Dementia-Friendly Transportation Services: A Scoping Review

BACKGROUND AND OBJECTIVES

Transportation is an important component of dementia-friendly communities. People living with dementia have the right to access transportation services to keep their mobility in their community, which is essential for independence, well-being, and quality of life. This scoping review maps the literature on dementia-friendly transportation services and explores their characteristics to inform future development and research.

RESEARCH DESIGN AND METHODS

Empirical quantitative and qualitative studies in English or French that informed on transportation services for people living with dementia in the community were searched in 15 databases. Two authors independently screened records and charted relevant characteristics from selected publications. Important findings were summarized with a narrative synthesis approach.

RESULTS

Thirty-five studies informed on important dimensions of transportation services in urban and/or rural context: availability, accessibility, acceptability, adaptability and affordability. Important insights were identified: the importance of staff training and attitude, and the challenges of availability of affordable services in the rural context. Emerging policy and program intervention areas include the need for access to quiet areas in transit hubs, training to use mass public transit and mobility management.

DISCUSSION AND IMPLICATIONS

The literature on dementia-friendly transportation services is important in the expansion and maintenance of mobility for people living with dementia in the community. The scope of the existing scientific literature remains limited. While several studies indicated a clear need for better access to dementia-friendly transportation services, the best practices still need to be demonstrated in the scientific literature.

Trends in police complaints and arrests on New York City subways, 2018 to 2023: an interrupted time-series analysis

BACKGROUND

Public transportation use is influenced by perceptions of safety. Concerns related to crime on New York City (NYC) transit have risen following NYC's COVID-19 pandemic state of emergency declaration in 2020, leading to declines in subway ridership. In response, the most recent mayoral administration implemented a Subway Safety Plan in 2022. This study aimed to quantify the effects of the COVID-19 pandemic and the Subway Safety Plan on rates of complaints to and arrests by the New York City Police Department (NYPD) Transit Bureau.

METHODS

Using publicly available data on complaints and arrests, we conducted interrupted time-series analyses using autoregressive integrated moving average models applied to monthly data for the period from September 2018 to August 2023. We estimated changes in the rates of complaints to and arrests by the NYPD Transit Bureau before and after: (1) the COVID-19 pandemic state of emergency declaration (i.e., March 2020), and (2) the announcement of the Subway Safety Plan (i.e., February 2022). We also examined trends by complaint and arrest type as well as changes in proportion of arrests by demographic and geographic groups.

RESULTS

After the COVID-19 pandemic declaration, there was an 84% increase (i.e., an absolute increase of 6.07 per 1,000,000 riders, CI 1.42, 10.71) in complaints to the NYPD Transit Bureau, including a 99% increase (0.91 per 1,000,000 riders, CI 0.42, 1.41) in complaints for assault and a 125% increase in complaints for harassment (0.94 per 1,000,000 riders, CI 0.29, 1.60). Following the Subway Safety Plan there was an increase in the rate of arrests for harassment (0.004 per 1,000,000 riders, CI 0.001, 0.007), as well as decreases in the proportion of arrests for individuals racialized as White (- 0.02, CI - 0.04, - 0.01) and proportion of arrests in the borough of Manhattan (- 0.13, CI - 0.17, - 0.09).

CONCLUSIONS

The increased rates of complaints to the NYPD Transit Bureau following the onset of the COVID-19 pandemic remained elevated following the enactment of the Subway Safety Plan. Further evaluation efforts can help identify effective means of promoting safety on public transportation.

Particle size of insoluble fibres and gelation of soluble fibres influence digesta passage rate throughout the gastrointestinal tract of finishing pigs

Fibres, as abundant in agricultural by-products, exhibit a large range of physicochemical properties that can influence digestive processes such as digesta mean retention time (MRT), thereby affecting nutrient digestion kinetics. In this study, we investigated the effects of particle size of insoluble fibres, and gelation of soluble fibres on MRT of liquids, fine solids, and fibrous particles in the different segments of the gastrointestinal tract (GIT) of pigs. Twenty-four boars (51.6 ± 4.90 kg) were allocated to four diets; two diets contained 15% wheat straw, either coarsely chopped or finely ground (1-mm screen), two diets contained 27% wheat bran without or with the addition of 10% low-methylated pectin. After 14 days of adaptation to the diet, a total collection of faeces was performed to determine the total tract digestibility of nutrients. Thereafter, pigs were fed diets supplemented with tracers for at least 5 days and dissected following a frequent feeding procedure to approach steady-state passage of digesta. The MRT of liquids (Co-EDTA), fine solids (TiO2), and fibrous particles (Chromium-mordanted fibres) in the different segments of the GIT were quantified. In the stomach, particle size reduction of straw decreased the MRT of fine solids by 02:39 h, and fibrous particles by 07:21 h (P < 0.10). Pectin addition to the wheat bran diet reduced the MRT of fine solids by 03:09 h, and fibrous particles by 07:10 h (P < 0.10), but not of liquids, resulting in less separation between digesta phases in the stomach compared with the bran diet (P < 0.05). In the mid-small intestine (SI), pectin addition reduced the MRT of fibrous particles and the separation between fibrous particles and fine solids. No further effects of particle size reduction of straw nor pectin addition on MRT and digestibility of starch, nitrogen, or fat were observed in the SI. In the large intestine (LI), particle size reduction of straw reduced separation between fibrous particles and fine solids (P < 0.10), while pectin addition had no effects. Total tract, non-starch polysaccharide degradation of straw was poor (∼31%), and unaffected by particle size reduction (P > 0.10). The complete fermentation of pectin did not influence the degradation of wheat bran fibres (∼51%). In conclusion, the effects of particle size of insoluble fibres and gelling properties of soluble fibres on the passage of digesta phases were most pronounced in the stomach, but less prominent in distal segments of the GIT.

