Major Metropolitan Cities Research Articles

Analysis of shoreline change between inlets along the coast of Chennai, India

Chennai is a major metropolitan city along the southeast coast of India and is popular for its world’s second longest sandy beach called as Marina beach the shoreline of which has been gradually advancing towards the Bay of Bengal over a century. The advance of the shoreline is due to the construction of breakwaters for the formation of the harbor of Chennai port, one of the 12 major ports of India. The study area is the stretch of the shoreline between two zones, viz., Zone I: Cooum (13° 4′ N and 80° 17′ 20″ E) and Zone II: Adyar (13° 0′ 49″ N and 80° 16′ 38″ E). The rate of shoreline change over the period 2000 to 2019 is analysed through statistical parameters using geographical information system and DSAS (digital shoreline analysis system) in the form of erosion and accretion. The LRR results elucidate that the Chennai coast has experienced an extremely dynamic feature with an average erosion rate of −1.67 m/year. The accretion due to the littoral drift with an average rate of +1.31 m/year is driven by the net alongshore current towards the north of the Adyar River.

Abstract PO-011: Mays Cancer Center, South Texas cancer survey: Preliminary results

Abstract Background People living in the Mays Cancer Center (MCC) catchment area face greater cancer-related disparities and face a greater risk of developing liver and cervical cancer. Other priority cancers include colorectal, prostate, and breast cancer. All five major metropolitan cities in the catchment area have lower use of preventive screening services compared to the rest of Texas and nation. In response the MCC conducted a community survey to examine South Texas residents’ 1) exposure to cancer information; 2) knowledge about cancer risk reduction; and 3) intentions and behaviors to reduce cancer risk. Methods A postal address file (PAF) was purchased of 58,960 households throughout the catchment area. The survey was distributed via mail on postcards in two waves. Wave one was launched in May 2020 and was distributed to 30,892 households. Each wave included two mail-outs two weeks apart. To bolster response rate, one week from the last mail out, two follow-up email blasts were sent one week apart to a list of 8,825 addresses from the same mailing list. Post-survey weighting will be applied to the full dataset upon project closeout to provide corrected standard errors and confidence intervals not available at this time. Results Preliminary results (n=432) show the survey has reached 35 of the 38 counties in the MCC catchment area, 36% are from urban counties and 51% rural. Majority of respondents were Hispanic (51%) followed by non-Hispanic white (NHW) (28%) and non-Hispanic black (NHB) (3%). Liver cancer risk: Overall 38% of respondents had been tested for Hepatitis C (n=302). Men had a higher rate of being tested (40%) when compared to women (37%). 51% of respondents were Hispanic followed by 35% NHW and 7% NHB. Colorectal cancer risk: Overall 25% of respondents had received a blood stool test (n=365). Higher than the state (10.9%) and the US (8.9%). Men had a higher rate of being tested (34%) when compared to women (22%). 45% of respondents were Hispanic followed by 43% NHW and 5% NHB. Breast cancer risk: Overall 60% of women had received a mammogram (n=249). Lower than the state (74.9%) and the US (78.3%). 56% (n=83) were Hispanic followed by 38% (n=57) NHW and 3% (n=5) NHB. Cervical cancer risk: Overall 86% (n=212) of women respondents had received a Papanicolaou test (n=246). Higher than the state (77.1%) and the US (80.1%). 58% (n=124) were Hispanic followed by 34% (n=72) NHW and 5% (n=10) NHB. Prostate cancer risk: Overall 49% (n=48) of men had received a PSA test (n=107). Higher than the state (27.1%) and the US (33.2%). 52% (n=25) were NHW followed by 42% (n=20) Hispanic and 2% (n=1) NHB. Conclusions Controlling for gender specific cancers women indicated a higher rate of screening behaviors when compared to men. The highest screening rates among women were found in Hispanics. Alternatively, screening rates were highest among NHW men. Men were more likely to have been screened for liver and colorectal cancer. Screening rates in the catchment area were higher than both state and US rates for pap, PSA, and blood stool tests. Citation Format: Rebecca Jones, Patricia Chalela, Harriet Van Loggerenberg, Edgar Munoz, Ruben Mesa, Amelie G. Ramirez. Mays Cancer Center, South Texas cancer survey: Preliminary results [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-011.

