Major Urban Centers Research Articles

Abstract Number ‐ 207: Modeling Optimal Patient Transport in a Stroke Network Capable of Remote Telerobotic Endovascular Therapy

Introduction Endovascular therapy (EVT) is the standard‐of‐care for large vessel occlusion stroke; however, timely access to treatment is still limited for a large proportion of the population. Telerobotic EVT has the potential to decrease time to treatment and expand existing networks of care to more rural populations. It is currently unclear how its implementation would impact existing stroke networks. Methods Conditional probability models were generated to predict the probability of excellent outcome (modified Rankin Scale 0–1 at 90 days post stroke) for patients with suspected large vessel occlusion (LVO). A baseline stroke network was created for California using existing intravenous thrombolysis (IVT) centers and comprehensive stroke centers (CSCs) capable of IVT and EVT. Optimal transport decisions and catchment areas were generated for the baseline model and three hypothetical scenarios through conversion of IVT centers at various distances from a CSC into centers capable of Telerobotic EVT [i.e. hospitals ≥ 15 and < 50 miles from a CSC were converted (Scenario 1), ≥ 50 and < 100 miles (Scenario 2), and ≥ 100 miles (Scenario 3)]. Catchment areas were calculated for each scenario using varied robotic procedural delay times and success rates. Results In the baseline model, 51 hospitals were designated as CSCs and 142 hospitals were designated IVT centers. Conversion of IVT centers into Telerobotic EVT centers decreased median travel time for LVO patients in all three scenarios. The estimated number of robotically treated LVOs per year in Scenarios 1, 2, and 3 were 2172, 740, and 212, respectively. Scenario 1 (15‐50 miles) was the most sensitive to robotic time delay and success rate, but all three scenarios were more sensitive to decreases in procedural success rate compared to time delay. Conclusions Telerobotic EVT has the potential to improve care for stroke patients outside of major urban centers. Compared to procedural time delays in robotic EVT, a decrease in procedural success rate would not be well tolerated. This modeling analysis can inform system planning for the potential advent of remote EVT care.

Exploring spatiotemporal pattern and agglomeration of road CO2 emissions in Guangdong, China

Road transport is a prominent source of carbon emissions. However, fine-grained regional estimations on road carbon dioxide (CO2) emissions are still lacking. This study estimates road CO2 emissions in Guangdong Province, China, at high spatiotemporal resolution, with a bottom-up framework leveraging massive vehicle trajectory data. We unveil the spatiotemporal pattern of regional road CO2 emissions and highlight the contrasts among cities. The Greater Bay Area (GBA) is found to produce 76 % of the total emissions, wherein Guangzhou emits the most while Shenzhen has the highest emission intensity. Emission agglomeration is still an under-explored field, which we advance in this paper. We propose Quantile-based Hierarchical DBSCAN (QH-DBSCAN) to explore road CO2 emission agglomeration in GBA. Our method is the first one to identify the specific location and scope of emission hotspots. Emission hotspots exhibit significant concentration on major urban centers. Considering emission characteristics from multiple perspectives, we derive six emission categories, including four emission zones and two emission connectors. The density-based property of our method results in spatially contiguous regions with similar emission patterns. Accordingly, we divide policy zones and propose targeted strategies for road carbon reduction. The study provides new technologies and insights to achieve regional sustainable development.

English

The fruit juice production sector is growing rapidly in Benin's major urban centers and appears to have enormous hygienic insufficiencies. This study aimed to identify and evaluate the microbiological quality of the different fruit juices produced in southern Benin. The methodological approach to the first objective consisted of a semi-structured survey coupled with direct observations of fifty enterprises produced fruit juices in the Municipalities of Cotonou and Abomey-Calavi. The microbiological quality evaluation of pineapple juice (Ananas cosmosus) consisted in the enumeration of microorganisms that alter both hygienic and market ability qualities of foodstuffs, using standard methods. This study revealed a strong diversity of fruit juices. There are thirteen (13) different mono-fruity juices, fifteen (15) poly-fruity juices with pineapple and nine (09) poly-fruity juices without pineapple. The pineapple mono-fruity juice is produced by almost all the enterprises (98%). Poly-fruity juices with pineapple are the most popular among consumers. From the microbiological point of view, a strong variation of the microbial load was noticed from one enterprise to another. With the exception of a few enterprises, about 18% of pineapple juices are microbiologically non-compliant. These pineapple juices contain mycotoxigenic yeasts and moulds, lactic acid bacteria, thermotolerant coliforms and Staphylococcus aureus. The consumption of these poor sanitary quality juices poses a real public health problem, as it exposes consumers to the severe food poisoning risks.   Key words: Fruit juice, diversity, pineapple, Ananas cosmosus, microbiological quality, non-compliance.