One-year trial evaluating the durability and antimicrobial efficacy of copper in public transportation systems

Surfaces on transit vehicles are frequently touched and could potentially act as reservoirs for micro-organism transmission. Regular cleaning and disinfection to minimize the spread of micro-organisms is operationally challenging due to the need to keep vehicles in circulation. The application of copper (Cu) alloys to high- touch surfaces could help reduce the risk of cross-contamination, however, little is known about the durability and efficacy of engineered copper surfaces after prolonged use. Three Cu products (decal, thermal fabrication, and alloy covers) were assessed over a 12-month period. These Cu products were randomly installed on 110 stanchions on three buses and four train (SkyTrain) cars in Vancouver and three buses, two subway cars, and two streetcars in Toronto with mirrored control surfaces directly opposite. Bacterial counts (Colony forming units, CFU) and ATP bioluminescence (ATPB) were measured every two months after peak morning routes. Durability of the Cu products were assessed monthly through visual inspection and colorimetry assays or by ex-situ microscopy. Cu products on stanchions reduced the mean colony forming units (CFU) of all vehicles by 42.7% in the mean CFU (0.573 (CI 95% 0.453-0.726), p-value < 0.001) compared to control surfaces. The three Cu products exhibited an overall 87.1% reduction in the mean ATPB readings (0.129 (CI 95% 0.059-0.285, p-value < 0.001) compared to controls. Surface Cu concentration for all three products was consistent throughout the 12-month period. Electron microscopy (SEM) and Energy-dispersive X-ray Spectroscopy (EDS) cross-sectional analysis showed no change in thickness or dealloying of Cu products, however SEM top-down analysis revealed substantial carbon accumulation on all surfaces. Cu products installed on transit vehicles maintained antimicrobial efficacy and durability after 12 months of use.

Will transit recover? A retrospective study of nationwide ridership in the United States during the COVID-19 pandemic

Although the COVID-19 pandemic highly impacted transit ridership as people reduced or stopped travel, these changes occurred at different rates in different regions across the United States. This study explores the impacts of COVID-19 on ridership and recovery trends for all federally funded transit agencies in the United States from January 2020 to June 2022. The findings of this analysis show that overall transit ridership hit a 100-year low in 2020. Changepoint analysis revealed that June 2021 marked the beginning of the recovery for transit ridership in the United States. However, even by June 2022, rail and bus ridership were only about two-thirds of the pre-pandemic levels in most metropolitan statistical areas (MSAs). Only in a handful of MSAs like Tampa and Tucson did rail ridership reach or exceed 2019 ridership. This retrospective study concludes with a discussion of some longer-term changes likely to continue to impact ridership, such as increased telecommuting and operator shortages, as well as some opportunities, such as free fares and increased availability of bus lanes. The findings of this study can help inform agencies about their performance compared to their peers and highlight general challenges facing the transit industry.

Transit communication via Twitter during the COVID-19 pandemic

Transit providers have used social media (e.g., Twitter) as a powerful platform to shape public perception and provide essential information, especially during times of disruption and disaster. This work examines how transit agencies used Twitter during the COVID-19 pandemic to communicate with riders and how the content and general activity influence rider interaction and Twitter handle popularity. We analyzed 654,345 tweets generated by the top 40 transit agencies in the US, based on Vehicles Operated in Annual Maximum Service (VOM), from January 2020 to August 2021. We developed an analysis framework, using advanced machine learning and natural language processing models, to understand how agencies' tweeting patterns are associated with rider interaction outcomes during the pandemic. From the transit agency perspective, we find smaller agencies tend to generate a higher percentage of COVID-related tweets and some agencies are more repetitive than their peers. Six topics (i.e., face covering, essential service appreciation, free resources, social distancing, cleaning, and service updates) were identified in the COVID-related tweets. From the followers' interaction perspective, most agencies gained followers after the start of the pandemic (i.e., March 2020). The percentage of follower gains is positively correlated with the percentage of COVID-related tweets, tweets replying to followers, and tweets using outlinks. The average like counts per COVID-related tweet is positively correlated with the percentage of COVID-related tweets and negatively correlated with the percentage of tweets discussing social distancing and agency repetitiveness. This work can inform transportation planners and transit agencies on how to use Twitter to effectively communicate with riders to improve public perception of health and safety as it relates to transit ridership during delays and long-term disruptions such as those created by the COVID-19 public health crisis.