Visualising internal migration flows across local authorities in England and Wales

Internal migration has significant impacts on the population structure, public services, economic and social development of local areas. In this research, we adopted the theory and methods of complex network analysis to visualise the internal migration flows across local authorities in England and Wales. The graphic prominently highlights two spatial and geographic characteristics of population mobility in England and Wales: a large proportion of internal migration is associated with clusters of neighbouring or nearby local authorities, and the most urban authorities, such as London and other major metropolitan cities, have net outward internal migration (i.e., more people moving out than in).

COVID-19 lockdown: a boon in boosting the air quality of major Indian Metropolitan Cities.

The COVID-19 lockdown has not only helped in combating the community transmission of SARS-CoV-2 but also improved air quality in a very emphatic manner in most of the countries. In India, the first phase of COVID-19 lockdown came into force on March 25, 2020, which was later continued in the next phases. The purpose of this study was to investigate the result of lockdown on air quality of major metropolitan cities—Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, Jaipur, and Lucknow—from March 25 to May 3, 2020. For this study, the concentration of six criteria air pollutants (PM2.5, PM10, CO, NO2, SO2, and O3) and air quality index during the COVID-19 lockdown period was compared with the same period of the previous year 2019. The results indicate a substantial improvement in air quality with a drastic decrease in the concentration of PM2.5, PM10, CO, and NO2, while there is a moderate reduction in SO2 and O3 concentration. During the lockdown period, the maximum reduction in the concentration of PM2.5, PM10, CO, NO2, SO2, and O3 was observed to be − 49% (Lucknow), − 57% (Delhi), − 75% (Mumbai), − 68% (Kolkata), − 48% (Mumbai), and − 29% (Hyderabad), respectively. The value of the air quality index (AQI) also dwindled significantly during the COVID-19 lockdown period. The maximum decline in AQI was observed – 52% in Bengaluru and Lucknow. The order of AQI was satisfactory > moderate > good > poor and the frequency order of prominent pollutants was O3 > PM10 > PM2.5 > CO > NO2 > SO2 during the lockdown period in all the aforementioned metropolitan cities.Graphic abstract

The Introduction of a Mandatory Mask Policy Was Associated with Significantly Reduced COVID-19 Cases in a Major Metropolitan City

Background: Whilst evidence of face masks’ effectiveness in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a natural experiment to assess the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions. Methods: Exponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.6.3). The model’s two linear segments straddle the hinge day, determined from the model fit, on which the mask policy began to take effect. We used two forms of data to assess change in mask usage: population-based survey data and images of people wearing masks in public places obtained from a major media outlet. Potential confounding factors (including daily COVID-19 tests, number of COVID-19 cases among population subsets affected differentially by the mask policy – e.g. healthcare workers) were examined for their impact on the results.Findings: Introduction of a mandatory mask policy was associated with an estimated 23% reduction in the effective reproduction ratio, from 1.18 to 0.91. The hinge day in the linear spline model occurred eight days after the policy was introduced on July 23, 2020. Daily cases grew exponentially in the first log-linear segment (k = +0.042, s.e. = 0.007), and decayed exponentially in the second (k = -0.023, s.e. = 0.017). Analysis of images of people in public spaces showed mask usage rose from approximately 43% to 97%. Analysis of survey data found that on the third day before policy introduction, 44% of participants reported “often” or “always” wearing a mask; on the fourth day after, 100% reported “always” doing so. No potentially confounding factors were associated with the observed change in growth rates.Interpretation: The mandatory mask use policy substantially increased public use of masks and was associated with a significant decline in COVID-19 transmission after introduction of the policy. The hinge date (where the shift in epidemic growth was observed) occurred eight days after policy introduction, consistent with the incubation time of COVID-19 and the time needed to test and report new cases. Although studies emphasise the importance of masks in a clinical setting, to our knowledge no previous peer reviewed publications measured the role of masks for controlling epidemics in the broader community.Funding Statement: This work was funded from Burnet Institute resources.Declaration of Interests: BC serves on the National COVID-19 Health Research Advisory Committee that provides guidance to the Federal Government’s COVID-19 response. NS, MH, A Saeri, EG and LS provide guidance to the Victorian Government’s COVID-19 response. MH and NS receive funding from the Victorian Government for the Optimise Study and modelling work. A Saeri and EG receive funding from the Victorian Government for the SCRUB project. CRM serves on the National COVID-19 Health Research Advisory Committee that provides guidance to the Federal Government’s COVID-19 response. She currently receives funding from the National Health and Medical Research Council and Medical Research Futures Fund, Office of Health Protection, Department of Health, Sanofi and from the Defence Intelligence Organisation. All authors have nothing to declare.

