The social determinants of health are demographic and socioeconomic characteristics that influence the population’s lifestyle and access to healthcare, including the comprehensive and universal care provided by Brazil’s Unified Health System (SUS). This study aims to understand how population characteristics are associated with the availability of health services in Greater S˜ao Paulo. We applied an
unsupervised machine learning technique to analyze how municipalities within the S˜ao Paulo Metropolitan Region cluster based on demographic and socioeconomic indicators. We then used the resulting clusters to evaluate the number of healthcare facilities available in each. Our findings indicate that peripheral cities in the region tend to share certain features, such as a higher proportion of Black and Brown populations and lower average income (up to one minimum wage). These clusters tend to have fewer healthcare facilities. In contrast, the cluster consisting solely of S˜ao Caetano do Sul, which has the highest proportion of White residents and a large share of individuals earning more than two minimum wages, has, relative to its population, the highest number of healthcare facilities, tripling the number found in the second-ranking cluster (Cluster 2). Through a machine learning approach, our results highlight the structural inequality present in the S˜ao Paulo Metropolitan Region and the disparities in access to healthcare, particularly in its peripheral areas.
Abstract Accurate information on urban tree species composition is critical for urban green space ecosystem management. However, achieving large-scale, high-precision species identification in complex metropolitan environments remains challenging. This study assessed the potential of medium-resolution multi-temporal optical imagery combined with airborne LiDAR for tree species classification in large heterogeneous urban areas (> 5000 km²). The results indicate that precise large-scale identification of urban tree species distribution is feasible by integrating multi-seasonal Sentinel-2 imagery with airborne LiDAR data based on a Random Forest hierarchical classification model. The overall classification accuracies for deciduous broadleaf species and evergreen broadleaf species were 63.32% and 76.77%, respectively. Multi-temporal spectra were the primary explanatory variables, with spring bands significantly affecting the classification of deciduous broadleaf species. For evergreen broadleaf species, each season has its own dominant spectral information. Classifications combining data from three seasons outperformed single- or two-season combinations. The incorporation of LiDAR-derived metrics improved the classification results for most species, with accuracy increases of up to 18.75% point for deciduous broadleaf species. Overall, the results demonstrate the effectiveness of combining medium-resolution multi-temporal optical imagery with LiDAR data for urban tree species classification, laying a foundation for quantifying ecosystem services provided by urban trees through remote sensing.
Amol M. Mehta, Sai P. Polineni, Praneet Polineni
et al.
Background Structural racism and rural/urban differences in stroke care affect care delivery and outcomes. We explored the interplay among structural racism, urbanity, and intravenous thrombolysis (tissue plasminogen activator) and endovascular thrombectomy (ET). Methods and Results In this retrospective study using complete, deidentified inpatient Medicare data (2016–2019), we identified incident acute ischemic stroke admissions, demographics, and hospital‐level variables. Medicare beneficiaries aged ≥65 years with incident acute ischemic stroke admission in large metropolitan and nonurban settings were included. Validated structural racism metrics at the county level and a composite structural racism score that incorporated measures of segregation, housing, employment, education, and income were studied. Among 951 914 patients, rural hospitals demonstrated lower intensive care unit capacity (27.5% versus 88.6%), stroke certification (5.3% versus 38.4%), and rates of tissue plasminogen activator (1.6% versus 12.3%) and ET (<1% versus 3.8%). Large metropolitan areas demonstrated higher levels of income inequality (Gini index −0.15 versus 0.11 SD), and racial segregation (dissimilarity index 0.29 SD higher than the US mean). The composite structural racism score was associated with increased odds of tissue plasminogen activator receipt (odds ratio, 1.47 [95% CI, 1.33–1.63]) and ET (odds ratio, 4.15 [95% CI, 2.98–5.79]). Despite greater access to stroke care in urban areas, a persistent racial disparity remained, with Black patients less likely to receive tissue plasminogen activator (odds ratio, 0.70 [95% CI, 0.68–0.72]) and ET (odds ratio, 0.63 [95% CI, 0.60–0.66]) compared with White patients. Conclusions We found persistent disparities in stroke care access and outcomes, influenced by structural racism and rural–urban differences. Further research should explore interactions between structural racism, urbanity, and health care delivery to inform effective interventions.
