Geographic Disparities Research Articles

A comparative study of sericin and gluten for magnetic nanoparticle-mediated drug delivery to breast cancer cell lines

With breast cancer emerging as a pressing global health challenge, characterized by escalating incidence rates and geographical disparities, there is a critical need for innovative therapeutic strategies. This comprehensive research navigates the landscape of nanomedicine, specifically focusing on the potential of magnetic nanoparticles (MNPs), with magnetite (Fe3O4) taking center stage. MNPs, encapsulated in biocompatible polymers like silica known as magnetic silica nanoparticles (MSN), are augmented with phosphotungstate (PTA) for enhanced chemodynamic therapy (CDT). PTA is recognized for its dual role as a natural chelator and electron shuttle, expediting electron transfer from ferric (Fe3+) to ferrous (Fe2+) ions within nanoparticles. Additionally, protein-based charge-reversal nanocarriers like silk sericin and gluten are introduced to encapsulate (MSN-PTA) nanoparticles, offering a dynamic facet to drug delivery systems for potential revolutionization of breast cancer therapy. This study successfully formulates and characterizes protein-coated nanocapsules, specifically MSN-PTA-SER, and MSN-PTA-GLU, with optimal physicochemical attributes for drug delivery applications. The careful optimization of sericin and gluten concentrations results in finely tuned nanoparticles, showcasing uniform size, enhanced negative zeta potential, and remarkable stability. Various analyses, from Dynamic Light Scattering (DLS) and scanning electron microscopy (SEM) to transmission electron microscopy (TEM), Fourier Transform Infrared Spectroscopy (FTIR), X-Ray diffraction analysis (XRD), and Thermogravimetric analysis (TGA), provide insights into structural integrity and surface modifications. Vibrating Sample Magnetometer (VSM) analysis underscores superparamagnetic behavior, positioning these nanocapsules as promising candidates for targeted drug delivery. In vitro evaluations demonstrate dose-dependent inhibition of cell viability in MCF-7 and Zr-75–1 breast cancer cells, emphasizing the therapeutic potential of MSN-PTA-SER and MSN-PTA-GLU. The interplay of surface charge and pH-dependent cellular uptake highlights the robust stability and versatility of these nanocarriers in tumor microenvironment, paving the way for advancements in targeted drug delivery and personalized nanomedicine. This comparative analysis explores the suitability of silk sericin and gluten, unraveling a promising avenue for the development of advanced, targeted, and efficient breast cancer treatments.

Instability and inequality in the British state

Abstract The UK state has been through many periods of perceived crisis, but the instability of the last decade has shaken some of the foundational institutions of British politics. Our main argument is that the rise of political instability relates to the failure of British politics to respond to structural inequality in society and politics. This includes growing economic and geographic disparities, as well as destabilizing divisions over long-standing social injustices. The infusion of these trends into the political process is the subject of the ‘asymmetric power model (APM)’, which acts as the theoretical underpinning of this paper and the special issue it introduces. In this editorial to the Parliamentary Affairs Special Issue on ‘Instability and inequality in the British state’, we elaborate these arguments and provide a brief overview of the eight papers in the issue, which cover the APM, the constitution, the UK Union, the Conservative Party, public policymaking, gender inequalities, intersectional inequalities, and geographical inequalities. Together, the papers identify the causes and features of the UK’s troubling inequality-instability dialectic and offer various practical and theoretical ways forward.

A Comprehensive Survey of 2024 Funding for Radiation Oncology Visiting Medical Student Electives.