Improved Across the Board Access to SARS-CoV-2 Laboratory Testing in an Integrated Medical System; the Veteran Affairs Medical Center (VAMC) Experience

Introduction/ObjectiveDue to the spread of SARS-CoV-2 – the causative pathogen behind COVID-19, a significant impact on society including significant death, morbidity, strain on the nation’s medical systems, and an economic shutdown of many sectors has come to pass. While society has been affected by this virus, it has also been documented in the mainstream news that this pandemic has disproportionately affected non-white minority groups, and that access to testing for vulnerable populations have been limited. Similarly, previously published epidemiological data by Zuvekas et al. show that populations with health insurance, higher socioeconomic class, and white in race have received significantly better access to private health care resources. As veterans represent a vulnerable population, as part of quality assurance, testing data was reviewed to verify that this trend was not also affecting the VAMC.MethodsAs part of a quality assurance/quality improvement project, a retrospective manual review of all SARS-CoV- 2 RT-PCR tests performed at the VAMC from March 11th, 2020 to April 13th, 2020. These tests were reviewed within the computerized medical record system to determine the age, gender, and ethnicity of the patients. The demographic data from this search was compared with the population statistics of the major metropolitan city that the VAMC is located in.ResultsOut of 571 patients who were tested for SARS-CoV-2, 264 (46%) had an ethnic African-Americans background, 135 (24%) had an ethnic Caucasian or white background, 8 had an ethnic Hispanic background, 3 had an ethnic native Hawaiian or other Pacific Islander background, 2 had an ethnic Asian background (0.4%), and 1 had an ethnic American Indian or Alaskan Native background. The rest had left ethnicity unanswered or was unknown/declined to state. The majority of those tested were males (392 or 69%). Ages of patients tested ranged from 24 to 98 years of age. The ethnic distribution of those tested was like the ethnic distribution within the city where the VAMC was located.ConclusionQuality healthcare to the entire population also means that healthcare should be accessible to all members who require it. The VAMC offers broad access for testing to all its patients of all ethnicities. This demonstrates, in the changing healthcare landscape, one of the many advantages of the Veteran Affairs system.

Air quality assessment among populous sites of major metropolitan cities in India during COVID-19 pandemic confinement.

The present study aims to determine the impact of COVID-19 pandemic confinement on air quality among populous sites of four major metropolitan cities in India (Delhi, Mumbai, Kolkata, and Chennai) from January 1, 2020 to May 31, 2020 by analyzing particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ammonia (NH3), sulfur dioxide (SO2), carbon monoxide (CO), and ozone levels. The most prominent pollutant concerning air quality index (AQI) was determined by Pearson’s correlation analysis and unpaired Welch’s two-sample t test was carried out to measure the statistically significant reduction in average AQI for all the four sites. AQI significantly plummeted by 44%, 59%, 59%, and 6% in ITO-Delhi, Worli-Mumbai, Jadavpur-Kolkata, and Manali Village-Chennai respectively. The findings conclude a significant improvement in air quality with respect to reduction of 49–73%, 17–63%, 30–74%, and 15–58% in the mean concentration of PM2.5, PM10, NH3, and SO2 respectively during the confinement for the studied locations. The p values for all of the four studied locations were found significantly less than the 5% level of significance for Welch’s t test analysis. In addition, reduced AQI values were highly correlated with prominent pollutants (PM2.5 and PM10) during Pearson’s correlation analysis. These positive results due to pandemic imprisonment might aid to alter the current policies and strategies of pollution control for a safe and sustainable environment. Graphical abstract