Impaired distal colonic pH in adults with cystic fibrosis

Previous wireless motility capsule (WMC) studies demonstrated decreased small intestinal pH in people with CF (PwCF) however the data is lacking on the colonic pH profile. We re-analyzed previously published WMC data to determine colonic pH/bicarbonate concentration and single cell RNA sequencing (sc-RNAseq) to examine the normal expression of acid-base transporters in the colon/rectum.CF patients showed significantly lower pH and bicarbonate concentration values, particularly in the distal rectosigmoid region. There was no difference in colonic motility parameters between CF and non-CF subjects. SLC26A3 is highly expressed bicarbonate transporter in the colon and rectum, more so than CFTR. While dysmotility can alter intraluminal pH, observed changes likely originate from alterations in intestinal ion transport rather than colonic dysmotility. SLC26A3 is abundantly expressed in the human colon and rectum and may be a therapeutic target for restoration of bicarbonate transport. These findings may help better understand the gastrointestinal symptoms in PwCF.

An evaluation of the impact of COVID-19 safety measures in public transit spaces on riders' Worry of virus contraction

The coronavirus pandemic has brought about global change in travel behavior. Transit ridership volumes have dropped to record lows. Concerning environmental, health, and social consequences lie in store if transit networks are not able to regain a substantial portion of pre-pandemic users. Transit providers have implemented several interventions aimed at both slowing the spread of the virus and retaining riders as travel restrictions lift. While the effectiveness of these measures has been evaluated with respect to spread rate reduction, little consideration has been given to their impact on riders' feelings of worry regarding virus contraction. By deploying a photo-simulation approach in a randomized control trial, this study finds that level of compliance with safety measures and the conditions of transit spaces themselves significantly impact riders' levels of worry. Given these findings, a series of recommendations are made regarding compliance practices that are expected to lessen rider worry regarding the risks of COVID-19 infection.

Three's a crowd? Examining evolving public transit crowding standards amidst the COVID-19 pandemic

The COVID-19 pandemic dramatically affected public transit systems around the globe. Because transit systems typically move many people closely together on buses and trains, public health guidance demanded that riders should keep a distance of about two meters to others changed the definition of "crowding" on transit in 2020. Accordingly, this research examines how U.S. public transit agencies responded to public health guidance that directly conflicted with their business model. To do this, we examined published crowding standards before the COVID-19 pandemic for a representative sample of 200 transit systems, including whether they started or changed their published standards during the pandemic, as well as the reasons whether agencies publicize such standards at all. We present both descriptive statistics and regression model results to shed light on the factors associated with agency crowding standards. We find that 56% of the agencies surveyed published crowding standards before the pandemic, while only 46% published COVID-19-specific crowding standards. Regression analyses suggest that larger agencies were more likely to publish crowding standards before and during the COVID-19 pandemic, likely because they are more apt to experience crowding. Pandemic-specific crowding standards, by contrast, were associated with a more complex set of factors. We conclude that the relative lack of pandemic standards reflects the uncertainty and fluidity of the public health crisis, inconsistent and at times conflicting with the guidance from public health officials, and, in the U.S., a lack national or transit industry consensus on appropriate crowding standards during the first year of the pandemic.

The Long-Term effects of COVID-19 on travel behavior in the United States: A panel study on work from home, mode choice, online shopping, and air travel

A critical challenge facing transportation planners is to identify the type and the extent of changes in people's activity-travel behavior in the post-Covid-19 pandemic world. In this study, we investigate the travel behavior evolution by analyzing a longitudinal two-wave panel survey data conducted in the United States from April 2020 to May 2021. Encompassing nearly 3,000 respondents across different states, we explored the effects of the pandemic on four major categories of work from home, travel mode choice, online shopping, and air travel. We utilized descriptive and econometric measures, including random effects ordered probit models, to shed light on the pandemic-induced changes and the underlying factors affecting the future of mobility in the post-pandemic world. Upon concrete evidence, our findings substantiate significant observed (i.e., during the pandemic) and expected (i.e., after the pandemic) changes in people's habits and preferences. According to our results, 48% of the respondents anticipate having the option to WFH after the pandemic, which indicates an approximately 30% increase compared to the pre-pandemic period. In the post-pandemic period, auto and transit commuters are expected to be 9% and 31% less than pre-pandemic, respectively. A considerable rise in hybrid work and grocery online shopping is expected. Moreover, 41% of pre-covid business travelers expect to have fewer flights (after the pandemic) while only 8% anticipate more, compared to the pre-pandemic.