Visiting electives provide an opportunity for medical students to engage with radiation oncology (RO) programs, likely influencing residency match outcomes. However, some student's out-of-pocket costs may be prohibitive, and in attempts to offset the financial burden of visiting electives, particularly for students underrepresented in medicine (URiM), some institutions offer scholarships. Here, we characterized the current domestic landscape of funded RO electives. Visiting electives were identified through the FREIDA and VSLO databases in April 2024. Funded elective availability and departmental characteristics were identified via internet search by two independent reviewers. Fisher's exact test was used to determine whether there was a difference in the distribution of scholarships across the US due to the small sample size. Ninety-two visiting electives were identified, with 40 programs offering URiM elective scholarships (43.5%). Twelve (30%) were funded specifically by RO departments, and 28 (70%) were part of broader institutional URiM scholarship initiatives. The median stipend provided was $2000 (IQR $500), range $1000-$5000. Analysis of scholarships by US census division and metro area revealed unequal distribution. Electives in New England, Mountain, and East North Central divisions had higher funding proportion compared to electives in the East South Central, West South Central, and Middle Atlantic divisions. Only 1/9 electives in New York City were funded compared with 4/6 in Los Angeles. Departments with funded electives had more faculty physicians and medical residents. In our review of the 2024 landscape, over 40% of RO electives offer financial support. However, we identified geographical disparities in the distribution of scholarships, highlighting the need for interventions to address unequal access to a wide array of training programs. Our study represents a valuable resource for students interested in RO and highlights the continued need to positively contribute to increasing diversity in the field. Future work exploring the impact of funded electives is needed.

Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000–2019

Background and aimThe global burden of digestive diseases mortality has been increasing over the last three decades. However, little is known about disparities in digestive diseases-specific mortality in the United States. This study aimed to examine racial, ethnic, state- and county-level disparities in digestive diseases mortality rate in the United States between 2000-2019. MethodsWe used the Institute of Health Metrics and Evaluation, Global Health Data Exchange to gather digestive diseases age-standardized mortality rates for five racial and ethnic groups (White, Black, Latino, American-Indian/Alaska Native [AIAN], and Asian-Pacific Islanders [API]) by sex, state, and county between 2000-2019. We used joinpoint regression analysis to evaluate the overall temporal trends by demography. ResultsThe overall cause-specific mortality rate decreased from 36.0 to 34.5 deaths per 100,000 population across all groups (2000-2019). In 2019, AIAN individuals had the highest mortality rate (86.2), followed by White (35.5), Latino and Black (both at 33.6), and API individuals (15.6). Significant increases occurred across some of the racial and ethnic groups, with an increased average annual percentage change (AAPC2000-2019) among AIAN (0.87%, 95% CI: 0.77-0.97) and White individuals (0.12%, 0.02-0.22) particularly among females, while Latino, Black, and API individuals showed reduced AAPC2000-2019. AIAN constitutes the main race affected in the top ten counties. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia. ConclusionsDespite an overall decrease in digestive diseases mortality, significant disparities persist across racial and ethnic groups. AIAN and White individuals experienced increased mortality rates, particularly among females. Targeted interventions and further research are needed to address these disparities and improve digestive health equity.

A spatial scientometric analysis of urban planning publications from 2010–2020: geographic disparities in urban planning knowledge production

PurposeThis paper analyzes and illustrates the spatial distribution of publications in international urban planning journals from 2010 to 2020.Design/methodology/approachThe study employs the Biblioshiny bibliometrix package in R to analyze 44,123 articles from 95 international planning journals. To conduct the spatial scientometric analysis, we adopted the United Nations’ geoscheme focusing on three geographical scales: country, subregion, and region. Collaboration patterns at the country and subregional levels were examined using the VOSviewer tool.FindingsThe study found evidence of a spatial polarization of urban planning scholarly knowledge production. Scholars based in the United States and the United Kingdom consistently published at higher rates than any other country in our data set. The region producing the largest number of publications was Europe, consisting of 39.92% of the total publication count. However, urban planning scholars from the Global South authored only 20.96% of planning publications from 2010–2020. Centralization of planning research is also evident within each region and subregion. As such, both the Global North and the Global South should not be framed as homogenous entities and spatial patterns of knowledge production should not be generalized. The analysis also established the emerging role of Northern America as a major collaborator in inter-country and inter-subregional research collaborations. Co-authorship patterns indicate low intra-regional collaboration in planning research, except for Europe.Originality/valueThis article argues that a culture of exclusivity may be occurring in urban planning publication production. By highlighting the spatial disparities in knowledge production, we emphasize the need to examine the structural and institutional barriers that exclude urban planning knowledge emerging from the peripheries in international planning journals.