Managing EMS systems with user abandonment in emerging economies

In many emerging economies, callers may abandon ambulance requests due to a combination of operational (small fleet size), infrastructural (long travel times) and behavioral factors (low trust in the ambulance system). As a result, ambulance capacity, which is already scarce, is wasted in serving calls that are likely to be abandoned later. In this article, we investigate the design of an ambulance system in the presence of abandonment behavior, using a two-step approach. First, because the callers’ actual willingness to wait for ambulances is censored, we adopt a Maximum Likelihood Estimator estimation approach suitable for interval censored data. Second, we employ a simulation-based optimization approach to explicitly incorporate customers’ willingness to wait in: (i) tactical short-term decisions such as modification of dispatch policies and ambulance allocations at existing base locations; and (ii) strategic long-term network design decisions of increasing fleet size and re-designing base locations. We calibrate our models using data from a major metropolitan city in India where historically 81.3% of calls were successfully served without being abandoned. We find that modifying dispatch policies or reallocating ambulances provide relatively small gains in successfully served calls (around 1%). By contrast, increasing fleet size and network re-design can more significantly increase the fraction of successfully served calls with the latter being particularly more effective. Redesigning bases with the current fleet size is equivalent to increasing the fleet size by 8.6% at current base locations. Similarly, adding 29% more ambulances and redesigning the base locations is equivalent to doubling the fleet size at the current base locations and adding 34% more ambulances and redesigning base locations is equivalent to a three-fold increase. Our results indicate that in the absence of changes in behavioral factors, significant investment is required to modify operational factors by increasing fleet size, and to modify infrastructural factors by redesigning base locations.

Nexus between willingness to pay for renewable energy sources: evidence from Turkey

The willingness to pay (WTP) plays a central role in directing appropriate policy regarding ambitious renewable energy targets. Based on this discrepancy, this study intends to investigate the willingness to pay (WTP) for Turkish citizens regarding green electricity by using a one-way analysis of variance (one-way ANOVA). The interviews were conducted comprising 2500 households in 12 major metropolitan cities of Turkey, which is based on the contingent valuation method and consists of 26 questions. The results indicate that for a 20% share of renewable energy, middle-income groups are willing to pay higher than lower and upper-income groups. Moreover, highly environmentally conscious people tend to pay more for a 20% share of green energy. On the other hand, high-income groups and old age groups indicated a positive and high willingness to pay for a 30% share of renewable energy (RE) sources. In addition, primary school and undergraduate educational groups recorded highly significant results for willingness to pay. The results also indicate that Turkish citizens are willing to pay 9.25 Turkish liras (TL) per month for a 20% share and 4.77 Turkish liras per month for a 30% share of renewable energy in total energy production.

Middle-Aged People’s Lifestyles and Preferred Characteristics of a Welfare House for the Aged

The purposes of this study are to investigate the differences in the preferred characteristics of a welfare house for the aged according to the lifestyle types of the middle class middle-aged. The preferred characteristics of the residential environment for a welfare house for the aged are categorized into preferred physical characteristics, preferred service & program characteristics, preferred management characteristics. This study conducted an online web-survey targeting the middle class middle-aged in 40-59 as potential consumers of welfare housing for the elderly, residing in the capital area, and six major metropolitan cities, during October, 2019. The data was collected from total 308 subjects, and the data analysis was conducted with the use of factor analysis, cluster analysis, Chi-square test (χ<SUP>2</SUP>), and one-way ANOVA. This study has conclusions as follows; 1) The middle-aged middle class preferred store, sauna, physiotherapy clinic, and trail among common-use spaces. In the provision of services, it would be needed to provide more various services such as basic emergency management & nursing service, and cleaning & laundry service. Regarding the programs, they preferred the horticulture, vegetable gardening, swimming, and learning musical instruments. 2) Lifestyles were classified into ‘Fashion·creativity-type’, ‘Achievement·creativity-type’, ‘Passive-type’ and ‘Leader-type’. In the preferred characteristics of welfare house for the aged in accordance with the types of lifestyle. Overall, the ‘Fashion·creativity-type’ preferred such leisure space and program compared to other groups while the ‘Leader-type’ relatively less preferred such leisure space and program than other groups.

