Hasil untuk "Metropolitan areas"

Tanya Yatsunenko, F. Rey, M. Manary et al.

Gut microbial communities represent one source of human genetic and metabolic diversity. To examine how gut microbiomes differ among human populations, here we characterize bacterial species in fecal samples from 531 individuals, plus the gene content of 110 of them. The cohort encompassed healthy children and adults from the Amazonas of Venezuela, rural Malawi and US metropolitan areas and included mono- and dizygotic twins. Shared features of the functional maturation of the gut microbiome were identified during the first three years of life in all three populations, including age-associated changes in the genes involved in vitamin biosynthesis and metabolism. Pronounced differences in bacterial assemblages and functional gene repertoires were noted between US residents and those in the other two countries. These distinctive features are evident in early infancy as well as adulthood. Our findings underscore the need to consider the microbiome when evaluating human development, nutritional needs, physiological variations and the impact of westernization.

E. Ostrom

Abstract This excerpt describes the intellectual journey that I have taken the last half-century from when I began graduate studies in the late 1950s. The early efforts to understand the polycentric water industry in California were formative for me. In addition to working with Vincent Ostrom and Charles Tiebout as they formulated the concept of polycentric systems for governing metropolitan areas, I studied the efforts of a large group of private and public water producers facing the problem of an overdrafted groundwater basin on the coast and watching saltwater intrusion threaten the possibility of long-term use. Then, in the 1970s, I participated with colleagues in the study of polycentric police industries serving U.S. metropolitan areas to find that the dominant theory underlying massive reform proposals was incorrect. Metropolitan areas served by a combination of large and small producers could achieve economies of scale in the production of some police services and avoid diseconomies of scale in the production of others.

F. Yuan, Kali E. Sawaya, Brian C. Loeffelholz et al.

J. Blau, P. Blau

I. Akyildiz, Xudong Wang, Weilin Wang

D. Massey, N. Denton

Fanhua Kong, Haiwei Yin, P. James et al.

Megawati Suci, Alfarizi Muhammad, Wardana Laskar Intifada Saifullah Fatah et al.

Urban waste management represent a strategic policy domain requiring technologically driven interventions and multi-stakeholder engagement, partciulary in metropolitan areas such as Surabaya City. This study aims to formulate policy recommendations for the devolepment of an efficient and adaptive waste management system through the integration of intelegent digital technologies. Employin an exploratory qualitative approach, this research synthesizes SWOT, PESTEl, and stakeholder analyses to identify key internal and external determinats affecting the efficacy of waste governance policies. The findings indicate that, despite intitusional strengths such as a smart city vision and adequate techological infrastructure, the implementation remains hindered by centralized decision making patterns and the limited integration of green technologies. Accordingly, this study proporse a waste management system model anchored in the Internet of Things (IoT), manchine leraning, and blockchain as a framework for digital policy transformation. These recommendations are operationalized into eight strategic action plans aimed at an enhancing systemic efficiency, stakeholder participation, and accelerating the achievement of the Sustainable Development Goals (SDGs), particulary in the domains of environmental governance and sustainable urban management.

Cheryl Barnabe, Eddy Lang, Rita Henderson et al.

