Walking Time Research Articles

Mobility trajectories in multiple sclerosis: A comparative study of timed 25-foot walk and a patient-reported outcome measure

Background: Loss of mobility is common in persons with multiple sclerosis (PwMS), but little is known about this impairment from the patient’s perspective. Objective: The aim is to model longitudinal variation in a mobility patient-reported outcome (PRO) and compare trajectories to those observed for Timed 25-Foot Walk (T25FW) in a retrospective cohort. Methods: Latent-class growth analysis was applied to 47,508 measures of Performance Scales© Mobility PRO (PS-Mobility) over ~4 years for 8524 PwMS. For 7347 PwMS, there were 41,988 T25FW measures during this period. Repeated measures correlation and concordance of trajectory assignment were evaluated. Results: At the group level, PS-Mobility and T25FW linearly worsened and repeated-measures correlation was moderate. Eight latent classes with varying shapes that worsened described PS-Mobility variation, compared to six latent classes for T25FW that differed by intercept. The agreement between PS-Mobility and T25FW cluster assignment was modest. A higher proportion of individuals who were Black/African American, older, Medicaid beneficiaries, living in deprived neighborhoods, had longer disease duration, had progressive disease, and ever smokers were assigned to more impaired clusters. Discussion: Cross-sectionally, PS-Mobility and T25FW were highly correlated, but longitudinally correlation was modest to moderate, underscoring the importance of considering both objective and subjective perspectives in evaluating mobility changes in PwMS.

Purified CD34+ Cells Transplantation in Patients with Angiitis-Induced Chronic Limb-Threatening Ischemia: A Single-Center Retrospective Study over a 10-Year Period

Angiitis-induced chronic limb-threatening ischemia (AICLTI) is defined as chronic limb-threatening ischemia (CLTI) caused by thromboangiitis obliterans (TAO) or other arteritis-related autoimmunological diseases. In the current study, we aimed to report the 10-year outcomes of AICLTI patients who underwent purified CD34+ cells (PCCs) transplantation. AICLTI patients who underwent PCCs transplantation at our center from May 2009 to September 2011 were retrospectively enrolled. The main outcome was major amputation-free survival (MAFS); other outcomes included Rutherford classification, intolerable pain-free walking time (IPFWT), Wong-Baker Faces Pain Rating Scale (WBFPS), recurrence, new lesions, quality of life (QoL) and patients' posttransplantation work conditions. Twenty-four patients were enrolled with a mean age of 41.5±7.8 years. Three underwent major amputation during the follow-up, and the 10-year MAFS was 87.5%. Eight were observed to have recurrence, and 2 had new lesions; the 10-year recurrence-free rate was 66.1%. All patients were unable to work at admission, 17 (70.8%) patients were reemployed after transplantation. The current study further demonstrated satisfactory long-term efficacy of PCCs transplantation, with a 10-year MAFS of 87.5%. However, the 10-year recurrence-free rate of 66.1% suggested that strict and regular long-term follow-up is necessary.

Short Physical Performance Battery and Cardio-Ankle Vascular Index Association in Older Patients with Heart Failure.

Balance dysfunction in older patients compromises independence and increases the risk of falls and disability. Arterial stiffness, an important parameter of atherosclerosis, can affect peripheral organs, including the brain, causing balance disorders. The cardio-ankle vascular index (CAVI), measured independently of blood pressure, has attracted attention as an indicator of arterial stiffness. However, the association between balance dysfunction and CAVI in patients with heart failure remains unclear. We investigated the association between the Short Physical Performance Battery (SPPB) score and CAVI in older patients with heart failure.We investigated heart failure patients from our cardiac rehabilitation database between 2017 and 2022. Physical function, body composition, and CAVI were measured the day before discharge. Body composition was assessed using bioelectrical impedance analysis. Physical function was determined by assessing handgrip strength, 6-minute walk distance, and SPPB. Sarcopenia was classified according to the Asian Working Group for Sarcopenia 2019 guidelines, defining sarcopenia as an SPPB total score ≤ 9.Among the 205 consecutive hospitalized patients aged ≥ 65 years (mean, 77.0 years; male, 140; female, 65), 45.0% had sarcopenia. CAVI was significantly higher in patients with sarcopenia than in those without (10.4 [9.5, 11.4] versus 9.8 [8.9, 10.8], respectively). Age, 6-minute walk distance, SPPB tandem time, 4-m walk time, 5 repetition sit-to-stand time, and SPPB score were significantly associated with CAVI, with tandem being an independent CAVI determinant (β = -0.142, P = 0.047).These results suggest an association between arterial stiffness and SPPB score in older patients with heart failure.