Diseases of the circulatory (Cardiovascular) system
This paper explores and proves the one-seventh area triangle using a purely algebraic approach as opposed to a geometric one. A triangle set purely in the complex plane is used so that we can utilise features of the complex number system to determine areas. The area of a triangle in determinant form is derived using these features, and a rigorous proof of the one-seventh area triangle follows.
Manjunath Krishnapur, Erik Lundberg, Koushik Ramachandran
Erdös posed in 1940 the extremal problem of studying the minimal area of the lemniscate $\{|p(z)|<1\}$ of a monic polynomial $p$ of degree $n$ all of whose zeros are in the closed unit disc. In this article, we prove that there exist positive constants $c,C$ independent of the degree $n$ such that \[ \dfrac{c}{\log n} \leq \min \text{Area}( \{ |p(z)|<1 \} ) \leq \frac{C}{\log \log n},\] improving substantially the previously best known lower bound (due to Pommerenke in 1961) as well as improving the best known upper bound (due to Wagner in 1988). We also study the inradius (radius of the largest inscribed disc); we provide an estimate for the inradius in terms of the area that confirms a 2009 conjecture of Solynin and Williams, and we use this to give a lower bound of order $(n \sqrt{\log n})^{-1}$ on the inradius, addressing a 1958 problem posed by Erdös, Herzog, and Piranian (confirming their conjecture up to the logarithmic factor). In addition to studying the area of $\{|p(z)|<1\}$, we consider other sublevel sets $\{|p(z)|<t\}$, proving both upper and lower bounds of the same order $1/\log \log n$ when $t>1$ and proving power law upper and lower bounds when $0<t<1$. We also consider the minimal area problem under a more general constraint, namely, replacing the unit disc with a compact set $K$ of unit capacity, where we show that the minimal area converges to zero as $n \rightarrow \infty$ (giving an affirmative answer to another question of Erdös, Herzog, Piranian); we also investigate the structure of the area minimizing polynomials, showing that the normalized zero-counting measure converges to the equilibrium measure of $K$ as the degree $n \rightarrow \infty$.
Resumo A Avaliação Ambiental Estratégica (AAE) é aplicada em 90 países para integrar o meio ambiente ao planejamento, como planos diretores, mas permanece voluntária no Brasil. A dimensão ambiental em relatórios internacionais de AAE de planos diretores é discutida pelo referencial teórico de boas práticas de AAE para identificar contribuições para o contexto brasileiro. Verificou-se elevado número de evidências dessas boas práticas, de padronização de etapas, de integração entre os planejamentos urbano e ambiental corroborando características intrínsecas e sistêmicas da AAE que permitem integrar a dimensão ambiental em planos diretores, independente do contexto de planejamento do país. Recomenda-se que a AAE seja adotada localmente, pois possibilita fomentar a integração da temática ambiental em políticas intersetoriais urbanas, um desafio no planejamento urbano.
Innocentia M. Modise, Nikolai Panichev, Khakhathi L. Mandiwana
A gaseous elemental mercury (Hg<sup>0</sup>) sampler was developed for the assessment of mercury (Hg) pollution from the air and utilised aluminium (Al) powder as the accumulation medium. The Hg sampler is presented as an alternative cost-effective sorbent that can be used for the assessment of Hg pollution in atmospheric air in areas where natural bio-indicators such as lichens and moss do not grow, including the urban environments. The chemical treatment of Al materials was necessary to weaken the aluminium oxide (Al<sub>2</sub>O<sub>3</sub>) layer to increase the adsorption capability of Al material. Treated Al samples were exposed to Hg vapours for one hour to two weeks in a Hg atmosphere chamber. Other Al powder samples were exposed to the ambient air at areas of the Tshwane Metropolitan Municipality for six to ten months. The analysis of samples by an RA-915+ Zeeman mercury analyser showed that the limit of detection (LOD) and limit of quantification (LOQ) for the determination of Hg in Al powder with a mass of 100 mg were found to be 0.31 ng g<sup>−1</sup> and 1.0 ng g<sup>−1</sup>, respectively. The content of Hg that accumulated on Al powder was linear from 0.1 to 25 ng g<sup>−1</sup>, thus enabling the measurement of Hg accumulation from air at the global average concentration level. Mercury from air that accumulated on Al powder in the Tshwane Metropolitan Municipality ranged between 70 ng g<sup>−1</sup> and 155 ng g<sup>−1</sup>.