Background During the first wave of the COVID-19 pandemic, there was a notable decline in emergency department (ED) usage in many jurisdictions. This study assessed changes in ED use during this period and explored how the pandemic may have aggravated existing healthcare access inequities.Objectives Our primary objective was to assess pandemic-related changes to ED visits and emergency hospitalisations for distinct demographic groups.Design We conducted a retrospective observational study using population-based provincial administrative data.Setting We analysed data from all the 109 EDs and urgent care centres in Alberta, Canada, during the first wave of the COVID-19 pandemic (15 March 2020 to 30 June 2020), and during the corresponding (control) period 1 year earlier. We conducted subgroup analyses by age, First Nations status, sex, location and material deprivation. We repeated all analyses for pre-selected life-threatening emergency diagnoses.Populations We examined outcomes for a priori subgroups, including female and ‘other’ sex patients, paediatric patients (age 0–17 years), seniors (age 65 years and older), patients living in remote areas (greater than 200 km from an urban centre), First Nations members and patients living in materially deprived postal codes falling into the two most deprived Pampalon Index quintiles.Primary and secondary outcome measures Primary outcomes were number of ED visits, number of ED visits with admission to hospital and number of ED visits resulting in patient death in the ED. A secondary outcome was change in ED use for life-threatening diagnoses (eg, cardiac conditions and hepatic disease).Results ED visits in the COVID-19 period decreased by 34% (Poisson means test p <0.001) and hospitalisations decreased by 15% (p <0.001) compared with 2019. Multivariable models showed an average decrease of 79.9 (p <0.001) ED visits, and 7.7 (p <0.001) fewer average admissions per facility for the COVID-19 period (vs 2019) in our ‘baseline’ group (non-First Nations, male, adult and metropolitan residents who were not materially deprived). First Nations patients, seniors and remote residents experienced smaller declines in ED visits compared with the baseline group. Females, seniors and children experienced larger reductions in emergency admissions, while First Nations patients had smaller reductions.Conclusion Reductions in critical emergency care and emergency hospital admissions were unequally distributed across demographic groups during the COVID-19 period. Study methods could be used to monitor and support equitable access to emergency care among distinct populations.

Raj Bridgelall

The relentless expansion of urban populations and the surge in e-commerce have increased the demand for rapid delivery services, leading to an increase in truck traffic that contributes to urban congestion, environmental pollution, and economic inefficiencies. The critical challenge this poses is not only in managing urban spaces efficiently but also in aligning with global sustainability goals. This study addresses the pressing need for innovative solutions to reduce reliance on truck transportation in congested urban areas without compromising the efficiency of freight delivery systems. This study contributes a novel approach that leverages electrified and autonomous aircraft (EAA) cargo shuttles to shift the bulk of air transportable freight from road to air, specifically targeting underutilized airports and establishing vertiports in remote locations. By applying data mining techniques to analyze freight flow data, this research identifies key commodity categories and metropolitan statistical areas (MSAs) where the implementation of EAA services could significantly mitigate truck-induced congestion. The findings reveal that targeting a select few commodities and MSAs can potentially decrease truck traffic, with electronics emerging as the dominant commodity category, and cities like Los Angeles and Chicago as prime candidates for initial EAA service deployment. Stakeholders in urban planning, transportation logistics, and environmental policy will find this study’s insights beneficial. This work lays a foundation for future innovations in sustainable urban mobility and logistics.

Sabyasachi Mondal, Abisa Sinha Adhikary, Ambar Dutta et al.

Escalating air pollution in urban areas is a matter of concern, and deteriorating air quality is having numerous impacts on human health and the environment. Kolkata is one of the most densely populated and highly polluted cities in India. The aim of this work is to predict the concentration of ambient PM2.5 using different air pollutants and meteorological parameters as predictor variables by using statistical and different Machine Learning techniques as well as to understand the influence of other air pollutants and meteorological factors in ambient PM2.5 prediction. Different advanced machine learning algorithms like Random Forest Regression, decision trees, k-nearest Neighbour, Support Vector Regression, Ridge Regression, Lasso Regression, and XGBoost have been used, and the results show that the XGBoost model exhibits higher linearity between predictions and observations, among other models. Moreover seasonal variation of the most influential factor for prediction of PM2.5 is also noticed during the analysis. This work adds to the broader comprehension of the convergence of environmental science, public health, and machine learning and it offers significant perspectives for sustainable urban planning and pollution control tactics in rapidly expanding metropolitan areas such as Kolkata.

Shijie Sun, Qun Sun, Fubing Zhang et al.