Exploring the lived experience of older Chinese “Shidu” parents who lost their only child: A phenomenology study

The purpose of this study was to explore lived experiences of older “Shidu” parents in China. A qualitative phenomenology study using Colaizzi’s method was employed in a major metropolitan city in China. 8 individuals from 5 families participated in this study. Participants were parents who had lost their only child. 3 participants were male and 5 were female. Four major themes emerged from the data: (1) “Shidu” means excessive grief, and facing spiritual dilemma; (2) “Shidu” often results in withdrawal from society, and social disorder to some extent; (3) Irrational perception on “Shidu” will cause more harmful feelings, like self-blame, guilt, low self-worth; and (4) “Shidu” means loss of support, and worrying about how to manage life after the death of their only child. The findings revealed that the older “Shidu” parents felt a strong desire to express their need for psychosocial support and understanding. These findings are related to the traditional Chinese culture that a child is the center of the family.

Hypothermia-related Deaths: A 10-year Retrospective Study of Two Major Metropolitan Cities in the United States.

Hypothermia-related deaths affect vulnerable populations and are preventable. They account for the vast majority of weather-related deaths in the United States. The postmortem diagnosis of hypothermia can be challenging, as there are no pathognomonic signs. The electronic databases of the New York City Office of Chief Medical Examiner and Harris County Institute of Forensic Sciences were searched for all fatalities where the primary cause of death included hypothermia, between January 2009 and July 2019. There were 139 hypothermia deaths in New York City (NYC) with an average annualized rate of 1.7 per million. During this same time, there were 50 hypothermia deaths in Houston with an average annualized rate of 2.4 per million. Males were more likely to die of hypothermia compared to females in both cities. The rate ratio (RR) in NYC was 3.55 (95% CI 2.40, 5.25), while the RR in Houston was 2.83 (95% CI 1.50, 5.32). Age- and sex-specific standardized hypothermia mortality rates were 18.2 (95% CI 15.1, 21.2) per million in NYC and 30.1 (95% CI 21.7, 38.6) per million in Houston. The comparative hypothermia death ratio was 1.66 (95% CI 1.19, 2.30), indicating hypothermia mortality in Houston was 66% higher than in NYC. There was no correlation between zip code poverty rates and hypothermia-related deaths. The most consistent autopsy finding was Wischnewski spots (56.6%), and ethanol was the most common toxicological finding (36.5%). Local agencies can use this data to target these higher-risk populations and offer appropriate interventions to try to prevent these deaths.

Adoption of Exclusive and Pooled TNC Services in Singapore and the US

On-demand mobility services provided by transport network companies (TNCs) have experienced significant growth in their adoption and diversification of services in major metropolitan cities around the world. This study analyzed primary data from Singapore to explore the sociodemographics of TNC users and determine who among TNC users is more likely to pool their trips and what modes these services are replacing. We compared these results with a comprehensive literature review of similar studies of TNC users in the metropolitan US. We found that the sociodemographics of TNC users in general are similar in Singapore and the US: younger, highly educated, and higher income individuals are more likely to have used TNC services. On the other hand, when differentiating by type of TNC service, we found that younger individuals from households that do not own a car are more likely to have pooled in Singapore, whereas employment is an important predictor in the US. We also found differences in mode substitution; whereas TNC trips in the US primarily induce additional trips or replace trips by public and non-motorized transport, in Singapore they primarily replace personal/private vehicle trips. In Singapore, we explored mode substitution by exclusive and pooled TNC services separately, and found that pooled trips draw more from public and nonmotorized transport, whereas exclusive trips replace more personal/private vehicle trips. These results suggest that people in Singapore view exclusive and pooled TNC services as distinct travel options that may be more closely related to other private or public transport, respectively. Differences between Singapore and the US highlight the importance of accounting for local context and suggest that the quality of all travel alternatives in the urban area will affect the mode substitution of TNC trips.

Market(ing) Wisdom Differences between Family and Non-Family Firms: An Empirical Study on Small and Medium Enterprises

In today’s competitive business environment, family and non-family small and medium enterprises (SMEs) strive to survive despite many challenges. Market knowledge and marketing efforts are crucial for them to sustain and enhance business with limited resources. In this paper, we examined three constructs (i) market orientation, (ii) marketing capabilities and (iii) marketing practices impact on the SMEs’ service sector performance. The interaction effect of ownership type (family and non-family firms) was also observed in the model. Data was collected from 240 SMEs in three major metropolitan cities. This study found positive relationships of each construct (market orientation, (ii) marketing capabilities and (iii) marketing practices) on firm performance as hypothesised. The interaction effect of ownership type i.e. family and non-family, evident on marketing capabilities and SMEs’ performance. Non-family businesses are open for adopting new ideas and personnel into decision making. Family firms should be more adaptable to compete with non-family firms. The managerial and theoretical implications discussed in family and non-family firms’ perspective.