Pet Attachment and Maintenance of Physical and Cognitive Function in Community-Residing Older Adults: Evidence From the Baltimore Longitudinal Study of Aging (BLSA)

ABSTRACT Pet ownership is associated with reduced deterioration in physical and cognitive function as older adults age. To date, little research focuses on whether the degree of attachment to the pet is related to the rate of deterioration in these functions. We examined the relationship of pet, dog, and cat attachment to changes in physical and cognitive function among 214 pet-owning, generally healthy, community-dwelling adults aged 50–100 years (M = 68.0, SD = 7.8) from the Baltimore Longitudinal Study of Aging (BLSA). Pet attachment was assessed using the pet ownership module administered during a regularly scheduled BLSA visit. Physical and cognitive assessments were administered every 1–4 years over 1–13 years (M = 7.5, SD = 3.6), including 400-meter walk time, usual and rapid-gait speed, Health ABC Physical Performance Battery, SF-12 Physical Component Score, California Verbal Learning (Immediate, Short, Long recall), Benton Visual Retention, Trail-Making (Trails A, B, B-A), Digit Span, Boston Naming (Naming), and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, controlling for age and comorbidities, greater pet attachment was associated with slower deterioration in physical performance (p = 0.009), usual-gait speed (p < 0.001), rapid-gait speed (p = 0.002), and executive function (Trails B: p = 0.005 and Trails B-A: p < 0.001), and faster deterioration in long-term recall (p < 0.001). Among dog owners (n = 121), a higher attachment was associated with slower deterioration in attention (Trails A: p = 0.046) and faster deterioration in short- (p = 0.025) and long-term (p = 0.019) recall. Among cat owners (n = 100), higher attachment was associated with a slower decline in physical wellbeing (p = 0.035). We provide important longitudinal evidence that pet attachment is differentially associated with the rate of decline in function older adults experience as they age and that attachment to different types of pets may have a different relationship to rates of decline. Potential explanations for these differences are proposed.

Targeted proteomics of cerebrospinal fluid in treatment naïve multiple sclerosis patients identifies immune biomarkers of clinical phenotypes

Multiple sclerosis (MS) is an inflammatory demyelinating disease with heterogeneous clinical presentations and variable long-term disability accumulation. There are currently no standard criteria to accurately predict disease outcomes. In this study we investigated the cross-sectional relationship between disease phenotype and immune-modulating cytokines and chemokines in cerebrospinal fluid (CSF). We analyzed CSF from 20 DMT-naïve MS patients using Olink Proteomics’ Target 96 Inflammation panel and correlated the resulting analytes with respect to (1) disease subtype, (2) patient age and sex, (3) extent of clinical disability, and (4) MRI segmental brain volumes. We found that intrathecal IL-4 correlated with higher Expanded Disability Status Scale (EDSS) scores and longer 25-foot walk times, and CD8A correlated with decreased thalamic volumes and longer 9-hole peg test times. Male sex was associated with higher FGF-19 expression, and Tumefactive MS with elevated CCL4. Several inflammatory markers were correlated with older age at the time of LP. Finally, higher intrathecal IL-33 correlated with increased MS lesion burden and multi-compartment brain atrophy. This study confirms immune heterogeneity underlying CSF profiles in MS, but also identifies several inflammatory protein biomarkers that may be of use for predicting clinical outcomes in future algorithms.