Neighborhood built environments and Hispanic/Latino adults' physical activity in the U.S.: The Hispanic community health study/study of Latinos community and surrounding areas study

Despite experiencing health inequities, less is known about neighborhood environments and physical activity among Hispanic/Latino adults compared to other populations. We investigated this topic in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Hispanic/Latino adults in the San Diego, California area of the U.S. completed measures of overall moderate-to-vigorous physical activity (MVPA) via accelerometry and domain-specific MVPA via questionnaire at Visits 1 (2008-2011; n = 4086) and 2 (2014-2017; n = 1776), ~6 years apart. 800-m home neighborhood buffers were used to create objective measures of residential, intersection, and retail density, bus/trolley stops, greenness, parks, and recreation area at Visit 1. Regression models tested the association of each neighborhood feature with MVPA at Visit 1 and over 6 years, adjusting for individual characteristics and neighborhood socioeconomic deprivation. At Visit 1, those in neighborhoods with higher vs. lower retail density or recreation area (+1 vs. -1 standard deviation from the mean) engaged in 10% more overall MVPA and 12-22% more active transportation. Those in neighborhoods with higher vs. lower residential density engaged in 22% more active transportation. Those in neighborhoods with higher vs. lower greenness and park count engaged in 14-16% more recreational MVPA. Neighborhood features were unassociated with changes in MVPA over 6 years. Although changes in MVPA over time were similar across neighborhoods, Hispanic/Latino adults living in neighborhoods with design features supportive of walking and recreational activity (e.g., greater residential and retail density, more parks and recreation facilities) were consistently more active. Improving neighborhood environments appears important for supporting physical activity among Hispanic/Latino adults.

Measuring spatial accessibility to urban services for older adults: an application to healthcare facilities in Milan

This study proposes a Geographic Information Systems-based methodology to measure accessibility to urban services from the elderly perspective to support urban planning processes. Specifically, it seeks to understand and clarify how the urban environment can influence the quality of life for older adults, mostly through pedestrian and public transport networks, locations of essential urban services, and the organisation of their resources. In light of a significant demographic change, policymakers will have to promote age-friendly urban planning approaches to guarantee equal access to services and activities. We propose a methodology to measure accessibility to healthcare provision services that considers land-use and mobility features and older adults' behavioural traits. The method belongs to the family of 2SFCA-2 steps floating catchment area-which evaluate accessibility as the combination of both supply and demand of urban services. Therefore, we have introduced innovative elements to shape actual mobility opportunities for the elderly and their travel choices. The methodology was applied to Milan's city to measure accessibility to the Health Protection Agency (ATS) services, which is responsible for healthcare assistance to the elderly dwelling in the city. The outputs show that a significant share of older people (almost 40%) suffer from poor accessibility to primary health services and that they mostly live in the city periphery. Moreover, the application to a case study has shown that the methodology could identify the critical aspects needed to aid urban planning to achieve a high quality of life for elderly people.

Transit use reduction following COVID-19: The effect of threat appraisal, proactive coping and institutional trust

Transit systems suffered from a significant demand decrease during COVID-19. Understanding the psychological motivators underlying reduced transit use can help transit authorities and operators to take proactive action towards returning to the "new normal" and increasing their preparedness towards future pandemics. This study is based on the protection motivation theory to understand the effect of threat appraisal, and coping appraisal and denial mechanisms on transit use reduction for commuting. The behavioral framework is validated by a survey of 856 transit users in Israel during August 2020, three months after the end of the lockdown and before the vaccine administration. The results show that: i) Skepticism, risk ubiquity, and personal immunity beliefs lead to maladaptive threat appraisal; ii) wearing masks and social distancing are antecedents of fear of infection while using transit and reduced transit use; iii) higher perceived threat deters transit use, while trust in transit operators motivates transit use; and iv) in a franchised transit system, trust in transit operators depends on the perceived level-of-service and trust in the ability of government authorities to regulate, monitor and enforce transit operators' preventive and protective actions.

Food insecurity and coping strategies in international migrants in transit through Mexico

Background

Although migrants in transit through Mexico have been known to consume insufficient food, data measuring food insecurity (FI) in this vulnerable population is scarce. This study assesses FI in migrants transiting Mexico by examining economic, physical and social food access.

Methods

Using a mixed-methods design and a convenience sample of migrants residing in a temporary shelter in Saltillo, Coahuila in northern Mexico, we applied 1) the Food Insecurity Experience Scale (adapted), and 2) a semi-structured interview exploring FI coping strategies.