Diversity gaps among practicing ophthalmologists in Canada: a landscape study

ObjectiveOutline geographic disparities in access to language-and gender-concordant ophthalmologic care in Canada. DesignCross-sectional. ParticipantsPracticing ophthalmologists in Canada (September 2023). MethodsData on ophthalmologists, including demographics, languages spoken, and practice locations, were collected from provincial regulatory body websites. Population data were extracted from the 2021 Statistics Canada Census. Ratio of ophthalmologists-to-potential patients and mean distances (absolute, population-weighted) to gender- and language-concordant care were calculated. The five most common languages spoken in the included provinces were analyzed. ResultsThere were 986 and 1338 ophthalmologists in the language and gender analysis, respectively. Few ophthalmologists spoke non-official languages in Saskatchewan, Manitoba, and Nova Scotia. In a population-weighted analysis, the distance to a language-concordant ophthalmologist were 4.55 times greater for Spanish speakers compared to their English counterparts. Cantonese speakers had the shortest distances to language-concordant care but were still had 40% greater distance than English speakers in the same regions. Despite French-speaking ophthalmologists being the most prevalent per 100 000 speakers, francophones outside Quebec endured distances over double that of anglophones to access language-concordant care. Females in Newfoundland and Saskatchewan faced the longest distances to access gender-concordant care. In Ontario, females may face 3 times the distance to gender-concordant ophthalmologists compared to males. Quebec approaches gender parity with a male-to-female ratio of 55:45. ConclusionsThe results highlight the disparities in accessibility to non-English ophthalmologic care and the underrepresentation of female ophthalmologists across Canada. These disparities underscore the need for targeted strategies to ensure that the ophthalmologic workforce mirrors the demographic of the population it serves.

Causes of Death and Mortality Trends in Individuals with Thalassemia in the United States, 1999-2020.

Our study aims to describe the mortality trends and disparities among individuals with thalassemia in the United States (US). We used CDC WONDER database to calculate the age-adjusted mortality rates (AAMRs) per 1,000,000 individuals and used the Joinpoint Regression Program to measure the average annual percent change (AAPC). Subgroup evaluations were performed by sex, age, race, census region, and urbanization level. From 1999 to 2020, there were 2797 deaths relatd to thalassemia in the US. The AAMR of thalassemia-related death showed a decreasing trend from 0.50 (95% CI, 0.41-0.58) in 1999 to 0.48 (95% CI, 0.41-0.55) in 2020 with the AAPC of -1.42 (95% CI, -2.42, -0.42). Asians have the highest AAMR (1.34 [95% CI, 1.20-1.47]), followed by non-Hispanic Blacks (0.65 [95% CI, 0.59-0.71]), non-Hispanic Whites (0.32 [95% CI, 0.30-0.33]), and Hispanics (0.11 [95% CI, 0.08-0.14]). Cardiovascular disease remains the leading cause of death among individuals with thalassemia. The urban population has a higher AAMR than the rural population (0.43 [95% CI, 0.41-0.45] vs 0.29 [95% CI, 0.26-0.32]). Our study calls for targeted interventions to address the racial and geographic disparities existed among individuals of thalassemia in the US.

Effectiveness of Japan’s Health Insurance System in Meeting Complex Long-Term Care Needs

Japan’s Long-Term Care Insurance (LTCI) system, introduced in 2000, was designed to address the growing needs of the country’s aging population. This study evaluates the effectiveness of the LTCI system in meeting complex long-term care needs, focusing on four key dimensions: access, quality, financial sustainability, and user satisfaction. Using quantitative analysis of data from national databases and surveys, the study reveals significant improvements in access to services and positive care outcomes, with approximately 80% of beneficiaries expressing satisfaction with the services received. However, geographic disparities persist, with rural areas facing limited service availability compared to urban centers. Financial sustainability remains a critical concern, as expenditures have risen by 20% over the past five years, highlighting the need for innovative funding models. The study recommends policy interventions to address regional disparities, ensure financial viability, and expand specialized services for individuals with complex care needs. By examining these challenges and opportunities, the study provides insights into the strengths and limitations of the LTCI system and offers guidance for future policy development. The findings underscore the importance of targeted reforms to enhance the system’s capacity to deliver high-quality, equitable care to Japan’s elderly population.

Geographic Disparities in Online Searches for Psoriasis Biologics in the United States: Google Trends Analysis.

Geographic Disparities in Online Searches for Psoriasis Biologics in the United States: Google Trends Analysis.