The multi-modal two-step floating catchment area (MM-2SFCA) method is an extension of the two-step floating catchment area (2SFCA) method that incorporates the impact of different transportation modes, thereby facilitating more accurate calculations of the spatial accessibility of public facilities in urban areas. However, the MM-2SFCA method does not account for the impact of distance within the search radius on supply–demand capacities, and it assumes an idealized supply–demand relationship. This paper introduces the gravity model into the MM-2SFCA method, proposing a multi-modal gravity-based 2SFCA (MM-G2SFCA) method to better account for distance decay and supply–demand relationships. Furthermore, a standardized gravity model is proposed based on the traditional gravity model. This model imposes constraints on upper and lower limits for distance decay weights without compromising the fundamental curve characteristics of the gravity model, thereby avoiding extreme weight scenarios. The accessibility of public hospitals in Shenzhen is evaluated through the integration of basic geographic information data, resident travel data, and official statistical data. The findings demonstrate that the standardized gravity model effectively addresses the issue of excessively high local distance weights in the traditional gravity model, making it more suitable as a distance decay function. The MM-G2SFCA method improves the consideration of distance and supply–demand relationships, thereby facilitating a more rational distribution of accessibility on a global scale. This study discovers differences in the spatial allocation of public hospital resources across the Shenzhen’s districts. Accessibility within the metropolitan core is significantly higher than that outside the core. Additionally, there is a notable difference in the level of accessibility among the districts. Accessibility is found to be better in district centers and along the main traffic arteries.

Shuoqi Ren, Amanda Giang

Abstract The urban environment impacts residents' health and well‐being in many ways. Environmental benefits and risks may be interactively and inequitably distributed across different populations in cities, and these patterns may change over time. Here, we assess the spatial distribution of environmental risks and benefits in pairs, considering synergies and trade‐offs, in an illustrative metropolitan area (Metro Vancouver) in Canada in the years 2006 and 2016. We classify census dissemination areas as sweet, sour, risky, or medium spots based on relative exposures for six environmental combinations: Walkability and NO2; heat stress and NO2; vegetation coverage and NO2; vegetation coverage and heat stress; walkability and accessibility to natural recreational areas; and heat stress and accessibility to natural recreational areas. We evaluate whether different population groups are disproportionately exposed to lower environmental quality based on linear regressions and other metrics. We find that while performance for individual environmental variables improved over the decade, considering their combinations, sweet spots became sweeter and sour spots became sourer. Residents with high material and social deprivation and visible minorities were disproportionately exposed to lower environmental quality in both years for most of the environmental combinations. Further, we find that these inequities were not improving over time for all groups: for instance, South Asian residents in the region faced higher disproportionate burdens or diminished access to benefits in 2016, as compared to 2006. Given these findings, we suggest considerations of cumulative exposure in prioritizing areas for intervention, targeting the sour and risky spots persistently experienced by overburdened populations.

M. Jun, Keechoo Choi, J. Jeong et al.

Teraphan Ornthammarath, Amorntep Jirasakjamroonsri, Patinya Pornsopin et al.

Abstract Background The Bangkok Basin has been known from non-instrumental observations of the local population to be subject to ground motion amplification due to the deep alluvial sediments and basin geometry. This study analyzes available seismic data to confirm that basin effects are significant in the Bangkok Basin. The paper contributes to the evaluation of basin effects by characterizing the engineering ground motion parameters and HVSR curves for the Bangkok basin which produce lengthening of ground motion duration with respect to nearby rock sites, albeit with very low ground motions. For this purpose, we analyzed ground motion records from seismic stations located within the Bangkok alluvial basin from 2007 to 2021. Recorded peak horizontal ground acceleration (PGA) for seismic stations inside the basin always exceeded 1 cm/s2 during eight earthquakes with Mw ≥ 5.5. Of these, two were intraslab events and six were shallow crustal earthquakes. These recorded ground motions shook high-rise buildings in Bangkok even though their epicentral distance exceeded 600 km. Methods Several time and frequency domain analyses (such as analysis of residual, HVSR, Hodogram plots, etc.) are used on the ground motion records in the Bangkok basin to determine the frequency content of recorded ground motion and to demonstrate the significance of surface waves induced by the deep basin in altering the engineering ground motion amplitudes. In addition, centerless circular array microtremor analysis is used to determine the depth of sedimentary basin to the bedrock. Results Based on comparisons from those stations located outside the Bangkok basin, we observed the capability of alluvial deposits in the Bangkok basin to amplify ground motion records by about 3 times. We observed that there is a unique site amplification effect between 0.3 and 0.1 Hz due to local surface waves and other moderate amplifications between 2 and 0.5 Hz due to a soft layer like other deep alluvial basins in other metropolitan areas. Conclusion We noticed that there is a unique site amplification effect between 0.1 and 0.3 Hz and smaller peaks around 2 and 0.5 Hz consistent with expectations for site amplification effects associated with deep basins. Moreover, we noticed the presence of low frequencies content of the surface wave generated within the basin which deserved further studies using the 2D/3D ground motion modelling through basin topography and velocity models.