Amanda Xavier, Cristine Bonfim, Pablo Cantalice
et al.
Lymphatic filariasis (LF) is a neglected tropical disease associated with poverty and poor environmental conditions. With the inclusion of vector control activities in LF surveillance actions, there is a need to develop simple methods to identify areas with higher mosquito density and thus a higher consequent risk of <i>W. bancrofti</i> transmission. An ecological study was conducted in Igarassu, which is in the metropolitan region of Recife, Pernambuco, Brazil. The mosquitoes were captured in 2060 houses distributed across 117 census tracts. The vector density index (VDI), which measures the average number of lymphatic-filariasis-transmitting mosquitoes per number of houses collected in the risk stratum, was constructed. Moreover, the social deprivation indicator (SDI) was constructed and calculated through principal component factor analysis. An average of 242 female <i>C. quinquefasciatus</i> were found in the high-risk stratum, while the average in the low-risk stratum was 108. The overall VDI was 6.8 mosquitoes per household. The VDI for the high-risk stratum was 13.2 mosquitoes per household, while for the low/medium-risk stratum, it was 5.2. This study offers an SDI for the density of <i>C. quinquefasciatus</i> mosquitoes, which can help reduce the costs associated with data collection and allows for identifying priority areas for vector control actions.
The modernist project was based on a hygienist ethic: providing ventilation and sunlight for all homes. Today, urban planning strategies are more selective. Densification and urban sprawl are constraining the sites of capital reproduction in metropolitan areas. Residential towers are being revalued, along with access to the skyline from domestic spaces. A question from the 1960s is being revisited: is it healthier to live high-up in collective housing? This article seeks to answer this question on the basis of a field survey conducted in the new/old residential towers of the Lyon and Saint-Étienne metropolitan area. Health is analyzed as an interrelation between a body and the environment, as a set of exposures (light, weather, sounds, pollutants, wind, heat, etc.) that requires studying the positioning of the inhabitant, their housing, the tower, and its neighborhood, as well as the permeability of these different scales, from the window to the balcony, elevator, and stairs. Residents recognize the physiological and psychological benefits of ventilation and sunlight, but access to the horizon involves other, more invisible vulnerabilities. Polysensorial, the insulation problems that persist in the upper floors are considered symptomatic of a physicalist approach to urban planning, which is out of step with the intensification of biochemical dimensions of health from home.
Rachael Beldham‐Collins, Georgia K.B. Halkett, Kellie Knight
et al.
Abstract Introduction Building research capacity within the radiation therapist workforce/profession is essential to guarantee research is embedded into core practices. Assessment of current capacity levels within organisation, department and individual domains needs to occur to establish a baseline and ensure research capacity building (RCB) strategies will be targeted successfully. This exploratory study aimed to identify the areas within each domain where radiation therapists would benefit from extra research assistance, that being research support and process changes, particularly in relation to the workplace and health sector. Methods Practising radiation therapists (RTs) within Australia were recruited through professional organisations and invited to complete the online Research Capacity Culture Tool (RCCT). The survey was conducted using Qualtrics with data exported to SPSS.V27 for analysis. Descriptive statistics and the Radiation Therapy Specific Survey Analysis Approach (RTSSAA) for the Research Capacity and Culture Tool were used to analyse and report the results. Results Survey participation rate was 121/2640 (4.6%). Within the Organisation and Department domains, the most research assistance was required in infrastructure (n = 92–37) and support (n = 66–45) categories, respectively. Participants from private sector (Organisation: 42.7%, Department: 53.7%) and metropolitan centres (Organisation: 32.6%, Department: 47.5%) required a higher rate of assistance when compared to their counterparts in both categories. The individual domain showed similar levels of assistance required across health sectors and work locations. Workplaces showed similar levels of complexity of research activity; private sector (62.5%) recorded the highest level of no research activity. Conclusion This study has provided insight into how the research capacity and culture of organisations and departments in which individuals' work will influence their abilities and opportunities to perform research.