The geoarchaeological investigation on the defunctionalisation of an Assyrian canals system reveals Late-Holocene land use transitions in Northern Mesopotamia

During the Assyrian rule over Northern Mesopotamia (present-day northern Iraq), complex systems of canals were built to increase the surface of cultivable land and improve the movement of people and goods across the irrigated waterscape of the hinterland of Nineveh and other major urban centres, with the aim of granting socio-economic prosperity to the empire. Nevertheless, supra-regional political instability eventually led to the rapid downfall of the Assyrian state during the late seventh century BCE, causing the swift abandonment of the canal systems. In this study, we examine the post-abandonment formation processes of the natural and anthropogenic infillings of three portions of King Sennacherib’s Khinis canal system (705–681 BCE, northwestern Kurdistan Region of Iraq) through means of archaeological, sedimentological and micromorphological analyses. We identify water lain sediments, desiccation features, colluvial gravel intake and pastoral occupation layers, anchoring the deposit to radiometric dating and contextualising it against the known regional climatic history. The interpretation of pedostratigraphic evidence highlights subsequent phases of use, abandonment, and repurposing of the canals, reflecting shifts in land-use from agriculture to pastoralism and dynamic adaptation and resilience of the local ancient communities in response to Late-Holocene climate changes and geopolitical events.

Consumer buying behavior towards online meat and meat products : In tier-I cities of India

Online meat and meat products shopping has become more popular now-a-days. People are willing to spend time and energy on purchasing fresh meat through e-commerce. Most of the existing e-retailers offer their services in metros and major urban centers targeting the urban population.The survey was conducted in Bengaluru city. A representative sample of 120 consumers purchasing meat as well as meat products through online retail outlets like Licious, Zappfresh, Tendercuts, Fipola, Freshmeat, Bigbasket, Amazon, Grofers etc.In comparison to other meat items, chicken meat (broiler/country bird) is chosen by 51.66 per cent of consumers. Eggs account for 41.70 per cent of daily consumer consumption, followed by other meat items. The monthly family consumption of meat and meat products is 43.33 per cent, with 3-5 kg consumed each month. Consumers’ reasons for preferring meat and meat goods on e-commerce websites suggest that 36.70% of the sample consumers prefer buying meat and meat products online due to a wider choice. Customers’ attraction to e-commerce when purchasing meat and meat goods finds that 17.50% of consumers were most drawn to buy online meat and meat products due to ease of use. Consumers who preferred to buy meat and meat products revealed that 51.70 per cent preferred butcher shops, while 32.50 per cent preferred online platform. Consumer preferences for fresh meat and meat products found that 42.50 per cent of sample consumers.

Concurrence dans la distribution au détail de combustibles liquides: Exploration de la dimension spatiale

Ce travail vise à étudier le niveau de concurrence spatiale entre les stations-services existant sur le marché de distribution au détail des combustibles liquides, à partir de l'analyse comparée de leur positionnement géospatial et de leur influence et variations de prix sur le marché national. Dans le cas du Chili, l'industrie se caractérise par sa forte concentration en nombre de fournisseurs et intégration verticale avec les segments de distribution de gros, transport et stockage, d'où l'importance de l'analyse en matière de concurrence. De plus, il existe une grande différenciation des produits en termes de localisation géographique, ce qui rend l'analyse spatiale essentielle. Ainsi, nous avons analysé en premier lieu l'impact du nombre de stations proches, du même réseau, et d'un réseau rival ou indépendants. Les résultats sont configurés selon deux approches. La première conclut que los résultats numériques sont consistants dans la dynamique des prix et le positionnement territorial des stations, car il apparait que les stations indépendantes ont un effet négatif sur le niveau de prix dans un rayon de 20 minutes, avec un réseau-action moyen de 0,19%. De même, on note un impact supérieur sur la distribution d'essence de 93 octanes et le Diesel que de l'essence de 97 octanes, car les segments de Diesel et 93 octanes sont les plus compétitifs de l'industrie, et dans le contexte où les stations indépendantes participent le plus. Dans la deuxième, les résultats montrent le rôle dominant de l'entreprise Copec : ce réseau est celui de plus grande influence négative sur le niveau des prix de ses rivales. Comme dans le premier modèle, les résultats varient par type de combustible, le rôle des réseaux d'essence de 97 octanes étant le plus important. Les résultats sont hétérogènes au niveau régional, plus élevés dans les zones géographiques densément peuplées par rapport aux zones australes et éloignées des principaux centres urbains.

Prospects for Introducing Medium-Density Row Housing in Jeddah City

Architectural researchers ensure that residential buildings in any area are appropriately planned for the landscape and meet the needs of current and future residents. Row houses are well known in residential sectors of the United States and many European countries, but the data on row housing in Saudi Arabia is very limited. As residential structures, row houses are reasonably priced and architecturally resilient. They also fill the affordable housing gap for middle-class residents – sometimes called the “missing middle” – in major urban centers such as Jeddah. Like other cities of its size, Jeddah has been slow to adopt medium-density residential structures. This research evaluates the Jeddah community’s likelihood of accepting row housing, surveying a cross-section of residents seeking housing options other than the apartments currently available. Our questionnaire investigated variables such as gender, age group awareness, house size, architectural functional features, preferable cost, and other considerations. The data and resulting analysis concluded that more than 90% of the respondents would prefer row houses to current options as their primary housing choice.