Martha R. Koenig, Amelia K. Wesselink, Andrea S. Kuriyama et al.

BackgroundProspective cohort studies that enroll participants before conception are crucial for deepening scientific understanding of how the preconception environment influences reproductive outcomes. While web-based research methods provide efficient and effective strategies to collect questionnaire-based data, few of these studies incorporate biospecimen collection, which can enhance the validity of exposure assessment. There is limited literature on the feasibility and cost-effectiveness of collecting biospecimens in web-based preconception cohort studies.MethodsWe evaluated the feasibility and cost-effectiveness of in-clinic and mail-based biospecimen collection in Pregnancy Study Online (PRESTO), a North American web-based preconception cohort study. Both members of the couple were eligible to participate if their conception attempt time was ≤3 months at enrollment. We invited study participants from the Boston, MA and Detroit, MI metropolitan areas to attend a study visit and provide urine and blood (hereafter “in-clinic protocol”). We invited all other participants to complete mail-based collection of urine and blood spots (hereafter “mail-based protocol”). We compared overall consent and protocol completion rates, demographic characteristics of those who consented and completed either of the protocols, and costs between mail-based and in-clinic protocols for biospecimen collection. Finally, we described logistical challenges pertaining to reliance on mail-based delivery of time-sensitive biospecimens compared with in-clinic methods.ResultsDuring January 2022-July 2022, 69% of female participants (134/195) and 42% of male participants (31/74) consented to participate in the mail-based protocol. Consent rates for the in-clinic protocol were 39% for female participants (289/739 during March 2014-July 2022) and 25% for male participants (40/157 during March 2017-July 2022). Participants who consented to participate were generally of higher socioeconomic position than non-participants. Deviations from the protocol occurred more frequently within the mail-based protocol but were easily corrected. The cost per participant enrolled was similar across protocols (mail-based: $276.14 vs. in-clinic: $270.38).ConclusionsOur results indicate that mail-based collection of biospecimens may create opportunities to recruit a larger and more geographically diverse participant population at a comparable cost-per-participant enrolled to in-clinic methods.

D. Lichter, D. Parisi, Michael Taquino

B. Ahmed

Landslides are a common hazard in the highly urbanized hilly areas in Chittagong Metropolitan Area (CMA), Bangladesh. The main cause of the landslides is torrential rain in short period of time. This area experiences several landslides each year, resulting in casualties, property damage, and economic loss. Therefore, the primary objective of this research is to produce the Landslide Susceptibility Maps for CMA so that appropriate landslide disaster risk reduction strategies can be developed. In this research, three different Geographic Information System-based Multi-Criteria Decision Analysis methods—the Artificial Hierarchy Process (AHP), Weighted Linear Combination (WLC), and Ordered Weighted Average (OWA)—were applied to scientifically assess the landslide susceptible areas in CMA. Nine different thematic layers or landslide causative factors were considered. Then, seven different landslide susceptible scenarios were generated based on the three weighted overlay techniques. Later, the performances of the methods were validated using the area under the relative operating characteristic curves. The accuracies of the landslide susceptibility maps produced by the AHP, WLC_1, WLC_2, WLC_3, OWA_1, OWA_2, and OWA_3 methods were found as 89.80, 83.90, 91.10, 88.50, 90.40, 95.10, and 87.10 %, respectively. The verification results showed satisfactory agreement between the susceptibility maps produced and the existing data on the 20 historical landslide locations.