PSIII-4 Exploring the behavioral effects of glycerol supplementation in ruminally cannulated cows grazing wheat pasture

Abstract Energy intake and metabolism have a key role in the control of dry matter intake (DMI), fermentation processes, and grazing behavior of beef cattle, and is likely affected by intertwined relationships between forage availability and stage of maturity, offering of energy supplements and climate- and animal-related factors. Ruminally cannulated mixed-breed nonlactating cows [n = 9; initial body weight (BW) = 564.4 ± 101.6 kg] grazing wheat pasture were used in a split-plot design with the objectives of evaluating the effects crude glycerine supplementation and forage maturity on grazing behavior. Treatment was the main plot, and stage of forage maturity was the subplot. Treatments were unsupplemented control (CON) and crude glycerine supplementation (SUP). Crude glycerol (37.2% glycerol, DM basis) was offered at 0.11% of BW (DM basis) and dosed intraruminally via rumen cannula at 0700 and 1900 h daily. The stages of wheat pasture maturity were March (MAR; vegetative stage) and April (APR; early reproductive stage). All cows were fitted with LoRa WAN tracking collars, housing GPS and triaxial accelerometers and allowing real-time inspection of cow position and activity data through time. Hourly (d 10 and 23) and daily change of walking distance (m), activity index and budget for grazing, resting, and walking time (min) were analyzed with a repeated measure mixed model for the split-plot design. Walking distance (1,200 ± 13 m), activity index (10,006 ± 122), resting time (607 ± 5 min), grazing time (662 ± 8 min) and walking time (171 ± 8 min) were not affected (P ≥ 0.52) by crude glycerine supplementation or by stage of forage maturity (P ≥ 0.07), but varied (P &amp;lt; 0.001) by day and by hour of day, likely indicating circadian effects on meal frequency and duration associated with the hour of the day and forage depletion through time. Grazing behavior was more likely affected by climate, pasture, animal, and management variables and less affected by GLY dose. Results indicate that crude glycerine may be used in supplements for cattle grazing wheat pasture to increase energy intake and without adversely creating associative or substitution effects, grazing behavior or sacrificing pasture utilization.

417 Impact of virtual fence technology on yearling steer behavior and performance

Abstract Virtual fencing (VF) has the capacity to transform the landscape of livestock management within extensive rangeland systems. The objective of this study was to evaluate the effect of Vence (Merck &amp; Co., Inc., Rahway, NJ) VF technology on yearling steer behavior and performance. Steers were allocated into one of two grazing systems [continuous grazing (CG) or rotational grazing (RG) managed using VF] across three different stocking rates (light, moderate, and heavy, 0.32, 0.40, and 0.72 animal unit months, respectively) for three grazing seasons. Based on initial body weight, steers were randomly blocked into six pastures (346 ± 39, 273 ± 34, and 319 ± 29 kg, respectively) at the South Dakota State University Cottonwood Field Station (n = 127, 135, and 127, in 2021, 2022 and 2023, respectively). Steers assigned to the CG treatment had free access to the entire pasture for the duration of the grazing season. Steers assigned to the RG treatment were rotated among virtual ‘paddocks’ for the duration of the grazing season. The days spent grazing in each paddock for the RG treatment were determined based on bi-weekly clip plots for biomass estimation. The VF collars were used to track steer location at 5-min intervals; only steers assigned to the RG treatment were managed with VF boundaries and exposed to auditory and electrical cues from the collars. Raw data was downloaded from Vence Herd Manager through an automatic programming interface and cleaned by removing messages that failed to transmit correctly or were outside the bounds of study site pastures. Animal behavior metrics of daily distance traveled (DDT), daily grazing time, daily resting time, and daily walking time were calculated for each individual animal and averaged by pasture using Program R. Steer weights were collected using SmartScales (C-Lock Inc, Rapid City, SD). Average daily gain (ADG) was calculated using a linear model to develop a regression equation for each individual animal using weight as the dependent variable and day of trial as the independent variable. The slope of the regression line was used to estimate ADG. Individual DDT, behavior, and performance metrics were analyzed using a mixed model analysis of variance (ANOVA) to compare the impact of grazing treatment and stocking rate (fixed effects) with year as the random effect. Treatment did not influence (P &amp;gt; 0.05) grazing, walking, or resting behavior. Similarly, no differences were detected in DDT between treatment groups or across different stocking rates. Furthermore, there were no differences (P &amp;gt; 0.05) in ADG across treatment groups. Implementation of VF had no impact on animal behavior or performance, justifying its use in grazing settings; however, financial and cattle finishing aspects still need to be evaluated to determine its overall benefits and costs.