G3 and G9 Rotavirus genotypes in waste water circulation from two major metropolitan cities of Pakistan

Rotavirus A (RVA) is a diarrheal pathogen affecting children under age five, particularly in developing and underdeveloped regions of the world due to malnutrition, poor healthcare and hygienic conditions. Water and food contamination are found to be major sources of diarrheal outbreaks. Pakistan is one of the countries with high RVA related diarrhea burden but with insufficient surveillance system. The aim of this study was to gauge the RVA contamination of major open sewerage collecting streams and household water supplies in two major metropolitan cities of Pakistan. Three concentration methods were compared using RNA purity and concentration as parameters, and detection efficiency of the selected method was estimated. Water samples were collected from 21 sites in Islamabad and Rawalpindi in two phases during the year 2014–2015. Meteorological conditions were recorded for each sampling day and site from Pakistan Meteorological Department (PMD). Nested PCR was used to detect the presence of RVA in samples targeting the VP7 gene. Logistic regression was applied to assess the association of weather conditions with RVA persistence in water bodies. Statistical analysis hinted at a temporal and seasonal pattern of RVA detection in water. Phylogenetic analysis of selected isolates showed a close association of environmental strains with clinical RVA isolates from hospitalized children with acute diarrhea during the same period. This is the first scientific report cataloging the circulating RVA strains in environmental samples from the region. The study highlights the hazards of releasing untreated sewerage containing potentially infectious viral particles into collecting streams, which could become a reservoir of multiple pathogens and a risk to exposed communities. Moreover, routine testing of these water bodies can present an effective surveillance system of circulating viral strains in the population.

Assessing total factor productivity growth of the passenger-bus transit systems in Indian metropolitan cities using the sequential Malmquist-Luenberger productivity index approach

ABSTRACT This article examines the patterns of total factor productivity (TFP) growth in eight state-owned passenger bus companies operating in major metropolitan cities of India. A state-of-the-art and innovative sequential Malmquist-Luenberger productivity index (SMLPI) approach is applied to compute unbiased estimates of TFP growth and its decomposed components. The empirical results based on the panel data set for the period 2011–2016 suggest that technical inefficiency is a common characteristic of bus companies providing passenger services in metropolitan cities. The analysis of TFP growth at the aggregate level reveals that the public bus transit system placed in Indian metropolitan cities experiences mild productivity regress, which is entirely attributable to efficiency loss. The disaggregated analysis provides that only four bus companies experience productivity gains throughout the sample period. Pune Mahamandal appears to be the most innovative bus company.

Pancreatic cancer: Do disparities in mortality rates exist with respect to socioeconomic status?

e19007 Background: Pancreatic cancer continues to have one of the highest mortality rates among major cancer diagnoses with rates greater than 90 percent for all stages and with five year survival rates below 10 percent. With access to treatment modalities such as chemo-radiation, staged surgical interventions and targeted therapies, survival times have increased but due to the costs of these procedures, they may not be accessible to all members of society. Recent studies have shown that lower socioeconomic status is associated with higher mortality rates and lower survival times. With this study we aim to investigate if disparities exist among socioeconomic classes, based on zip code location, in a major multi-ethnic metropolitan city using census data. Methods: Malignant neoplasm mortality data at the ZIP code level was gathered from the New York City Department of Health Vital Statistics Mortality Data from years 2009-2011. NYC population data was gathered from the U.S. Census Bureau 2010 decennial census. We used ordinary least squares regression to assess the independent association between neighborhood median income and neighborhood mortality from malignant neoplasms arising from the pancreas. Results: In 2009-2011, 2,527 deaths from malignant neoplasms arising from the pancreas were recorded across NYC. There is no statistically significant correlation between neighborhood median income and age-adjusted mortality from malignant neoplasms arising from the pancreas for males and for females. For males, there was an R-squared of 0.001721 ( P-value &gt; 0.05). For females, there was an adjusted adjusted R-squared of 9.818e-05 ( P-value &gt; 0.05). Conclusions: Neighborhood median income is not associated with an increase in mortality rate with respect to neoplasms arising from the pancreas.