Nelson Adekoya, Henry Roberts, Benedict I. Truman

Objective To describe characteristics of a nationally representative sample of patient visits that ended with a referral for follow-up medical care after discharge from hospital emergency department (ED) visits. Methods We used 2018 National Hospital Ambulatory Medical Care Survey data to identify patient characteristics associated with higher rates of visits with referrals for follow-up medical care after ED discharge from nonfederal short-stay and general hospitals throughout the United States. Referral included categories of all disposition variables that indicated referral to a source of care consistent with the patient’s clinical condition at ED discharge. Results Approximately 97 million of 130 million visits (29 700/100 000 US resident population) were referred for follow-up medical care during 2018. Visit referral rates were higher among females (33 100) than among males (26 300/100 000 population); higher among Black patients (61 700) than among White patients (25 600/100 000 population); highest in the South (33 200/100 000 population); and similar rates in Nonmetropolitan (29 900/100 000 population) and Metropolitan Statistical Areas (30 200/100 000 population). Visit referral rates were higher for patients with Medicaid/Children's Health Insurance Program (CHIP) (66 900) than those with Medicare (31 500) or private insurance (14 000/100 000 population). Abnormal clinical findings and injuries were the discharge diagnoses most often referred for follow-up medical care. Conclusion Higher visit referral rates were observed among female sex, non-Hispanic Black race, Medicaid/CHIP, abnormal clinical findings, and injuries. Future studies might reveal reasons that prompted higher referral rates among various patients’ characteristics.

Zemmrich C, Bramlage P, Hillmeister P et al.

Claudia Zemmrich,1 Peter Bramlage,2 Philipp Hillmeister,3 Mesud Sacirovic,3 Ivo Buschmann3 1Deutsche Angiologie-CRO, Berlin, Germany; 2Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany; 3Department of Angiology, Medical University Brandenburg, Brandenburg, GermanyCorrespondence: Claudia ZemmrichDeutsche Angiologie CRO (DA-CRO), Straubinger Strasse 20, Berlin, 12683, GermanyTel +49 178 7152405Email claudia.zemmrich@da-cro.deIntroduction: Coronary artery disease (CAD) and peripheral arterial disease (PAD) account for significant morbidity and mortality in Germany and are more prevalent in rural, non-metropolitan areas. The goal of this study is to screen patients for their current atherosclerotic status, initiate treatment according to the latest scientific findings using a standardised multimodal approach and track their atherosclerotic status over one year.Methods and Analysis: This manuscript describes the study protocol of a prospective, multicentre registry of 500 sequential patients with CAD and/or PAD in rural, non-metropolitan regions of Germany. Patients, who visit the “WalkByLab” at the Brandenburg Medical School, Brandenburg, Germany, will be assessed by using our structured, multimodal risk factor management (SMART) tool to evaluate cardiovascular morbidity data, collect information on care and deliver multimodal therapy. The study’s primary objective is a cross-sectional examination of the risk profile, diagnostic and therapeutic status in this patient group. Secondary objectives include the assessment of risk factor correlations as well as changes in risk-factor profile and therapy adherence. Patients will be examined at baseline and followed up at three-monthly intervals for one year. Over this time, atherosclerotic risk factors and patient adherence to defined therapeutic strategies will be evaluated. Study completion is estimated to be December 2021. An expansion of this concept into other rural, non-metropolitan neighbouring regions is planned.Ethics and Dissemination: This registry was assessed and approved by the ethics committee of the Brandenburg State Medical Association, Brandenburg, Germany, and conducted in accordance with the Declaration of Helsinki. The study findings will be disseminated through usual academic channels including meeting presentations and peer-reviewed publications.Protocol Version: 1.0.Keywords: coronary artery disease, peripheral arterial disease, atherosclerosis, rural, risk factor, quality improvement