Effect of a soft exosuit on daily life gait performance in people with incomplete spinal cord injury: study protocol for a randomized controlled trial

BackgroundPeople with incomplete spinal cord injury (iSCI) often have gait impairments that negatively affect daily life gait performance (i.e., ambulation in the home and community setting) and quality of life. They may benefit from light-weight lower extremity exosuits that assist in walking, such as the Myosuit (MyoSwiss AG, Zurich, Switzerland). A previous pilot study showed that participants with various gait disorders increased their gait speed with the Myosuit in a standardized environment. However, the effect of a soft exosuit on daily life gait performance in people with iSCI has not yet been evaluated.ObjectiveThe primary study objective is to test the effect of a soft exosuit (Myosuit) on daily life gait performance in people with iSCI. Second, the effect of Myosuit use on gait capacity and the usability of the Myosuit in the home and community setting will be investigated. Finally, short-term impact on both costs and effects will be evaluated.MethodsThis is a two-armed, open label, randomized controlled trial (RCT). Participants will be randomized (1:1) to the intervention group (receiving the Myosuit program) or control group (initially receiving the conventional program). Thirty-four people with chronic iSCI will be included. The Myosuit program consists of five gait training sessions with the Myosuit at the Sint Maartenskliniek. Thereafter, participants will have access to the Myosuit for home use during 6 weeks. The conventional program consists of four gait training sessions, followed by a 6-week home period. After completing the conventional program, participants in the control group will subsequently receive the Myosuit program. The primary outcome is walking time per day as assessed with an activity monitor at baseline and during the first, third, and sixth week of the home periods. Secondary outcomes are gait capacity (10MWT, 6MWT, and SCI-FAP), usability (D-SUS and D-QUEST questionnaires), and costs and effects (EQ-5D-5L).DiscussionThis is the first RCT to investigate the effect of the Myosuit on daily life gait performance in people with iSCI.Trial registrationClinicaltrials.gov NCT05605912. Registered on November 2, 2022.

Mapping Health Disparities: Spatial Accessibility to Healthcare Facilities in a Rural District of Ghana Using Geographic Information Systems Techniques

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Access to healthcare is crucial for health equity and outcomes, especially in resource-limited rural areas. Despite expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p &amp;lt;.001) and secondary (χ²(1, N=80) = 15.93, p &amp;lt;.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p &amp;lt;.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p &amp;lt;.001) were significantly associated with healthcare access. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.

Clinical effect of free chimeric anterolateral thigh flap and chimeric thoracodorsal artery perforator flap in chronic osteomyelitis

BackgroundChronic osteomyelitis poses a formidable challenge for orthopedic practitioners in the realm of clinical practice. Chimeric perforator flap is a commonly used repair method for chronic osteomyelitis. The purpose of this study was to compare the clinical efficacy of chimeric anterolateral thigh flap (C-ALTP) and chimeric thoracodorsal artery perforator flap (C-TDAP) for the treatment of chronic osteomyelitis. MethodsA retrospective analysis was performed on patients with chronic osteomyelitis of the lower extremity who underwent two kinds of treatment with chimeric perforator flaps from January 2014 to March 2022. The preoperative basic data, the operative and postoperative basic information of the two groups were collected and statistically analyzed. ResultsSixty-six patients were included in this study, and both groups achieved good aesthetic and functional results. Intraoperative results showed that the intraoperative blood loss and flap acquisition time in the C-TDAP group were less than those in the C-ALTP group. The incidence of postoperative complications in the donor and recipient sites in the C-TDAP group was significantly lower than that in the C-ALTP group, which led to a high reoperation rate in the C-ALTP group. Long-term follow-up showed that the wound healing time and weight-bearing walking time in the C-TDAP group were less than those in the C-ALTP group. ConclusionsBoth chimeric perforator flaps can effectively treat osteomyelitis with composite tissue defects, effectively eliminate inflammation of affected limbs and promote wound healing. However, C-TDAP flaps have more reliable healing effects on wounds and donor sites, and have fewer complications. Level of evidenceIII, Case–control study.