Results

Of the 54 participants, 74.1% reported moderate or severe FI and 24.1% reported severe FI, especially reduced food quantity. Interviewees reported poverty, cargo train travel, and crime as FI contributing factors. All interviewees used FI coping strategies, principally altering food intake and using social resources. Many strategies reported implied negative consequences for both nutrition and general health.

Conclusions

This study provides a comprehensive assessment of FI in a mobile population using a standard international measure. Results confirm widespread and severe FI, highlighting a potential humanitarian crisis requiring both national and international attention. Further research is critical to inform strategies for guaranteeing the right to food access for migrants in transit through third (non-destination) countries.

Investigating the association between mass transit adoption and COVID-19 infections in US metropolitan areas

Urbanization introduces the threat of increased epidemic disease transmission resulting from crowding on mass transit. The coronavirus disease 2019 (COVID-19) pandemic, which has directly led to over 600,000 deaths in the US as of July 2021, triggered mass social distancing policies to be enacted as a key deterrent of widespread infections. Social distancing can be challenging in confined spaces required for transportation such as mass transit systems. Little is published regarding the degree to which mass transit system adoption effects impacted the rise of the COVID-19 pandemic in urban centers. Taking an ecological approach where areal data are the unit of observation, this national-scale study aims to measure the association between the adoption of mass transit and COVID-19 spread through confirmed cases in US metropolitan areas. National survey-based transit adoption measures are entered in negative binomial regression models to evaluate differences between areas. The model results demonstrate that mass transit adoption in US metropolitan areas was associated with the magnitude of outbreaks. Higher incidence of COVID-19 early in the pandemic was associated with survey results conveying higher transit use. Increasing weekly bus transit usage in metropolitan statistical areas by one scaled unit was associated with a 1.38 [95% CI: (1.25, 1.90)] times increase in incidence rate of COVID-19; a one scaled unit increase in weekly train transit usage was associated with an increase in incidence rate of 1.54 [95% CI: (1.42, 2.07)] times. These conclusions should inform early action practices in urban centers with busy transit systems in the event of future infectious disease outbreaks. Deeper understanding of these observed associations may also benefit modeling efforts by allowing researchers to include mathematical adjustments or better explain caveats to results when communicating with decision makers and the public in the crucial early stages of an epidemic.

Cecorectal (CRA) versus ileorectal (IRA) anastomosis after colectomy for slow transit constipation (STC): a meta-analysis

INTRODUCTION

We conducted this meta-analysis, to compare cecorectal (CRA) and ileorectal anastomosis (IRA), regarding perioperative safety and efficacy, in patients submitted to colectomy for refractory slow transit constipation (STC).

METHODS

This study followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. To identify all eligible records, a systematic literature search in the electronic scholar databases (Medline, Scopus, Web of Science) was performed.

RESULTS

Overall, 5 trials and 291 patients were included in this meta-analysis. Pooled comparisons confirmed the comparability of the two techniques regarding perioperative complications (p = 0.55). CRA was associated with a shorter operation (p = 0.0004) and hospitalization duration (p = 0.001). Although there was no difference in terms of gastrointestinal symptoms, functional outcomes, and patient satisfaction, CRA resulted in lower long-term Wexner scores (p < 0.0001).

CONCLUSION

Due to several study limitations, further large-scale RCTs are required to verify the findings of the present meta-analysis.

A data-driven analysis of the potential of public transport for German commuters using accessibility indicators

Background

A significant mode shift will be required in order to meet the ambitious greenhouse gas emissions reduction targets in Germany and elsewhere. Such a mode shift can only be achieved by a combination of drastic push and pull measures. Getting commuters to switch modes might be particularly difficult and have a negative impact on their access to employment and welfare.

Methodology

We investigate the potential for a mode shift from car to public transport for German commuters using a data-driven approach based mainly on open data sources that avoids complex transport model runs. Different datasets on the home and workplace location of all employees in Germany are consolidated to create an origin-destination commuter matrix at traffic analysis zone level. The commuter matrix is merged with travel time data for car and public transport to calculate a spatially disaggregated and mode-specific measure of accessibility. The comparison of accessibility by car and public transport is used to derive the potential for a mode shift and identify potential challenges and barriers.

Results

Public transport accessibility to workplaces is poorer across the country compared to access by car. On average, public transport travel times are almost three times higher than the corresponding car travel times. The differences in accessibility are largely independent of the region type. Results are validated by an independent dataset from a household travel survey. Based on these results, the potential for a mode shift appears to be very low.

