OBJECTIVE: To identify what transportation barriers pediatric patients face when traveling to a major metropolitan orthopaedic center, how these barriers affect care, and what changes can be made to address this issue.
METHODS: A cross-sectional transportation survey was administered to 107 caregivers of patients being seen in the orthopaedic clinic at a tertiary children\'s hospital in a large metropolitan area. Using logistic regression analysis, we compared socioeconomic characteristics, transportation methods, and scheduling practices among caregivers who reported missing at least one visit in the past and those who reported never missing a visit.
RESULTS: 13% (14/108) of caregivers reported missing one or more past visits due to late arrival or transportation issues. Families that traveled more than 45 minutes to clinic (P = 0.04), waited more than one week to schedule a visit (P = 0.002), or reported difficulty scheduling a visit (P = 0.02) were significantly more likely to have a history of nonattendance. In addition, patients who were nonambulatory (P = 0.007), used a mobility device (P = 0.007), or were non-White (P < 0.05) were significantly more likely to have missed a visit.
CONCLUSIONS: Travel time, difficult or delayed scheduling, and patient ambulatory status were all associated with missing orthopaedic clinic visits although other socioeconomic factors were not related. Interventions to improve orthopaedic clinic attendance should focus on promoting accessibility for patients with mobility limitations and encouraging simple and timely scheduling practices.

Shared E-scooter (SE) travel is a low-carbon transportation method that can be further enhanced by integrating with metro systems. This study aims to quantify the impact of the built environment, attitude preferences, weather perception, and other factors on the evaluation and intention to use the \"SE-metro transfer\" travel mode, as well as how to efficiently and concisely measure and model these effects. Empirical analysis was conducted using questionnaire data from Changsha, China, with 683 participants surveyed. Three satisfaction models were established and compared based on the Technology Acceptance Model (TAM), and an optimal M2 model was expanded to incorporate users\' subjective perceptions of weather, proposing a method to simplify questionnaire length. The study found that well-designed vehicles and infrastructure, along with necessary supporting facilities, play important roles in enhancing SE usage. However, there are still many areas for optimization in Changsha\'s SE policies. Despite the advantages of SE in terrain and physical fitness, which have significantly expanded and changed their user base compared to traditional shared bicycles, there is still much potential to adapt to the middle-aged and older user groups. The results of this study can provide valuable insights for professionals and government officials in designing systems, constructing infrastructure, and formulating policies.

Older adults who cease driving are more likely to experience psychosomatic decline than those who continue driving. This mixed-methods study was intended to examine differences in psychosomatic functions depending on driving status and lifestyle activities, and factors affecting engagement in additional lifestyle activities after driving cessation. The quantitative analysis included individuals aged 60 and above. Driving status, lifestyle activities, and psychosomatic functions were assessed. For qualitative analysis, semi-structured interviews were conducted with the driving-cessation group to determine the factors affecting involvement in various lifestyle activities after driving cessation. Analysis of covariance was used for quantitative data, while text mining and qualitative inductive analysis were used for qualitative data. Older adults who engaged in more lifestyle activities walked faster than those who engaged in fewer lifestyle activities, even after driving cessation. Actively using local and personal resources may increase engagement in lifestyle activities after driving cessation.

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 (PM2·5 and NO2), 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.
RESULTS: 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.
CONCLUSIONS: 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.
BACKGROUND: Health Research Council of New Zealand and University of Otago.

BACKGROUND: Oreochromis niloticus has great economic value and potential for farming and development. Transportation of fish was done for breeding or trading purpose and it is a challenging aspect of aquaculture. This study aimed to investigate the effect of transportation in freshwater and brackish water on the resistance of O. niloticus as well as transportation stress mitigation effect of NaCl. Four equal groups were used; each of 50 fish, the 1st group served as the control (P 1), while the 2nd group (PT 2) was transported in water without salt, the 3rd (PT 3) and 4th (PT 4) groups were transported in water containing 5 gL- 1 and 10 gL- 1 salt respectively. PT 2, PT 3 and PT 4 were transported for 5 h without any rest or sedative drugs.
RESULTS: The serum cortisol of O. niloticus significantly increased at 0 h and then decreased at 12 and 24 h post transportation in the PT 2 group and non-significantly increased at all point times in the PT 3 and PT 4 groups comparing to P 1 group. Mucin2 gene (MUC2) expression was non-significantly up regulated in the PT 2 group and down regulated in the PT 3 and PT 4 groups at 0 h comparing with P 1 group, but at 12 and 24 h it was significantly up regulated in the PT 2, PT 3 and PT 4 groups. The β Defensin-1 (β D1) and 2 (β D2) genes expression was non-significantly down-regulated in the PT 2 group and significantly up regulated in the PT 3 and PT 4 groups at 0 h., while at 12 and 24 h was significantly down regulated in the PT 2 group and non-significantly down regulated in the PT 3 and PT 4 groups, it significantly down regulated in the PT 2 and PT 3 group and non-significantly down regulated in the PT 4 group at 24 h. Non-significant up regulation in interleukin - 1β (IL-1β) gene expression was reported in the PT 2 group and non-significant down regulation in the PT 3 and PT 4 groups at 0 h. However, significant up regulation was recorded in the PT 2, PT 3 and PT 4 groups at 12 and 24 h. The Tumor necrosis factor-alpha (TNF-α) gene expression was non-significantly up regulated in the PT 2 group and non-significantly down regulated in the PT 3 and PT 4 groups at 0 h. However, it was significantly up regulated in the PT 2, PT 3 and PT 4 groups at 12 and 24 h.
CONCLUSIONS: The results of this study confirmed the stressful effect of transportation on O. niloticus as well as the transportation stress mitigation effect of NaCl.