Application of Geographic Information Systems (GIS) in the Study of Prostate Cancer Disparities: A Systematic Review.

Introduction: PCa is one of the cancers that exhibits the widest disparity gaps. Geographical place of residence has been shown to be associated with healthcare access/utilization and PCa outcomes. Geographical Information Systems (GIS) are widely being utilized for PCa disparities research, however, inconsistencies in their application exist. This systematic review will summarize GIS application within PCa disparities research, highlight gaps in the literature, and propose alternative approaches. Methods: This paper followed the methods of the Cochrane Collaboration and the criteria set of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles published in peer-reviewed journals were searched through the PubMed, Embase, and Web of Science databases until December 2022. The main inclusion criteria were employing a GIS approach and examining a relationship between geographical components and PCa disparities. The main exclusion criteria were studies conducted outside the US and those that were not published in English. Results: A total of 25 articles were included; 23 focused on PCa measures as outcomes: incidence, survival, and mortality, while only 2 examined PCa management. GIS application in PCa disparities research was grouped into three main categories: mapping, processing, and analysis. GIS mapping allowed for the visualization of quantitative, qualitative, and temporal trends of PCa factors. GIS processing was mainly used for geocoding and smoothing of PCa rates. GIS analysis mainly served to evaluate global spatial autocorrelation and distribution of PCa cases, while local cluster identification techniques were mainly employed to identify locations with poorer PCa outcomes, soliciting public health interventions. Discussion: Varied GIS applications and methodologies have been used in researching PCa disparities. Multiple geographical scales were adopted, leading to variations in associations and outcomes. Geocoding quality varied considerably, leading to less robust findings. Limitations in cluster-detection approaches were identified, especially when variations were captured using the Spatial Scan Statistic. GIS approaches utilized in other diseases might be applied within PCa disparities research for more accurate inferences. A novel approach for GIS research in PCa disparities could be focusing more on geospatial disparities in procedure utilization especially when it comes to PCa screening techniques. Conclusions: This systematic review summarized and described the current state and trend of GIS application in PCa disparities research. Although GIS is of crucial importance when it comes to PCa disparities research, future studies should rely on more robust GIS techniques, carefully select the geographical scale studied, and partner with GIS scientists for more accurate inferences. Such interdisciplinary approaches have the potential to bridge the gaps between GIS and cancer prevention and control to further advance cancer equity.

The Influence of Disparities on Prostate Cancer at Diagnosis in the Charlotte Metropolitan Area.

Prostate cancer (PCa) is the most diagnosed noncutaneous malignancy and second leading-cause of cancer death in men, yet screening is decreasing. As PCa screening has become controversial, socioeconomic disparities in PCa diagnosis and outcomes widen. This study was designed to determine the current disparities influencing PCa diagnosis in Charlotte, NC. The Levine Cancer Institute database was queried for patients with PCa, living in metropolitan Charlotte. Socioeconomic status (SES) was determined by the Area Deprivation Index (ADI); higher ADI indicated lower SES. Patients were compared by their National Comprehensive Cancer Network risk stratification. Artificial intelligence predictive models were trained and heatmaps were created, demonstrating the geographic and socioeconomic disparities in late-stage PCa. Of the 802 patients assessed, 202 (25.2%) with high-risk PCa at diagnosis were compared with 198 (24.7%) with low-risk PCa. High-risk PCa patients were older (69.8±9.0 vs. 64.0±7.9 years; p<0.001) with lower SES (ADI block: 98.4±20.9 vs. 92.1±19.8; p=0.004) and more commonly African-American (White: 66.2% vs. 78.3%, African-American: 31.3% vs. 20.7%; p=0.009). On regression, ADI block was an independent predictor (odds ratio [OR]=1.013, 95% confidence interval [CI] 1.002-1.024; p=0.024) of high-risk PCa at diagnosis, whereas race was not (OR=1.312, 95% CI 0.782-2.201; p=0.848). A separate regression demonstrated higher ADI (OR=1.016, 95% CI 1.004-1.027; p=0.006) and older age (OR=1.083, 95% CI 1.054-1.114; p<0.001) were independent predictors for high-risk PCa. Findings, depicted in heatmaps, demonstrated the geographic locations where men with PCa were predicted to have high-risk disease based on their age and SES. Socioeconomic status was more closely associated with high-risk PCa at diagnosis than race. Although, of any variable, age was most predictive. The heatmaps identified areas that would benefit from increased awareness, education, and screening to facilitate an earlier PCa diagnosis.

