mode to the total miles traveled. Standard UF curves provide a prediction of the expected achievable UF by a PHEV given its all-electric range (AER), but such predictions entail assumptions about both the driving patterns (distance traveled and energy intensity) and charging behavior. Studies have attempted to compare the real-world UF achieved by PHEVs to their standard values, but deviations can stem from deviations in assumptions about: (i) achievable electric range, (ii) travel distance and (iii) charging frequency. In this paper, we derive analytical models for modified utility factor curves as a function of both AER and charging behavior. We show that average charging frequency is insufficient to exactly predict UF but can still estimate bounds. Our generalized model can also provide insights into the efficacy of PHEVs in reducing carbon emissions. [ABSTRACT FROM AUTHOR]

In this article, we introduce the command cntraveltime, which can calculate both the travel distance and the travel time between two locations in China with respect to different modes of transportation (driving, public transport, and cycling). Existing commands such as georoute, traveltime, and mqtime have difficulties in parsing Chinese locations. cntraveltime solves this outstanding challenge via a feature that enables it to call route-planning services from the Baidu Maps Open Platform. The results of rigorous testing on the features of the command show that, relative to similar existing commands, cntraveltime has the highest capacity in terms of functionality and precision. This suggests that it can be regarded as a useful complement to other existing commands, especially when calculating travel distance and time for locations within China. [ABSTRACT FROM AUTHOR]

In mining, open pits have slopes cut as steep as possible to ensure efficient mining yet not too steep to jeopardize safety. Building on existing contributions, the Texas A&M University Mine Slope database (TAMU-MineSlope) was created to provide global-scale insights into the runout mechanics of open pit slope failures and offer the database to engineers for further study. The database includes 134 cases of open pit slope failures that occurred at 76 mines worldwide. Based on energy principles and an analysis of the TAMU-MineSlope data, an equation to predict the travel distance of the slope failure mass is presented in this paper. Furthermore, based on the case histories analysis, an equation to predict the setback distance is proposed. Finally, the TAMU-MineSlope database shows that the average width to height ratio of the failing slope mass is 2.7 and that, for this ratio, the 3D factor of safety (FS) can reach a value 15% higher than the 2D FS. The database has been released in the public domain. [ABSTRACT FROM AUTHOR]

Introduction: The reasons for the geographic disparities in liver‐related mortality across the US remain ill‐defined. We sought to investigate the impact of travel distance to liver transplantation (LT) programs and social vulnerability on county differences in liver‐related mortality. Methods: Data on LT registrants were obtained from the Scientific Registry of Transplant Recipients Standard Analytic Files (SRTR SAFs) between 2004 and 2019. Liver‐related mortality data were obtained from the Center for Disease Control and Prevention's Wide‐ranging Online Data for Epidemiologic Research (CDC WONDER) platform. Spatial epidemiological clustering of county‐level LT registration and liver‐related mortality rates was determined using local Moran's I. Comparison analyses assessed social vulnerability index (SVI) and travel distance within various county clusters. Results: Among 151 864 LT waitlist registrants who were diagnosed with liver disease due to hepatitis C virus (HCV) or hepatitis B virus (HBV) (n = 68 479, 45.1%), alcohol (n = 38 328, 25.2%), non‐alcoholic steatohepatitis (NASH) (n = 17 485, 11.5%), liver tumors (n = 16 644, 11.0%), and other diseases (n = 10 928, 7.2%), median SVI was 59.3 (IQR, 40.1–83.4). SVI (76.2 vs. 24.3, p <.001) was greater in the highest versus lowest liver‐related mortality quartiles. The travel distances to LT centers (143.1 miles vs. 107.2 miles, p <.001) was longer in the lowest versus highest LT registration quartiles. Counties with low LT registration rates and high liver‐related mortality rates were associated with long travel distances and high SVI. In contrast, while counties with high LT registration rates and high liver‐related mortality rates had comparable SVI, travel distance was relatively shorter. Conclusion: Counties with greater SVIs were associated with higher liver‐related mortality, with the highest SVI counties having the highest overall liver‐related mortality. Longer travel distances were associated with higher liver‐related mortality. These findings highlight the impact of social determinants of health (SDOH) on liver disease outcomes. [ABSTRACT FROM AUTHOR]