Activating the potential for more walking in work tour: An explorative study on car commuters

This paper investigates the Potential for More Walking (PMW) in work tour among car commuters and proposes ways to encourage them to activate this potential. The study utilized a sample of 621 car commuters in the city of Qom, Iran, who expressed a willingness to replace their daily commute pattern with an alternative commute pattern that involves more walking time. The findings of the random effect binary logit model indicated that network patterns with improved connectivity in the residential neighborhood have a significant impact on activating the PMW. Additionally, subjective factors such as positive perceptions towards sidewalk conditions, longer distances between home and workplace, and positive attitudes towards walking were found to be associated with an increased tendency to activate the PMW. Moreover, the study assessed a set of transportation demand management measures that could influence individual behavior towards activating the PMW. The results indicated that pull measures are generally more effective than push measures in promoting walking during work commuting. Furthermore, the measures of turning streets with dense land-uses into pedestrian malls, increasing green spaces on sidewalks, and widening sidewalks were found to have the highest impact on activating the PMW, respectively.

Superficial Heat Therapy and Therapeutic Exercise in Individuals with Knee Osteoarthritis

Introduction: Knee Osteoarthritis is a major cause of pain and locomotor disability worldwide. Several physical therapy modalities have been recommended in reviewed clinical guidelines and systematic reviews, such as exercises, and electro and thermotherapy resources. Objective: This study evaluated the influence of the application of superficial heat therapy and/or therapeutic exercise on reducing pain and improving functional capacity in patients with knee osteoarthritis. Methods: 30 patients were divided into three groups (superficial heat, exercises, superficial heat plus exercises) and underwent 10 treatment sessions. Pain intensity was assessed using the visual analog scale; muscle flexibility with Wells’ bank test; strength gain with testing of one maximum repetition; walking time was analyzed with a walking test over a distance of 10 meters; and the Lequesne functional questionnaire was used to assess the functional activities of patients. Results: All treatments performed reduced knee pain. The exercise group showed an improvement in flexibility and quadriceps muscle strength. And the group that received superficial heat and therapeutic exercise showed better performance in time over a fixed distance covered. Conclusions: Therapeutic exercise and superficial thermotherapy performed in isolation showed beneficial effects in individuals with knee osteoarthritis. However, the therapeutic intervention carried out in combination showed better results in all parameters evaluated, suggesting that the clinical treatment can improve the quality of life of these individuals.

171 Decline in adherence to Physical Activity Guidelines among the Dutch population

Abstract Purpose In the Netherlands, the number of people who meet the Physical Activity Guidelines in 2022 has dropped dramatically to a level lower than in 2019. In order to get more insight in this decline, we compared PA behavior in 2022 (after the coronavirus pandemic) with 2019 (before the pandemic). Methods For this study the 2019 and 2022 data collection of the Health Survey/Lifestyle Monitor (Statistics Netherlands (CBS) in collaboration with National Institute for Public Health and the Environment (RIVM)) was used. This is an annual survey including a random sample of the Dutch population (N ± 10,000). Physical activity was measured with the Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH). Specifically, time spend on walking and biking to work/school and in leisure time, playing sports, household activities, activities at work or school, gardening and, for children, playing outside and physical education was asked. Results In 2022, 44% of the Dutch population 4 years and older was sufficiently physically active compared to 49% in 2019. The decline was highest among young adults aged 18–29 (9.2 percent point), adolescents aged 12–17 (7.5 percent point), people who do paid work (6.4 percent point) and people educated to a higher level (7.5 percent point). All of these groups cycled less in their leisure time (-27, -51, -25 and -22 minutes per week, respectively), although for young adults this difference was not statistically significant. Adolescents also cycled less time to school (-48 minutes per week), but the mean number of days they cycled to school remained the same (4 days a week). In addition, young adults walked less, particularly in their leisure time (-39 minutes per week). Conclusions The decline in adherence to the Physical Activity Guidelines is mainly related to a decline in cycling time and, for young adults, a decline in walking time. Especially among adolescents the decrease in the number of minutes cycling between 2019 and 2022 is striking. However, in both 2019 and 2022, they cycled on average 4 days a week to school. A possible explanation for this is the increased use of electric bicycles.