Geographical Disparities in Colorectal Cancer in Canada: A Review.

Colorectal cancer (CRC) is a prominent contributor to cancer-related mortality in Canada. This review paper sheds light on the research conducted in Canada to scrutinize the influence of economicfactors. The review seeks to uncover notable disparities in Colorectal cancer incidence and mortality rate across diverse Canadian populations, including Indigenous communities, rural dwellers, and individuals with lower socioeconomic status (SES). Recent investigations reveal significant disparities in CRC incidence, mortality, and treatment outcomes among various demographic groups in Canada. Indigenous peoples, rural populations, and those with lower SES are particularly vulnerable to these disparities. Access to screening and specialized cancer care is notably limited for these marginalized populations, exacerbating existing health inequities. Furthermore, emerging evidence underscores the potential influence of dietary factors on CRC risk, highlighting the importance of tailored prevention and treatment strategies. The findings underscore the urgent need for targeted interventions aimed at enhancing access to CRC screening and specialized cancer care for disadvantaged populations in Canada. By addressing these disparities, more individuals can undergo timely screening and receive early-stage diagnoses, thereby improving prognosis and ultimately saving lives. However, to effectively bridge these gaps, further research is imperative to elucidate the underlying mechanisms driving these disparities and to identify and implement effective interventions.

An exploratory analysis of the impact of area-level exposome on geographic disparities in aggressive prostate cancer

Numbers of aggressive prostate cancer (aPC) cases are rising, but only a few risk factors have been identified. In this study, we introduce a systematic approach to integrate geospatial data into external exposome research using aPC cases from Pennsylvania. We demonstrate the association between several area-level exposome measures across five Social Determinants of Health domains (SDOH) and geographic areas identified as having elevated odds of aPC. Residential locations of Pennsylvania men diagnosed with aPC from 2005 to 2017 were linked to 37 county-/tract-level SDOH exosome measures. Variable reduction processes adopted from neighborhood-wide association study along with Bayesian geoadditive logistic regression were used to identify areas with elevated odds of aPC and exposome factors that significantly attenuated the odds and reduced the size of identified areas. Areas with significantly higher odds of aPC were explained by various SDOH exposome measures, though the extent of the reduction depended on geographic location. Some areas were associated with race (social context), health insurance (access), or tract-level poverty (economics), while others were associated with either county-level water quality or a combination of factors. Area-level exposome measures can guide future patient-level external exposome research and help design targeted interventions to reduce local cancer burden.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet and Metabolites in Chronic Kidney Disease.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, and its association with renal outcomes remains unclear. In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, diet data were collected at baseline using food frequency questionnaires. Modified Poisson regression was used to examine the association of MIND diet with incident chronic kidney disease (CKD). In the REGARDS stroke case-cohort, 357 metabolites were measured in baseline plasma. Weighted linear regression was used to test associations between MIND diet and metabolites. Weighted logistic regression was used to test associations between MIND-associated metabolites and incident CKD. Mediation analyses were conducted to determine whether metabolites mediated the relationship between MIND diet and CKD. A higher MIND diet score was associated with a decreased risk of incident CKD (risk ratio 0.90, 95% CI (0.86-0.94); p = 2.03 × 10-7). Fifty-seven metabolites were associated with MIND diet (p < 3 × 10-4). Guanosine was found to mediate the relationship between MIND diet and incident CKD (odds ratio for indirect effects 0.93, 95% CI (0.88-0.97); p < 0.05). These findings suggest a role of the MIND diet in renal outcomes.