Impact of TNC on travel behavior and mode choice: a comparative analysis of Boston and Philadelphia

We compare responses from an online survey among 700 customers of transportation network companies (TNC) in Boston and Philadelphia to investigate TNC's impact on vehicle ownership, trip making, and mode choice. We first use a qualitative comparative analysis to examine changes in respondents' travel behavior and vehicle ownership after adopting TNC. We then use a random parameter logit regression analysis to investigate customers' preferences between transit and TNC based on a choice experiment. We find that in both cities, TNC allows customers, including those who currently do not own a car, to either delay purchasing a car or forgo a car altogether. TNC enables customers across income levels to take trips that they otherwise would not have taken. Meanwhile, TNC substitutes for more than complementing transit. The random parameter logit analysis indicates that when choosing between TNC and transit, individuals in both cities consider waiting time and overall travel time for transit to be more burdensome than those for TNC. Bostonians perceive the time spent walking to and from transit to be less burdensome, and the time spent traveling in vehicle to be more burdensome than do Philadelphians. Differences in built environment, mode share within transit systems, and income likely contribute to respondents' different values of time between the two cities. Our paper is the first to compare individual trade-off between transit and TNC in two cities with different urban settings and transit services. The findings have implications on transit service planning, station area improvements, parking regulations, and traffic management.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11116-021-10220-5.

Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth

BACKGROUND

Clinical symptoms of patients with small intestinal bacterial overgrowth (SIBO) may overlap with symptoms of gastroparesis. Prior studies suggest delayed small intestinal transit is associated with SIBO, but have not shown an association between delayed gastric emptying and SIBO. However, these studies have generally relied on the indirect method of breath testing to diagnose SIBO.

AIMS

The aim of this study was to examine the association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy.

METHODS

In a single-center retrospective study of previous research participants who presented for small bowel enteroscopy for diagnostic evaluation of SIBO, we identified 73 participants who underwent gastric emptying study by scintigraphy. A microbiological diagnosis of SIBO was made in patients based on culture results of jejunal aspirates. Clinical symptoms were assessed using the total gastroparesis cardinal symptom index (GCSI) score. We compared delayed gastric emptying, 2- and 4-h gastric retention, and gastroparesis symptoms between patients with and without a microbiological diagnosis of SIBO.

KEY RESULTS

Among 29 participants with SIBO and 44 without SIBO, 33 (45%) had evidence of delayed gastric emptying. There was no significant association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy. Percent retained at 2 and 4 h, and total GCSI scores did not differ significantly between those with and without SIBO.

CONCLUSIONS

Although delayed gastric emptying is common in patients with suspected SIBO, gastric emptying is not associated with a microbiological diagnosis of SIBO.

How is COVID-19 reshaping activity-travel behavior? Evidence from a comprehensive survey in Chicago

The novel COVID-19 pandemic has caused upheaval around the world and has led to drastic changes in our daily routines. Long-established routines such as commuting to workplace and in-store shopping are being replaced by telecommuting and online shopping. Many of these shifts were already underway for a long time, but the pandemic has accelerated them remarkably. This research is an effort to investigate how and to what extent people's mobility-styles and habitual travel behaviors have changed during the COVID-19 pandemic and to explore whether these changes will persist afterward or will bounce back to the pre-pandemic situation. To do so, a stated preference-revealed preference (SP-RP) survey is designed and implemented in the Chicago metropolitan area. The survey incorporates a comprehensive set of questions associated with individuals' travel behaviors, habits, and perceptions before and during the pandemic, as well as their expectations about the future. Analysis of the collected data reveals significant changes in various aspects of people's travel behavior. We also provide several insights for policymakers to be able to proactively plan for more equitable, sustainable, and resilient cities.

How does transit-oriented developments (TODs) deviate noise pollution of buildings? A comparative study of TODs and non-TODs

Scholarly debates on the unique features of transit-oriented developments (TODs) have surged over the last decade. Studies have examined their amenities and disamenities; however, lacking is exploring the relationship between TOD sound levels and buildings. Understanding this relationship has implications for communities and the urban form from environmental pollution aspects. This study explores the implications of sound on TOD buildings in the Dallas-Fort Worth metropolitan area by comparing them with non-TODs, specifically the relationship between buildings and street characteristics, and sound, as well as the potential effects of this relationship on TOD residents. Data include sound pressure levels through TOD buildings and streets compared with non-TOD buildings and streets. Using a two-level hierarchical linear model (HLM) help examine such characteristics at both micro and macro levels. The findings show that buildings located within TODs are exposed to higher sound levels with 1.4 dB(A) difference. The study provides insights into the relationship between sound, environmental pollution, building science, and transportation-featured elements of the built environment.