Long-term effects of pre-weaning social housing on response to a social and housing transition in pregnant heifers

Dairy cattle are routinely managed in social groups and subject to various management and social transitions, yet conventional approaches to rearing dairy calves limit social experience during early weeks of life. The objective of this study was to evaluate long-term effects of dairy calf social housing, with calves housed individually or in pairs, on long-term behavioral responses observed in pregnant heifers following social regrouping and introduction to a novel housing environment. Holstein heifers were raised during the milk-feeding period (provided 8 L/d milk replacer) in either individual pens (n = 20 heifers) or paired pens (n = 20 pens; 1 focal heifer/pen) and subsequently identically managed in groups on pasture from 9 weeks of age. At 30 d before expected calving, pregnant heifers were moved from pasture to a free stall barn, which represented introduction to a novel social group and an unfamiliar housing environment. Behavior was continuously recorded from video for 24 h, beginning at 0000 h on the day after introduction, to characterize feeding behavior, locomotor activity, and stall usage, as well as social proximity and competitive behavior surrounding the feed bunk and stall. Stocking density of the free stall barn fluctuated and was categorized as low (≤75%, 100 × animals in pen/available stalls), medium (>75%, 100%), or high (≥100%). Body weights obtained following calving indicated that previously PH heifers were heavier (632.3 vs. 593.4 kg; PH vs. IH), and body weight was included as a covariate in analysis of feeding behavior. Upon introduction to the free stall pen, previously PH heifers spent more time walking (1.9 vs. 1.3 min/h) with no effect of calf social housing on duration of lying time. However, stall use was subject to an interaction between previous housing treatment and stocking density and differed overall between previous housing treatments; previously PH heifers spent less time in the stall, particularly at high stocking density (29.4 vs. 48 min/h), due to shorter (29.6 vs. 95.7 min/visit) but marginally more frequent stall visits. Previously pair-housed heifers were also less likely to be displaced from a stall (44 vs. 85% of heifers replaced; PH vs. IH). Feeding behavior was similarly influenced by previous housing treatment particularly at high stocking density, with previously PH heifers spending more time feeding (8.2 vs. 4.2 min/h) and visiting the feed bunk more frequently (1.5 vs. 0.8 visits/h). These results suggest that preweaning social housing had long-term effects on behavior and ability to adapt to a novel environment which became most apparent under heightened competitive pressure.

Average Time Consumption Per Character - a Practical Performance Metric for Generic Synchronous BCI Spellers.

The information transfer rate (ITR) is widely accepted as a performance metric for generic brain-computer interface (BCI) spellers, while it is noticeable that the communication speed given by ITR is actually an upper bound which however can never be reached in real systems. A new performance metric is therefore needed. In this paper, a new metric named average time consumption per character (ATCPC) is proposed. It quantifies how long it takes on average to type one character using a typical synchronous BCI speller. To analytically derive ATCPC, the real typing process is modelled with a random walk on a graph. Misclassification and backspace are carefully characterized. A close-form formula of ATCPC is obtained through computing the hitting time of the random walk. The new metric is validated through simulated typing experiments and compared with ITR. Firstly, the formula and simulation show a good consistency. Secondly, ITR always tends to overestimate the communication speed, while ATCPC is more realistic. The proposed ATCPC metric is valid. ATCPC is a qualified substitute for ITR. ATCPC also reveals the great potential of keyboard optimization to further enhance the performance of BCI spellers, which was hardly investigated before.

Healthcare providers' perceptions of infant physical activity and communication.

Healthcare providers (HPs) play a critical role in disseminating information about infant health and development. Two key developmental areas for infants are physical activity (PA) and communication. Few studies have examined HPs views of these topics. Thus, HPs may need support to promote these early development outcomes in infants. Thus, the study explored HPs' perceptions of infant PA and communication. A total of 13 HPs with a wide variety of backgrounds were recruited. Zoom semi-structured interviews were based on the Health Belief Model. Deductive content analysis was utilized to analyze data. HPs knew little about PA guidelines. HPs were concerned about an infant's PA because of limited playtime and tummy time. Most HPs advised parents on PA and motor development milestones, with crawling, walking, and tummy time. HPs also wanted to learn about PA measurement tools. PA promotion was hindered by parents' busy schedules, lack of time, and language barriers. Most HPs advised parents on verbal and nonverbal communication. Many HPs were unfamiliar with communication assessment methods and wanted to learn more. HPs had limited knowledge about PA guidelines and communication measurement tools. Efforts are needed to identify easily accessible ways to educate HPs that could be disseminated to parents.