Using a novel methodology to map Post-COVID services for children and young people in England: a web-based systematic search

BackgroundPost-COVID Condition (PCC), also known as ‘Long COVID,’ refers to persistent symptoms following a coronavirus 2 (SARS-CoV-2) infection. The prevalence of PCC in children and adolescents varies, impacting multiple body systems and affecting daily functioning. Specialised paediatric hubs were established in England to address the needs of young individuals with PCC. Additional local services also emerged, yet patients report challenges accessing services. To better understand the landscape of paediatric PCC services, we used a novel methodology using a web-based systematic search.MethodsA web-based search was conducted in July 2023 using DEVONagent Pro. Search terms related to Long COVID and Pediatrics in England. Eligible sources providing information on PCC services for children and young people were included. A supplementary manual search and NHS England Post-COVID Network were also consulted. Data extraction included service location, characteristics, and referral pathways. Population estimates were derived from UK Census data.ResultsAmong 342 identified records, 27 services met eligibility criteria, distributed unevenly across regions. Specialised hubs covered 13 locations, while additional services were concentrated in the South of England and London. Services varied in team composition, age range treated, and support offered. A lack of standardised approaches for paediatric PCC was evident.DiscussionWe used a novel methodology for systematically mapping online resources, providing valuable insights into service accessibility and aiding the identification of potential gaps. We observed geographical disparities in access to paediatric PCC services and the absence of standardised approaches in managing symptoms. Given the challenges faced by young individuals seeking support for their PCC the need for equitable and standardised care became apparent. The study contributes to closing the research-practice gap and calls for further research to identify effective treatments for paediatric PCC, acknowledging the diversity of reported symptoms and the importance of tailored approaches.

A retrospective analysis of the trends in the prevalence of female genital mutilation and associated factors among women of reproductive age in Nigeria 2011-2021.

Female genital mutilation (FGM) is widely acknowledged globally as a violation of the fundamental human rights of girls and women. FGM is still widely practiced in Nigeria but at diminishing rates. Primary care physicians must educate and campaign to end this hazardous practice in Nigeria, especially in high-incidence areas. This study fills the knowledge gap by identifying FGM determinants to help policymakers reduce it. The study employed a retrospective cross-sectional design using data from the United Nations International Children's Emergency Fund for 2011, 2016-2017, and 2021. The sampling involved multistage cluster sampling. Data analysis utilized IBM-SPSS, presenting FGM prevalence across years and exploring associations with various factors. This study analyzed 63,365 Nigerian women across a decade (2011, 2016-2017, and 2021). FGM awareness fluctuated (35.1% in 2016-2017, 33.0% in 2011, and 31.9% in 2021), while FGM prevalence increased from 46.6% (2011) to 69.5% (2021). Education correlated with lower FGM prevalence. Geographic disparities were observed, with the Southwest having the highest (70.1%) and the Northeast having the lowest (34.5%) prevalence. Religion influenced FGM rates, with Christians (54.2%) and those with other/no religion (58.0%) showing higher rates than Muslims (52.6%). Urban women had a slightly lower prevalence (52.6%) than rural women (54.2%), and wealth quintiles displayed variations. Variability was also evident among states, ranging from 2.0% to 86.3%. Daughters' circumcision was influenced by maternal circumcision status, education, region, religion, and wealth quintile. Common FGM procedures involved removing genital flesh (63.7%) and nicking without removal (55.1%), often performed by nurses/midwives (63.7%). The study emphasized the urgent need for continuous awareness campaigns and education to combat FGM among Nigerian women. Education emerged as a critical factor in reducing FGM, highlighting the importance of investing in girls' education.

Supply chain optimization: bibliometric analysis, research structure and future outlook

Purpose Supply chain (SC) research has boomed over the past two decades. Significant contributions have been made to the field from various analytical and decision-making perspectives. This paper, a comprehensive bibliometric study, aims to identify the key research contributors, institutions and themes. Design/methodology/approach A comprehensive knowledge domain visualization of over 1,000 articles, published between 2000 and 2022, is carried out to construct a bird’s eye view of the field in terms of research production, key authors, main publication outlets, geographic disparity of the contributions and emerging research trends. Additionally, collaboration patterns among researchers and institutions are mapped to highlight the communication networks underlying research initiatives. Findings Results show an explosive growth in the number of articles tackling supply chain optimization (SCO) issues with a significant concentration of the contributions in a relatively small cluster of authors, journals, institutions and countries. Among the many important findings, our analysis indicates that mixed-integer linear programming is the most commonly used model, while robust optimization is the method of choice for handling uncertainty. Furthermore, most SC models are developed at only one level of the organizational hierarchy and consider only one planning horizon. The importance of developing integrated SCO systems is key for future research. Originality/value The study fills the optimization techniques gap that exists in SC management bibliometric studies and presents a thematic map for the SCO research highlighting the various research foci.