Medical physics. Medical radiology. Nuclear medicine
In the context of rural revitalization strategies and humans’ increasing leisure pursuits, rural tourism has begun to act as a new development path of rural economic growth and industrial transformation. This phenomenon generally occurs in rural areas around metropolitan areas, manifesting as the transformation or reconstruction of rural spaces. As a result, many new types of tertiary industry spaces utilizing rural land for leisure activities have emerged. We analyze the connotations of rural spatial and industrial transformation from the perspective of spatial production and innovatively propose that the transformed space is an ecological product, which includes three types in practice: industrial space, consumption space, and residential space. This study facilitates urban–rural integration and common prosperity. Given the lack of analysis of rural ecological products, especially rural spatial ecological products (e.g., rural B&Bs and other tertiary industry spaces), this study aims to explore the value expression and driving factors of rural spatial ecological products based on geo-visual (spatially visualizing) analytical tools looking at 10361 B&Bs in Jiangsu and Zhejiang Provinces of China as typical examples. Our results show that (1) the value of rural spatial ecological products is reflected in the price that urban consumers are willing to pay for rural natural landscapes, which constitutes an ecological premium; and (2) the prices of rural spatial ecological products are strikingly different at multiple spatial scales, and this difference is related to the local ecological resources. This study provides insights into the rational allocation of the limited resources required for rural construction, which helps optimize the spatial planning of rural ecotourism and enhance the gametogenous development momentum of rural areas. At the same time, this study theoretically expands the research results of cultural ecosystem services.
Pierre-Alexandre Bliman, Nga Nguyen, Nicolas Vauchelet
The Sterile Insect Technique (SIT) is one of the sustainable strategies for the control of disease vectors, which consists of releasing sterilized males that will mate with the wild females, resulting in a reduction and, eventually a local elimination, of the wild population. The implementation of the SIT in the field can become problematic when there are inaccessible areas where the release of sterile insects cannot be carried out directly, and the migration of wild insects from these areas to the treated zone may influence the efficacy of this technique. However, we can also take advantage of the movement of sterile individuals to control the wild population in these unreachable places. In this paper, we derive a two-patch model for Aedes mosquitoes where we consider the discrete diffusion between the treated area and the inaccessible zone. We investigate two different release strategies (constant and impulsive periodic releases), and by using the monotonicity of the model, we show that if the number of released sterile males exceeds some threshold, the technique succeeds in driving the whole population in both areas to extinction. This threshold depends on not only the biological parameters of the population but also the diffusion between the two patches.
Abdul Haris, Muhammad Munawir Syarif, Hamed Narolla
et al.
This study aims to develop a framework for multicriteria analysis to evaluate alternatives for sustainable corn agricultural area planning, considering the integration of ecological, economic, and social aspects as pillars of sustainability. The research method uses qualitative and quantitative approaches to integrate ecological, economic, and social aspects in the multicriteria analysis. The analysis involves land evaluation, subcriteria identification, and data integration using Multidimensional Scaling and Analytical Hierarchy Process methods to prioritize developing sustainable corn agricultural areas. Based on the results of the RAP-Corn analysis, it indicates that the ecological dimension depicts less sustainability. The AHP results yield weight distribution and highly relevant scores that describe tangible preferences. Priority directions are grouped as strategic steps toward achieving the goals of sustainable corn agricultural area planning.
Ee-Leng Tan, Furi Andi Karnapi, Linus Junjia Ng
et al.
With rapid urbanization comes the increase of community, construction, and transportation noise in residential areas. The conventional approach of solely relying on sound pressure level (SPL) information to decide on the noise environment and to plan out noise control and mitigation strategies is inadequate. This paper presents an end-to-end IoT system that extracts real-time urban sound metadata using edge devices, providing information on the sound type, location and duration, rate of occurrence, loudness, and azimuth of a dominant noise in nine residential areas. The collected metadata on environmental sound is transmitted to and aggregated in a cloud-based platform to produce detailed descriptive analytics and visualization. Our approach to integrating different building blocks, namely, hardware, software, cloud technologies, and signal processing algorithms to form our real-time IoT system is outlined. We demonstrate how some of the sound metadata extracted by our system are used to provide insights into the noise in residential areas. A scalable workflow to collect and prepare audio recordings from nine residential areas to construct our urban sound dataset for training and evaluating a location-agnostic model is discussed. Some practical challenges of managing and maintaining a sensor network deployed at numerous locations are also addressed.