To relate the distance traveled from the patient's residence to the gestational trophoblastic neoplasia (GTN) reference center (RC) and the occurrence of unfavorable clinical outcomes, as well as to estimate the possible association between this distance and the risk of metastatic disease at presentation, the need for multiagent chemotherapy to achieve remission and loss to follow-up before remission. Retrospective historical cohort study of patients with GTN followed at 8 Brazilian GTN-RC, from January 1st, 2000 - December 31st, 2017. Evaluating 1055 cases of GTN, and using a receiver operating characteristic curve, we found a distance of 56 km (km) from the residence to the GTN-RC (sensitivity = 0.57, specificity = 0.61) best predicted the occurrence of at least one of the following outcomes: occurrence of metastatic disease, need for multiagent chemotherapy to achieve remission, or loss to follow-up during chemotherapy. Multivariate logistic regression adjusted by age, ethnicity, marital status and the reference center location showed that when the distance between residence and GTN-RC was ≥56 km, there was an increase in the occurrence of metastatic disease (relative risk - RR:3.27; 95%CI:2.20–4.85), need for multiagent chemotherapy (RR:1.36; 95%CI:1.05–1.76), loss to follow-up during chemotherapy (RR:4.52; 95CI:1.93–10.63), occurrence of chemoresistance (RR:4.61; 95%CI:3.07–6.93), relapse (RR:10.27; 95%CI:3.08–34.28) and death due to GTN (RR:3.62; 95%CI:1.51–8.67). The distance between the patient's residence and the GTN-RC is a risk factor for unfavorable outcomes, including death from this disease. It is crucial to guarantee these patients get prompt access to the GTN-RC and receive follow-up support. • The distance between the patient's residence and GTN reference center (RC) is a risk factor for unfavorable outcomes. • Living ≥56 km from the RC is associated with metastases, need for multiagent chemotherapy and loss to follow-up. • Patients living long distances (≥56 km) for GTN-RC need special supportive care to facilitate optimal treatment and outcome. [ABSTRACT FROM AUTHOR]

Macroscopic traffic models represent a promising tool to design strategies for ecological routing. To benefit from this tool, we must first characterize the relationship between path emissions and distance traveled or travel time on aggregated networks, i.e., a regional network. This paper investigates this relationship between two toy networks and a real urban network representing the city of Innsbruck (Austria). We utilize an accumulation-based model based on the Macroscopic Fundamental Diagram to mimic the traffic dynamics in the network and utilize the COPERT IV model to estimate the travel emissions, focusing on the carbon dioxide $CO_{2}$ . We show that there is a linear relationship between the total emissions of $CO_{2}$ and the average travel time of internal paths, i.e., paths that take place completely within a single region. We also show that in some cases, there is a linear relationship between the total emissions and the average travel distance or travel time of paths that cross multiple regions in the network. However, the latter is not always true as traffic dynamics play an important role in path emissions. In other words, eco-friendly paths on regional networks do not necessarily follow the shortest paths in terms of distance or time.

The increase in population and urbanisation of hilly regions have increased the risk due to landslides. This manuscript presents a data-driven approach with a random forest algorithm to estimate the projected area, length, travel distance, and width of landslides, using elevation and slope information. The method is tested for two different study areas (Idukki and Wayanad), using three different combinations of inputs. The input features considered were elevation ([Formula: see text]), tangential slope ([Formula: see text]), drop height ([Formula: see text]), angle of reach ([Formula: see text]) and the profile curvature ([Formula: see text]). A total of 144 models were considered and were evaluated using mean-absolute-error ([Formula: see text]) and root-mean-square-error (RMSE) values. The results indicate that, by using E and θ alone, the [Formula: see text] value in estimating the length values for flow-like landslides in Wayanad was reduced from 472.74 m to 204.64 m. Out of the 48 combinations considered, [Formula: see text] values have increased in seven cases and [Formula: see text] values in eight cases only. The pre-trained models are saved and used to develop an easy-to-use tool, which can bypass the complications associated with the existing statistical approaches. The tool can be used by untrained personnel for preliminary hazard assessment.

Background: Travel is a major barrier to healthcare access for Veteran Affairs (VA) patients, and disproportionately affects rural Veterans (approximately one quarter of Veterans). The CHOICE/MISSION acts' intent is to increase timeliness of care and decrease travel, although not clearly demonstrated. The impact on outcomes remains unclear. Increased community care increases VA costs and increases care fragmentation. Retaining Veterans within the VA is a high priority, and reduction of travel burdens will help achieve this goal. Sleep medicine is presented as a use case to quantify travel related barriers. Objective: The Observed and Excess Travel Distances are proposed as two measures of healthcare access, allowing for quantification of healthcare delivery related to travel burden. A telehealth initiative that reduced travel burden is presented. Design: Retrospective, observational, utilizing administrative data. Subjects: VA patients with sleep related care between 2017 and 2021. In-person encounters: Office visits and polysomnograms; telehealth encounters: virtual visits and home sleep apnea tests (HSAT). Main Measures: Observed distance: distance between Veteran's home and treating VA facility. Excess distance: difference between where Veteran received care and nearest VA facility offering the service of interest. Avoided distance: distance between Veteran's home and nearest VA facility offering in-person equivalent of telehealth service. Key Results: In-person encounters peaked between 2018 and 2019, and have down trended since, while telehealth encounters have increased. During the 5-year period, Veterans traveled an excess 14.1 million miles, while 10.9 million miles of travel were avoided due to telehealth encounters, and 48.4 million miles were avoided due to HSAT devices. Conclusions: Veterans often experience a substantial travel burden when seeking medical care. Observed and excess travel distances are valuable measures to quantify this major healthcare access barrier. These measures allow for assessment of novel healthcare approaches to improve Veteran healthcare access and identify specific regions that may benefit from additional resources. [ABSTRACT FROM AUTHOR]

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