New Innovations to Address Sudden Cardiac Arrest

Mortality from sudden cardiac arrest remains high despite increased awareness and advancements in emergency resuscitation efforts. Various gaps exist in bystander resuscitation, automated external defibrillators, and access. Significant racial, gender, and geographic disparities have also been found. A myriad of recent innovations in sudden cardiac arrest uses new machine learning algorithms with high levels of performance. These have been applied to a broad range of efforts to identify individuals at high risk, recognize emergencies, and diagnose high-risk cardiac arrhythmias. Such technological advancements must be coupled to novel public health approaches to best implement these innovations in an equitable way. The authors propose a data-driven, technology-enabled system of care within a public health system of care to ultimately improve sudden cardiac arrest outcomes.

Place of Birth and Cognitive Function Among Older Americans: Findings From the Harmonized Cognitive Assessment Protocol.

Growing evidence suggests that place of birth (PoB) and related circumstances may have long-lasting and multiplicative contributions to various later-life outcomes. However, the specific contributions to different domains of cognitive function in late life remain less understood. This study investigated the extent to which state of birth contributes to a wide range of domains of later-life cognitive function. A nationally representative sample of Americans aged 65 and older (N = 3,333) from the Health and Retirement Study (HRS) Harmonized Cognitive Assessment Protocol (HCAP) was utilized. Cognitive function was assessed in HCAP and linked to HRS state of birth data to explore the contribution of PoB to later-life cognitive disparities. Regression-based Shapley decompositions were employed to quantify this contribution. PoB significantly contributed to all assessed cognitive domains including memory, executive function, language and fluency, visuospatial function, orientation, and general cognitive function. Geographic disparities in cognitive function were evident across PoB, with individuals born in U.S. southern states and foreign-born individuals performing worse than those born in other states. Overall, state of birth accounted for 2.2%-9.7% of the total variance in cognition after adjusting for age, sex, and race/ethnicity. This contribution declined to 2.0%-7.0% after further adjusting for comprehensive socioeconomic and health factors over the life course, and was robust to the control of current state of residence. PoB has lasting contributions to later-life cognition, with significant geographic disparities observed. Addressing these disparities requires more equalized place-based policies, resources, and early-life environments to promote health equity over the life course.

Quantitatively exploring the influence of geographical conditions on ecological quality using a novel remote sensing model: a comparison between two geographical disparity regions in China

ABSTRACT The ecological quality of a region is significantly influenced by its geographical conditions, which can yield different effects on ecosystems. Nevertheless, the lack of adequate technology has impeded quantitative investigations into these differences. Consequently, there is an increasing demand for effective techniques to quantitatively measure differences in ecological quality resulting from variations in geographical conditions. This study applied the novel Remote Sensing-based Ecological Index (RSEI) concurrently to two distinct provincial-level regions in China, Fujian and Ningxia, to quantitatively detect their ecological differences. These two regions possess contrasting geographical conditions, with Fujian having high forest coverage and abundant rainfall, while Ningxia features low forest coverage and extensive loess plateau and desert terrain. By linking geographical factors with their corresponding ecological responses, we conducted a comprehensive analysis to determine whether the contrasting geographical conditions between the two regions had caused significant disparities in their ecological status. The results indicate that the contrasting geographical conditions have indeed led to marked ecological differences, with Fujian exhibiting excellent ecological status, while Ningxia lags behind due to unfavorable geographical conditions. In terms of RSEI scores, Fujian consistently achieved higher RSEI values (>0.8) in the study years, reaching an excellent ecological level, whereas Ningxia recorded scores lower than 0.45 during the comparable years, corresponding to a poor to moderate ecological level. Regarding the impact of geographical factors on ecological conditions, the positive contributions of greenness and wetness indicators to the ecology in Fujian were significantly greater than those in Ningxia (58% vs. 39%), whereas the contributions of negative indicators, dryness and hotness, were notably higher in Ningxia compared to Fujian (|–61|% vs. |–42|%). The successful concurrent application of RSEI to these two geographically distant regions also demonstrates the robustness of the RSEI technique.