Luiz Carlos Day Gama, Ana Hermeto, Philipe Scherrer Mendes
We aim to study the role of labor market mismatch in the context of international migration. Mismatch employment occurs when high-skill workers are employed in occupations that do not need such education and vice versa. The results show: i) undereducation is on average lower among immigrants, while overeducation is higher among immigrants; ii) immigrants are more likely to be employed than natives; iii) mismatch is important in explaining wages; iv) there are differences in occupational mismatch effects; v) the immigrant’s place of origin is not important to explain occupation status but it is very important to explain differences in wages.
Jorge A Bonilla, Alejandro Lopez-Feldman, Paula C Pereda
et al.
Recent studies have shown a relationship between air pollution and increased vulnerability and mortality due to COVID-19. Most of these studies have looked at developed countries. This study examines the relationship between long-term exposure to air pollution and COVID-19-related deaths in four countries of Latin America that have been highly affected by the pandemic: Brazil, Chile, Colombia, and Mexico. Our results suggest that an increase in long-term exposure of 1 μg/m3 of fine particles is associated with a 2.7 percent increase in the COVID-19 mortality rate. This relationship is found primarily in municipalities of metropolitan areas, where urban air pollution sources dominate, and air quality guidelines are usually exceeded. By focusing the analysis on Latin America, we provide a first glimpse on the role of air pollution as a risk factor for COVID-19 mortality within a context characterized by weak environmental institutions, limited health care capacity and high levels of inequality.
Pedro Mendonça Castelo Branco, Sidney Jard da Silva
Resumo A uberização do trabalho é mais uma etapa no processo de desconfiguração dos pactos sociais conformados no período fordista. A estratégia de construção de “parceiros” possibilita a externalização de custos de capital fixo para uma multidão de trabalhadores precários, como também uma fuga, por parte das empresas, da responsabilidade de garantir os direitos trabalhistas e as seguridades ocupacionais. Diante desse novo terreno de exploração do trabalho, impulsionado por grandes empresas transnacionais que operam para além das limitações nacionais e acumulam em escala global, aqui são apresentadas iniciativas de organização dos uberizados a partir de experiências internacionais e nacionais à luz do conceito de sindicalismo de movimento social.
Abstract Background Little is known about the usage of coping strategies recommended by the World Health Organization and the Centers for Disease Control and Prevention during the COVID-19 pandemic and whether coping strategy usage varies by pre-pandemic mental health. This study examined the prevalence of different coping strategies and associations of their usage with pre-pandemic mental health. Methods Data were collected from adults residing in metropolitan areas of the U.S. South in May/June 2020 using random-digit-dialing and web-based surveys (n = 1,644). We estimated the prevalence of each coping strategy: (1) keeping up-to-date about COVID-19; (2) taking breaks from the news or social media; (3) taking care of physical health; (4) engaging in relaxing activities; (5) reaching out to and spending time with others; and (6) trying to find comfort in religious or spiritual beliefs. We examined the association between the use of each strategy and pre-pandemic mental health using modified Poisson regression, adjusting for covariates. We also analyzed the association between pre-pandemic mental health and the number of coping strategies employed using ordered logistic regression. Results The most prevalent strategies were: “keeping up-to-date about COVID-19” (53%), “taking care of physical health” (52%), and “reaching out to and spending time with others” (52%). Good pre-pandemic mental health was associated with an increased prevalence of “reaching out to and spending time with others” (adjusted prevalence ratio, 1.43; 95% confidence interval, 1.07–1.91). The use of other coping strategies and the number of coping strategies used during the pandemic did not vary by pre-pandemic mental health. Conclusions Our findings suggest that people who had good pre-pandemic mental health were more likely to connect with other people during the COVID-19 pandemic. Given the well-documented impact of social support on mental health in disaster contexts, efforts to promote safe social connections for those with pre-existing mental health concerns are needed.