Assessing the Travel Demand and Mobility Impacts of Transformative Transportation Technologies in Indiana

The rapid development of transformative transportation technologies, such as bike-sharing, shared e-scooters, and ride-hailing systems, is reshaping the transportation landscape. These transformative transportation technologies have the potential to significantly change travel behavior and travel demand and affect transportation agencies’ planning, operations, and decision-making. The objective of this project is to develop a framework and models to quantify the potential travel demand and mobility impacts of transformative transportation technologies in Indiana cities. This project analyzed historical system usage data and conducted survey studies to evaluate the availability and use of transformative transportation technologies in select Indiana cities. The project also proposed a data-driven model to study the relationship between shared micro-mobility and the existing transit system and developed a simulation model to analyze the potential mode choice change under different future development scenarios. Additionally, based on a comprehensive literature review, a list of operations; environmental, health and safety; and accessibility and equity metrics were identified as the Key Performance Indicators to evaluate transformative transportation technologies. Furthermore, as this study was conducted in the midst of the COVID-19 pandemic, the impacts of the pandemic on both traditional and transformative transportation systems were also examined as documented in the literature and stated in our survey

Impressions on Reliability and Students’ Perceptions of Learning in a Peer-Based OSCE

Background: Peer assessment of performance in the objective structured clinical examination (OSCE) is emerging as a learning instrument. While peers can provide reliable scores, there may be a trade-off with students’ learning. The purpose of this study is to evaluate a peer-based OSCE as a viable assessment instrument and its potential to promote learning and explore the interplay between these two roles. Methods: A total of 334 medical students completed an 11-station OSCE from 2015 to 2016. Each station had 1–2 peer examiners (PE) and one faculty examiner (FE). Examinees were rated on a 7-point scale across 5 dimensions: Look, Feel, Move, Special Tests and Global Impression. Students participated in voluntary focus groups in 2016 to provide qualitative feedback on the OSCE. Authors analysed assessment data and transcripts of focus group discussions. Results: Overall, PE awarded higher ratings compared with FE, sources of variance were similar across 2 years with unique variance consistently being the largest source, and reliability (rφ) was generally low. Focus group analysis revealed four themes: Conferring with Faculty Examiners, Difficulty Rating Peers, Insider Knowledge, and Observing and Scoring. Conclusions: While peer assessment was not reliable for evaluating OSCE performance, PE’s perceived that it was beneficial for their learning. Insight gained into exam technique and self-appraisal of skills allows students to understand expectations in clinical situations and plan approaches to self-assessment of competence

Public Education for Work Zone Safety

This project aims to help improve work zone driver safety in Indiana through driver education and public awareness campaigns. The project focused on two specific objectives: (1) to design a public awareness campaign to increase drivers’ knowledge and influence positive attitudes about work zone driver safety practices; and (2) to prepare educational materials to be incorporated into driver’s education or training curriculum prior to taking driving test and getting a driver’s license issued. The campaign was informed by formative research, conducted using a survey to assess public knowledge and attitudes. Based on these results, campaign messages were designed. The effectiveness of the campaign messages was tested through an online survey which provided feedback to improve the effectiveness of materials and messages. This report concludes with recommendations to INDOT for the successful implementation of the public awareness campaign and educational materials, that might be applicable to other states as well

Design of Educational Material and Public Awareness Campaigns for Improving Work Zone Driver Safety

This project aims to help improve work zone driver safety in Indiana through driver education and public awareness campaigns. The project focused on two specific objectives: (1) to design a public awareness campaign to increase drivers’ knowledge and influence positive attitudes about work zone driver safety practices; and (2) to prepare educational materials to be incorporated into driver’s education or training curriculum prior to taking driving test and getting a driver’s license issued. The campaign was informed by formative research, conducted using a survey to assess public knowledge and attitudes. Based on these results, campaign messages were designed. The team also designed an education curriculum which consists of three modules and fourteen knowledge questions. This report concludes with recommendations to INDOT for the successful implementation of the public awareness campaign and educational materials, that might be applicable to other states as well

Assessing the Travel Demand and Mobility Impacts of Transformative Transportation Technologies in Indiana

SPR-4413The rapid development of transformative transportation technologies, such as bike-sharing, shared e-scooters, and ridehailing systems, is reshaping the transportation landscape. These transformative transportation technologies have the potential to significantly change travel behavior and travel demand and affect transportation agencies\u2019 planning, operations, and decisionmaking. The objective of this project is to develop a framework and models to quantify the potential travel demand and mobility impacts of transformative transportation technologies in Indiana cities. This project analyzed historical system usage data and conducted survey studies to evaluate the availability and use of transformative transportation technologies in select Indiana cities. The project also proposed a data-driven model to study the relationship between shared micro-mobility and the existing transit system and developed a simulation model to analyze the potential mode choice change under different future development scenarios. Additionally, based on a comprehensive literature review, a list of operations; environmental, health and safety; and accessibility and equity metrics were identified as the Key Performance Indicators to evaluate transformative transportation technologies. Furthermore, as this study was conducted in the midst of the COVID-19 pandemic, the impacts of the pandemic on both traditional and transformative transportation systems were also examined as documented in the literature and stated in our survey