Designing microtransit services in suburban areas: A case study in Palermo, Italy

Poor quality of Public Transport (PT) services is one of the main causes of social exclusion for people living in the suburbs. Public transport companies usually allocate few financial resources to these areas, providing transport services with low frequency, poor accessibility, poor reliability, and high waiting times at stops. Recently, microtransit has emerged as an effective solution to improve the travel experience in suburban areas, particularly for non-commuting trips during off-peak hours. This paper presents an integrated methodological approach for designing microtransit services to meet the mobility needs of people living in low-density suburbs. By conducting a Reveled Preference (RP) and Stated Preference (SP) survey and developing a travel demand model, the demand was estimated and used as input to simulate and size the service. Combining GIS and simulation models, Key Performance Indicators (KPIs) were assessed; fleet size to meet the trip requests was identified and the fare was selected using a sensitivity analysis. The method was applied to a real case study to design a new microtransit service with flexible routes and on-demand stops in a suburban area in Palermo, Italy. The results highlight how introducing a microtransit service with 30 nine-seater vans could change the mobility habits of people living in the suburban area, being attractive and financially sustainable if costing 2 €, or just a little more than the existing fixed-route bus service. It could improve the travel experience by reducing the average waiting time at stops to around 5 min and improve access to amenities and PT hubs by guaranteeing a walking time of maximum about 8 min.

Toxicity and Sublethal Effects of Piper hispidinervum Essential Oil on Behavioral and Physiological Responses of Sitophilus zeamais Populations.

This study aimed to evaluate the toxicity of Piper hispidinervum essential oil (PHEO) against 11 Brazilian populations of Sitophilus zeamais (Coleoptera: Curculionidae). The effects of sublethal doses of PHEO on the behavior (walking and flying), respiration, and population growth (ri) of the insect populations were investigated. PHEO toxicity was determined through concentration-mortality bioassays, with mortality curves established using increasing PHEO concentrations ranging from 140.00 to 1000.00 μL kg-1. Behavior was evaluated based on walking distance, walking time, walking speed, walking time proportion, flight height, and flight takeoff success. Respiration was measured via the respiratory rate, while population growth (ri) was assessed through the instantaneous growth rate. All 11 populations of S. zeamais were susceptible to PHEO, showing no signs of resistance. The populations exhibited varying behavioral and physiological responses to sublethal exposure to PHEO, indicating different mitigation strategies. The results confirm that PHEO possesses insecticidal potential for controlling S. zeamais populations. However, the observed behavioral and physiological responses should be considered when establishing control measures in pest management programs for stored products.

Universal distribution of the number of minima for random walks and Lévy flights.

We compute exactly the full distribution of the number m of local minima in a one-dimensional landscape generated by a random walk or a Lévy flight. We consider two different ensembles of landscapes, one with a fixed number of steps N and the other till the first-passage time of the random walk to the origin. We show that the distribution of m is drastically different in the two ensembles (Gaussian in the former case, while having a power-law tail m^{-3/2} in the latter case). However, the most striking aspect of our results is that, in each case, the distribution is completely universal for all m (and not just for large m), i.e., independent of the jump distribution in the random walk. This means that the distributions are exactly identical for Lévy flights and random walks with finite jump variance. Our analytical results are in excellent agreement with our numerical simulations.

Frustrated random walks: A fast method to compute node distances on hypergraphs.

A hypergraph is a generalization of a graph that arises naturally when attribute-sharing among entities is considered. Compared to graphs, hypergraphs have the distinct advantage that they contain explicit communities and are more convenient to manipulate. An open problem in hypergraph research is how to accurately and efficiently calculate node distances on hypergraphs. Estimating node distances enables us to find a node's nearest neighbors, which has important applications in such areas as recommender system, targeted advertising, etc. In this paper, we propose using expected hitting times of random walks to compute hypergraph node distances. We note that simple random walks cannot accurately compute node distances on highly complex real-world hypergraphs, which motivates us to introduce frustrated random walks (FRW) for this task. We further benchmark our method against DeepWalk, and show that while the latter can achieve comparable results, FRW has a distinct computational advantage in cases where the number of targets is fairly small. For such cases, we show that FRW runs in significantly shorter time than DeepWalk. Finally, we analyze the time complexity of our method, and show that for large and sparse hypergraphs, the complexity is approximately linear, rendering it superior to the DeepWalk alternative.