Macroscopic road safety impacts of public transport: A case study of Melbourne, Australia

Mode shift from private vehicle to public transport is often considered as a potential means of improving road safety, given public transport's lower fatality rates. However, little research has examined how public transport travel contributes to road safety at a macroscopic level. Further, there is a limited understanding of the individual effects of different public transport modes. This paper explores the effects of commuting by public transport on road safety at a macroscopic level, using Melbourne as a case study. A random effect negative binomial (RENB) and a conditional autoregressive (CAR) model are adopted to explore links between total and severe crash data to commuting mode shares and a range of other zonal explanatory factors. Overall, results show the great potential of public transport as a road safety solution. It is evident that mode shift from private vehicle to public transport (i.e. train, tram, and bus), for commuting would reduce not only total crashes, but also severe crashes. Modelling also demonstrated that CAR models outperform RENB models. In addition, results highlight safety issues related to commuting by motorbike and active transport. Effects of sociodemographic, transport network, and land use factors on crashes at the macroscopic level are also discussed.

An evaluation of transit procurement training

We evaluated a training course called "Orientation to Transit Procurement", designed and conducted by the National Transit Institute. This course is designed to provide Federal Transit Administration (FTA) grantees an overview of regulations and best practices related to the procurement process. Our objective in conducting the evaluation was to understand how transit agency staff made changes in procurement practices in response to the course training. The evaluation was mixed mode: an Internet survey followed by in-depth interviews with a small group of respondents. Survey respondents were also provided with an open-ended question providing us with additional context for our evaluation. Results show that the training is substantially successful at meeting the goal of improving procurement practices at transit agencies; indeed, most respondents report making changes at their agencies as the proximate result of the training. This was at odds with our exploration of knowledge of procurement topics, as most respondents gave inaccurate answers on multiple-choice "knowledge questions". This may have been due to question structure or, more likely, the nature of online surveys. Suitable training on the procurement of information technology was also a main concern. The lack of training in this area is indicative of the broader challenge facing public transit agencies in how to incorporate new forms of technology into their existing practices and bureaucratic structures.

Dataset on the importation of the exotic shrimp Penaeus vannamei broodstock (Boone, 1931) to India

Penaeus vannamei is an exotic shrimp species that has gained high culture momentum, since its introduction to India [1]. Currently, the culture of the species in the Country is being done by the shrimp farmers by importation of Specific Pathogen Free (SPF) vannamei broodstock from approved suppliers, which are located overseas. The value of one brooder normally ranges from 50 to 61 US $, excluding the custom duty, processing fee and other charges for the transboundary shipment of the stock to India. The P. vannamei stock are permitted to be imported to the Country by the hatchery operators only through the single declared port of entry, i.e. Chennai in Tamil Nadu in the Country. The imported parent shrimps are then to be quarantined at the Aquatic Quarantine Facility before being transported to the vannamei hatcheries [2]. This article reports the data available on import of vannamei broodstock to India since its importation to India in 2009. The dataset presented here contains information on transit and quarantine mortality of the brooders following the shipment of the stock by the various broodstock suppliers from the overseas.

Correlation between colonic secretion and colonic motility in rats: Role of ghrelin

AIM

To explore the relationship between colonic secretory function and colonic motility.

METHODS

Using a rat model chronically implanted with intracerebroventricular (ICV) and cecal catheters, we validated the correlation between colonic secretion and colonic motor functions, as well as the role of ICV injection volume.

RESULTS

Compared to saline controls (5 μL/rat), ICV acyl ghrelin at 1 nmol/5 μL enhanced the total fecal weight, accelerated the colonic transit time, and increased the fecal pellet output during the first hour post-injection, while ICV des-acyl ghrelin at 1 nmol/5 μL only accelerated the colonic transit time. These stimulatory effects on colonic motility and/or secretion from acyl ghrelin and des-acyl ghrelin disappeared when the ICV injection volume increased to 10 μL compared with saline controls (10 μL/rat). Additionally, the ICV injection of 10 μL of saline significantly shortened the colonic transit time compared with the ICV injection of 5 μL of saline. The total fecal weight during the first hour post-injection correlated with the colonic transit time and fecal pellet output after the ICV injection of acyl ghrelin (1 nmol/5 μL), whereas the total fecal weight during the first hour post-injection correlated with the fecal pellet output but not the colonic transit time after the ICV injection of des-acyl ghrelin (1 nmol/5 μL).

CONCLUSION

Colonic secretion does not always correlate with colonic motility in response to different colonic stimulations. Acyl ghrelin stimulates colonic secretion.

Environmental, behavioral, and psychological predictors of transit ridership: Evidence from a community intervention

Understanding who takes advantage of new transit (public transportation) interventions is important for personal and environmental health. We examine transit ridership for residents living near a new light rail construction as part of "complete street," pedestrian-friendly improvements. Adult residents (n=536) completed surveys and wore accelerometer and GPS units that tracked ridership before and after new transit service started. Transit riders were more physically active. Those from environments rated as more walkable were likely to be continuing transit riders. Place attachment, but not perceived physical incivilities on the path to transit, was associated with those who continued to ride or became new riders of transit. This effect was mediated through pro-city attitudes, which emphasize how the new service makes residents eager to explore areas around transit. Thus, place attachment, along with physical and health conditions, may be important predictors and promoters of transit use.