Short-term triple therapy with azithromycin for Helicobacter pylori eradication: Low cost, high compliance, but low efficacy

<p>Abstract</p> <p>Background</p> <p>The Brazilian consensus recommends a short-term treatment course with clarithromycin, amoxicillin and proton-pump inhibitor for the eradication of <it>Helicobacter pylori </it>(<it>H. pylori)</it>. This treatment course has good efficacy, but cannot be afforded by a large part of the population. Azithromycin, amoxicillin and omeprazole are subsidized, for several aims, by the Brazilian federal government. Therefore, a short-term treatment course that uses these drugs is a low-cost one, but its efficacy regarding the bacterium eradication is yet to be demonstrated. The study's purpose was to verify the efficacy of <it>H. pylori </it>eradication in infected patients who presented peptic ulcer disease, using the association of azithromycin, amoxicillin and omeprazole.</p> <p>Methods</p> <p>Sixty patients with peptic ulcer diagnosed by upper digestive endoscopy and <it>H. pylori </it>infection documented by rapid urease test, histological analysis and urea breath test were treated for six days with a combination of azithromycin 500 mg and omeprazole 20 mg, in a single daily dose, associated with amoxicillin 500 mg 3 times a day. The eradication control was carried out 12 weeks after the treatment by means of the same diagnostic tests. The eradication rates were calculated with 95% confidence interval.</p> <p>Results</p> <p>The eradication rate was 38% per intention to treat and 41% per protocol. Few adverse effects were observed and treatment compliance was high.</p> <p>Conclusion</p> <p>Despite its low cost and high compliance, the low eradication rate does not allow the recommendation of the triple therapy with azithromycin as an adequate treatment for <it>H. pylori </it>infection.</p

A survey of the ATP-binding cassette (ABC) gene superfamily in the salmon louse (Lepeophtheirus salmonis)

Salmon lice,Lepeophtheirus salmonis(Kr&oslash;yer, 1837), are fish ectoparasites causing significant economic damage in the mariculture of Atlantic salmon,Salmo salarLinnaeus, 1758. The control ofL.salmonisat fish farms relies to a large extent on treatment with anti-parasitic drugs. A problem related to chemical control is the potential for development of resistance, which inL.salmonisis documented for a number of drug classes including organophosphates, pyrethroids and avermectins. The ATP-binding cassette (ABC) gene superfamily is found in all biota and includes a range of drug efflux transporters that can confer drug resistance to cancers and pathogens. Furthermore, some ABC transporters are recognised to be involved in conferral of insecticide resistance. While a number of studies have investigated ABC transporters inL.salmonis, no systematic analysis of the ABC gene family exists for this species. This study presents a genome-wide survey of ABC genes inL.salmonisfor which, ABC superfamily members were identified through homology searching of theL.salmonisgenome. In addition, ABC proteins were identified in a reference transcriptome of the parasite generated by high-throughput RNA sequencing (RNA-seq) of a multi-stage RNA library. Searches of both genome and transcriptome allowed the identification of a total of 33 genes / transcripts coding for ABC proteins, of which 3 were represented only in the genome and 4 only in the transcriptome. Eighteen sequences were assigned to ABC subfamilies known to contain drug transporters,i.e. subfamilies B (4 sequences), C (11) and G (2). The results suggest that the ABC gene family ofL.salmonispossesses fewer members than recorded for other arthropods. The present survey of theL.salmonisABC gene superfamily will provide the basis for further research into potential roles of ABC transporters in the toxicity of salmon delousing agents and as potential mechanisms of drug resistance

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

A latent class analysis of public perceptions about shared mobility barriers and benefits

The United States faces urban issues like congestion and pollution due to heavy car dependency, with over 91% owning cars and 87% driving to work. In response to these challenges, various shared mobility solutions have been integrated into transportation systems, encompassing bike-sharing, e-scooter sharing, and ride-hailing, but have not seen widespread adoption. To this end, this study investigates the perception of these services in the context of benefits and barriers. A survey was conducted in Indianapolis, Indiana and distributed online, gathering 424 responses. Latent class analysis (LCA) was used to determine groups of individuals with similar perceptions. The LCA identified three classes regarding perceptions of shared mobility benefits, and three others in relation to barriers. Regarding benefits, the classes include “Casual observers of benefits,” predominantly comprising older, less active females; “Benefits proponents,” featuring a majority of young, well-educated, higher-income males who prioritize health; and “Non-believers in benefits,” primarily consisting of older individuals, often identifying as black, with lower incomes and less active commuting. In terms of barriers, the classes are “Indifferent about barriers,” mainly comprising younger, lower-income individuals; “Shared mobility bystanders,” primarily characterized by older individuals with infrequent work commutes; and “Barrier conscious,” mostly including younger, well-educated, racially diverse individuals with complex commuting patterns. In both the benefits and barriers categories, the largest classes consist of individuals with neutral perspectives on shared mobility, signifying that a substantial portion of the population has not fully embraced these services. The study recommends policies to promote shared mobility to this significant population segment