Horse\'s stress responses have been reported during road transport in temperate but not tropical environments. Therefore, this study measured cortisol levels, heart rate (HR), and heart rate variability (HRV) in horses during medium-distance road transport with different truck conditions in a tropical environment. Six horses were repeatedly transported in either air-conditioned trucks with full (ATF) or space (ATS) loads or non-air-conditioned trucks with full (N-ATF) and space (N-ATS) loads. Blood cortisol was determined beforehand and 5, 30, and 90 minutes post-transport. HR and HRV were assessed pre-transport and at 15-minute intervals until 90 minutes post-transport. Cortisol levels increased significantly in N-ATS horses (but non-significantly in ATF, ATS, and N-ATF horses) at 5 minutes post-transport and returned to baseline by 30 minutes post-transport. Predominant parasympathetic nervous system (PNS) activity was observed during the first few hours and returned to baseline until the destination was reached. A recurrent, increased PNS activity was detected post-transport. Interaction effects of air condition-by-loading condition-by-time, air condition-by-time, and separate effects of air condition and time were observed on HR and various HRV variables during transport. A transient increase in beat-to-beat intervals, coinciding with decreased HR, was observed in ATF horses. The PNS index increased, corresponding to a decreased sympathetic nervous system index, in ATS horses during transport. We suggest that medium-distance road transport causes no stress for transport-experienced horses in a tropical environment. Air and loading conditions impacted hormonal and autonomic modulation, causing different responses in horses transported in differently conditioned trucks.

The deployment of public electric vehicle charging stations (EVCS) is a critical component of transportation electrification. Recent studies have highlighted growing concerns about disparities in accessibility to public chargers between different demographic groups. This research expands ongoing equity concerns by contextualizing existing transportation equity discourse and analyzing public charger access disparities in Austin, Texas. Using threshold equity toolkits, we investigated public EVCS access disparity across different races and income groups. We conducted a generalized additive model regression to measure and visualize the effects of possible determinants on public EVCS access. The analysis results revealed that a public EVCS access disparity exists in Austin, with most chargers being installed in areas where the majority of the population is Non-Hispanic White. There was a more equal distribution of public EVCSs across income quartiles when compared with race. However, middle- and high-income groups had better access than lower-income communities in terms of distance to the nearest public EVCSs. Our regression analysis found that regional and socio-demographic factors, such as race and income, have a statistically significant impact on public charger access. The regression analysis also revealed that Austin\'s current public EVCS deployment seems to favor communities above the poverty level and with higher numbers of registered electric vehicles. Local policymakers should reflect on the findings of this study to develop an equitable transportation electrification plan. Federal environmental justice plans such as the Justice40 initiative can benefit from incorporating more local contexts to better invest in disadvantaged communities.

The construction of road infrastructure has resulted in the degradation of wildlife habitat and the decrease of ecological network connectivity and stability. Studying the impacts of road infrastructure on wildlife life and migration is significant for regional wildlife conservation and ecological network optimization. We assessed the impacts of road infrastructure on habitat suitability using the MaxEnt model based on wildlife occurrence point data in the Guangdong-Hong Kong-Macao Greater Bay Area. We constructed the ecological networks and identified ecological breakpoints using the minimum cumulative resistance model, and compared the ecological network connectivity of different scenarios with the landscape connectivity index and graph theory index. The results showed that railway and motorway significantly affected habitat suitability, causing a decrease in wildlife habitat suitability. Affected by road infrastructure, the fragmentation of ecological sources intensified, the resistance of ecological corridors increased, and the ecological network connectivity and stability significantly decreased. A total of 536 ecological breakpoints were identified, which were concentrated in the area adjacent to ecological sources. The results would provide important scientific references for wildlife habitat conservation and ecological restoration in the Guangdong-Hong Kong-Macao Greater Bay Area.
道路基础设施的建设导致野生动物栖息地生境退化,以及生态网络连通性和稳定性降低等问题。研究道路基础设施对野生动物生活和迁徙的影响,对区域野生动物保护和生态网络优化具有重要意义。本研究基于野生动物的出现点位数据,利用MaxEnt模型评估粤港澳大湾区道路基础设施对生境适宜性的影响,采用最小累计阻力模型构建生态网络并识别生态断裂点,同时,使用景观连通性指数与图论指数对比不同情景的生态网络连通性。结果表明: 研究区内部的铁路和高速公路对生境适宜性产生显著影响,造成野生动物栖息地适宜性降低;受道路基础设施的影响,生态源地破碎化加剧,生态廊道的通行阻力增加,生态网络的连通性和稳定性明显下降;共识别生态断裂点536处,集中分布于生态源地附近。研究结果可为粤港澳大湾区野生动物栖息地保护和生态网络连通性修复提供重要的科学参考。.