Peripheral injection of pancreatic polypeptide enhances colonic transit without eliciting anxiety or altering colonic secretion in rats

Pancreatic polypeptide (PP) is a negative regulator of energy homeostasis that suppresses food intake and lowers body weight. Similar to other gastrointestinal-derived peptides, PP also modulates gastrointestinal motility and may be involved in the regulation of anxiety. Previous studies revealed that PP suppresses gastric emptying but increases colonic motility in mice. In our present study, we assessed the effect of PP on anxiety as well as colonic motility and secretory function. Intracerebroventricular and intravenous routes of PP were administered in conscious rats. Our results showed that intracerebroventricular administration of PP did not affect anxiety in the open field test. Intravenous injection of PP accelerated colonic transit, but did not significantly change fecal amount and fecal fluid composition. On the other hand, intracerebroventricular injection of PP did not alter colonic transit, fecal amount, or fluid composition. In conclusion, peripheral, but not central PP administration enhances colonic motility without eliciting anxiety or altering colonic secretion.

Public Transit Equity Analysis at Metropolitan and Local Scales: A Focus on Nine Large Cities in the US

Recent studies on transit service through an equity lens have captured broad trends from the literature and national-level data or analyzed disaggregate data at the local level. This study integrates these methods by employing a geostatistical analysis of new transit access and income data compilations from the Environmental Protection Agency. By using a national data set, this study demonstrates a method for income-based transit equity analysis and provides results spanning nine large auto-oriented cities in the US. Results demonstrate variability among cities' transit services to low-income populations, with differing results when viewed at the regional and local levels. Regional-level analysis of transit service hides significant variation through spatial averaging, whereas the new data employed in this study demonstrates a block-group scale equity analysis that can be used on a national-scale data set. The methods used can be adapted for evaluation of transit and other modes' transportation service in areas to evaluate equity at the regional level and at the neighborhood scale while controlling for spatial autocorrelation. Transit service equity planning can be enhanced by employing local Moran's I to improve local analysis.

Eluxadoline benefits patients with irritable bowel syndrome with diarrhea in a phase 2 study

BACKGROUND & AIMS

Simultaneous agonism of the μ-opioid receptor and antagonism of the δ-opioid receptor can reduce abdominal pain and diarrhea in patients with irritable bowel syndrome with diarrhea (IBS-D) without constipating side effects. We evaluated the efficacy and safety of a minimally absorbed, μ-opioid receptor agonist and δ-opioid receptor antagonist (eluxadoline) in a phase 2 study in patients with IBS-D.

METHODS

We randomly assigned 807 patients to groups that received oral placebo twice daily or 5, 25, 100, or 200 mg oral eluxadoline for 12 weeks. The primary end point was clinical response at week 4, defined by a mean reduction in daily pain score from baseline of ≥ 30%, and of at least 2 points on 0-10 scale, as well as a stool consistency score of 3 or 4 on the Bristol Stool Scale (1-7) for at least 66% of daily diary entries during that week.

RESULTS

Significantly more patients receiving 25 mg (12.0%) or 200 mg (13.8%) eluxadoline met the primary end point of clinical response than patients given placebo (5.7%; P < .05). Patients receiving eluxadoline at 100 mg and 200 mg also had greater improvements in bowel movement frequency and urgency, global symptoms, quality of life, and adequate relief assessments (P < .05). Additionally, patients receiving 100 mg (28.0%) or 200 mg (28.5%) eluxadoline were significantly more likely than those receiving placebo (13.8%; P < .005) to meet the US Food and Drug Administration response end point during the full 12 weeks of the study. Eluxadoline was well tolerated with a low incidence of constipation.

CONCLUSIONS

In a phase 2 study of the mixed μ-opioid receptor agonist/δ-opioid receptor antagonist eluxadoline vs placebo in patients with IBS-D, patients given eluxadoline were significantly more likely to be clinical responders, based on a composite of improvement in abdominal pain and stool consistency. Further study of eluxadoline is warranted to assess its potential as a treatment for IBS-D.

Achieving recommended daily physical activity levels through commuting by public transportation: unpacking individual and contextual influences

This paper estimates the amount of daily walking associated with using public transportation in a large metropolitan area and examines individual and contextual characteristics associated with walking distances. Total walking distance to and from transit was calculated from a travel diary survey for 6913 individuals. Multilevel regression modelling was used to examine the underlying factors associated with walking to public transportation. The physical activity benefits of public transportation varied along gender and socio-economic lines. Recommended minutes of daily physical activity can be achieved for public transportation users, especially train users living in affluent suburbs.