Experimental investigation on EGR technique and performance evaluation of diesel engine using diesel blend cotton seed oil as renewable fuel

Rising fossil-fuel prices and associated environmental pollution with their use have resulted in increased global interest in biodiesel production and use. The quest for bio-fuels has therefore been boosted throughout the world to protect the global environment and substitute bio-diesel fossil fuels. The objective is to evaluate the seed oil of cotton to be used as an alternative fuel. Cottonseed oil has diesel-like fuel properties. Cottonseed oil is mixed with diesel in different proportions viz 10%, 20%, 30%, 40% and tested in a single-cylinder diesel engine with exhaust gas recirculation. Bio-diesel is produced from cottonseed oil through a chemical process called transesterification. The country will face two major challenges in the next millennium, namely the energy crisis and the degradation of the environment. The day's weeping need is to have power, which means gas, more oil, and cheaper fuels in simple terms. The ever-increasing spending on imports of fuel oil is causing people's economic instability, price rises, and misery. In addition, grooving use of automobiles in our major metropolitan cities causes rapid degradation of the air environment due to vehicle exhaust pollution. There has been a growing demand for petroleum fuels over the past few years, the least petroleum fuels are stored fuel, extracted from the earth. With the petroleum fuels currently known and their increasing demand for consumption, it is feared that they will not last long. The performance and emission characteristics are calculated in this experimental with exhaust gas recirculation. It is investigated the viability and suitability of bio-diesel as an alternative diesel engine fuel with exhaust gas re-circulator. By comparison, the performance characteristics appear to be improved with the use of cottonseed oil for brake power, total fuel consumption, specific fuel consumption, and thermal efficiency, and NO and NOx are reduced.

Differences between pharmacists' perception of counseling and practice in the era of prescription drug misuse.

Objective:This study was conducted to assess pharmacists’ practices when counseling patients on their prescription medications, and their preferences for training.Methods:Five focus group discussions of community pharmacists (n=45, with seven to eleven participants in each group) were conducted in a major metropolitan city in the southern United States. Participants were recruited via email using a list of community pharmacists provided by the Texas State Board of Pharmacy. All focus group discussions were structured using a moderator guide consisting of both discrete and open-ended questions. Qualitative analysis software was used to analyze the data with a thematic analysis approach.Results:The participants in this study had a high self-efficacy regarding their ability to counsel on both new and opioid prescriptions. Many pharmacists experienced the same barriers to counseling and agreed on the components of counseling. However, the themes that emerged showed that the participants exhibited only a partial understanding of the components of counseling. The themes that emerged in the thematic analysis were perceived confidence and discordant counseling practices, inadequate infrastructure, lack of comprehensive counseling, inconsistent use of the Prescription Drug Monitoring Program (PDMP), and pharmacists’ desired training/assistance.Conclusions:Community pharmacists are in a unique position to help combat the opioid crisis; however, there has been very little research on the pharmacist-patient interaction in this context. With policy changes, such as the PDMP mandate, going into effect across the country, it is important to capitalize on the potential community pharmacists have in ameliorating the opioid crisis in the United States.

문화적 차이가 지각된 위험과 브랜드 충성도 관계에 미치는 영향: 집단주의와 위험회피의 조절효과를 중심으로

The objective of the paper is to identify effects of cultural differences between Korean and American consumers on the relationship between perceived risk and brand loyalty. Specifically we aim to analyze moderating effects of collectivism vs individualism and high vs low uncertainty avoidance tendency. We collected samples of college students from Seoul in Korea and from major metropolitan cities in USA. The results of empirical analysis show that a negative relationship between perceived risk and brand loyalty is found across different cultural groups. However, the negative relationship is found more strongly among consumers with collectivistic rather than individualistic tendency. And so among consumers with low uncertainty avoidance than those with high uncertainty avoidance. Thus, we can conclude that cultural differences moderate the relationship between consumer’s perceived risk and brand loyalty.