BACKGROUND: It is unknown whether short-term transportation affects endocrine responses similarly in horses with and without insulin dysregulation (ID).
OBJECTIVE: To characterise the effect of short-term transportation on stress parameters and insulin responses to an oral sugar test (OST) in horses with and without ID.
METHODS: Longitudinal cohort study.
METHODS: Fourteen adult non-pregnant, non-PPID mares of mixed light breeds were grouped as either ID (n = 7) or non-ID (n = 7) based on endocrine testing. Over 2 weeks, horses were transported once, in groups of 3-4 in a horse trailer on a round-trip journey of ~1.5 h. Blood and saliva were collected 24 h and 1 h pre-transportation, directly after unloading and 15 min, 1 h, 3 h plus 24 h post-transportation. An OST was performed 24 h pre-transportation and 3 h post-transportation with a pre- (T0) and post-OST sample collected 60 min later (T60). Heart rates and rectal temperatures were also collected throughout the study. Serum insulin, serum cortisol, and plasma glucose were measured using validated assays. Repeated measures ANOVA were used to determine differences after transportation and between ID and non-ID horses. Non-normal data were log-transformed and multiple comparisons were adjusted using Bonferroni post hoc tests.
RESULTS: Mean insulin was higher in ID horses versus non-ID horses (mean = 109.9 μU/mL vs. 30.2 μU/mL, p < 0.001; 95% CI for mean difference = [55.6-107.7 μU/mL]). Mean serum insulin increased following OST at T60 in ID horses pre- (154.6 μU/mL, p = 0.04; 95% CI = [86.3-223.0 μU/mL]) and post-transportation (284.6 μU/mL, p = 0.03; 95% CI = [114.3-454.8 μU/mL]). Non-ID horses had a mean OST T60 insulin post-transportation of 56.6 μU/mL (95% CI = [29.1-84.1 μU/mL]); above recognised threshold [45 μU/mL] for ID diagnosis.
CONCLUSIONS: Small number of horses, only mares used, and OST not performed immediately post-transportation.
CONCLUSIONS: Performing an OST 3 h following short-term transportation may result in inaccurate ID status.
UNASSIGNED: Atualmente não se sabe se o transporte de curto prazo afeta as respostas endócrinas de maneira semelhante em cavalos com e sem disfunção insulinêmica (DI).
OBJECTIVE: Caracterizar o efeito do transporte de curto prazo nos parâmetros de estresse e nas respostas de insulina a um teste de açúcar oral (TAO) em cavalos com e sem DI.
UNASSIGNED: Estudo de coorte longitudinal. MÉTODOS: Quatorze éguas adultas não prenhes, sem disfunção da pars intermédia da pituitária, de raças leves foram agrupadas como DI (n = 7) ou não‐DI (n = 7) com base em testes endócrinos. Durante 2 semanas, as éguas foram transportadas uma vez, em grupos de 3 a 4,em um caminhão de cavalos, em uma viagem de ida e volta de ~1,5 h. Sangue e saliva foram coletados 24 h e 1 h antes do transporte, diretamente após o descarregamento e 15 min, 1 h, 3 h e 24 h após o transporte. Um TAO foi realizado 24 h antes do transporte e 3 h após o transporte, com uma amostra pré‐ (T0) e pós‐TOA coletada 60 min depois (T60). Frequências cardíacas e temperaturas retais também foram coletadas ao longo do estudo. Insulina sérica, cortisol sérico e glicose plasmática foram medidos usando ensaios validados. ANOVA de medidas repetidas foi utilizada para determinar diferenças após o transporte e entre cavalos com e sem DI. Dados não normais foram transformados logaritmicamente e comparações múltiplas foram ajustadas usando testes post hoc de Bonferroni.
RESULTS: A média de insulina foi maior em cavalos com DI em comparação aos cavalos sem DI (média = 109,9 μU/mL vs 30,2 μU/mL, p < 0,001; IC 95% para diferença de média = [55,6–107,7 μU/mL]). A média de insulina sérica aumentou após o TAO em T60 em cavalos com DI antes (154,6 μU/mL, p = 0,04; IC 95% = [86,3–223,0 μU/mL]) e após o transporte (284,6 μU/mL, p = 0,03; IC 95% = [114,3–454,8 μU/mL]). Cavalos sem DI tiveram uma média de insulina TAO T60 pós‐transporte de 56,6 μU/mL (IC 95% = [29,1–84,1 μU/mL]); acima do limite reconhecido [45 μU/mL] para diagnóstico de DI. PRINCIPAIS LIMITAÇÕES: Pequeno número de cavalos, uso apenas de éguas e TAO não realizado imediatamente após o transporte. CONCLUSÕES: Realizar um TAO 3 horas após o transporte de curto prazo pode resultar em um status de DI impreciso.

OBJECTIVE: 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.
CONCLUSIONS: 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.
RESULTS: GOV (03/09/2022): NCT04607941.