The Impact of Urban Sprawl on Carbon Emission in Qingdao-Shandong Province

Qingdao is a city located along the eastern province of Shandong, specifically along the east cost of the Republic of China, establishing the reasons why it is considered as one of the largest metropolitan cities within the province. Urbanization of the city is widely considered as one of the inevitable tendencies driven towards accompanying the process of modernization and industrialization of the human society. This research study sought to examine the Impact of urban sprawl on carbon emission in Qingdao-Shandong Province. According to the findings, urban sprawl is considered as an irreversible global aspect, with some of its fundamental characteristics hedged on the increase of populations in major urban centers, the increased densities and expansion of the spatial sizes of cities, and a rampant changes in the manner in which land and buildings are used; all these managed through the inclusion of planning schemes and strategies. Qingdao-Shandong Province is in this case expected to experience a rise in the demand for travel that will see an increase of over 4.7 million people and trips on a daily basis from the 9.4 million thresholds in 2020.

Breaking policy on land for Ho Chi Minh City: Some implications from the draft of adjustment of law on land

For the important role of a major economic and urban center, Ho Chi Minh City needs a distinguished legal, administrative, and economic institution. The advantage of a breakthrough mechanism for specific urban administrations not only creates resilience for HCMC but also brings positive externalities, pulling socio-economic activities of the region and the whole country, quickly approaching the national development goals, and then contributing to the budget. The efficiency after more than five years of implementing Resolution 54/2017/QH14 is a testament to the choice of policy model. However, the rapid growth of economic activities in Ho Chi Minh City once again poses new requirements as well as the need for a new and more breakthrough in this unique optional policy. More importantly, the drafting of a new draft resolution on a new particular sandbox mechanism for HCMC should aim to effectively solve the administrative bottlenecks that are currently arising. Urban governments especially HCMC need to be empowered to be more proactive, more flexible, and more creative. In most of the content that exists a great need for a breakthrough mechanism, the state management of land plays an important role and therefore should be enlisted to find possible solutions while drafting the revised Law on land, which is also being finalized for submission to the National Assembly. The discussion of the article thus proposes resolutions from the content of the draft Resolution on the specific mechanism for Ho Chi Minh City and the relevant provisions in the mentioned draft of the Law on land adjustment.

Superdiversity and its explanatory limits

Abstract Superdiversity is a key term that has taken hold in macro sociolinguistic commentary over the last decade. It has been used to explore the increasing linguistic diversity, particularly in major urban centres in the West, brought about by changing patterns of migration and transmigration. Within sociolinguistics, this has led to an increasing focus on the complex multilingualism that can now be found in diverse urban contexts. The focus on multilingualism that superdiversity brings is a welcome, albeit belated, recognition of the normalcy of mutilingualism, thus challenging the inherent monolingualism still underpinning much language policy, pedagogy, and practice. However, the rise of superdiversity as a theoretical framework has also led to an increasingly deconstructivist view of languages by its proponents – questioning and/or rejecting distinctions between so called named languages, particularly national languages, while also critiquing standard language registers. In this commentary, I outline the benefits that superdiversity has brought to sociolinguistics over the last decade but also highlight, and critique, its explanatory limits. The latter include, among others, its ahistoricity, its almost exclusive focus on migrants in urban contexts, its dimissal of non-urban, often Indigenous, language contexts, and its rejection of language rights and standard language varieties.

Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway

BackgroundThe verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the present study is to identify individual and contextual barriers and facilitators of access to mental health services during the period preceding an offense leading to a verdict of NCRMD.MethodsThe sample includes 753 people found NCRMD in Québec, Canada. All episodes of mental health hospitalizations and service use before the index offense were identified using provincial administrative health data, for an average period of 4.5 years. Access was conceptualized as a function of the possibility of seeking, reaching and receiving appropriate health care services, based on Lévesque and colleagues patient-centred model of access to care.Generalized linear models were computed to identify the individual and contextual predictors of: (1) seeking mental healthcare (at least one contact with any type of services for mental health reasons); (2) reaching psychiatric care (at least one contact with a psychiatrist); (3) receiving psychiatric care, operationalized as (3a) continuity and (3b) intensity. Factors associated with volume of emergency mental health services were examined as exploratory analysis.ResultsGeographical considerations were highly important in determining who reached, and who received specialized mental health care – above and beyond individual factors related to need. Those who lived outside of major urban centres were 2.6 times as likely to reach psychiatric services as those who lived in major urban centres, and made greater use of emergency mental health services by 2.1 times. Living with family decreased the odds of seeking mental healthcare by half and the intensity of psychiatric care received, even when adjusting for level of need.ConclusionsFindings support efforts to engage with the family of service users and highlights the importance of providing resources to make family-centred services sustainable for health practitioners. Health policies should also focus on the implementation of outreach programs, such as Forensic Assertive Community Treatment teams as part of prevention initiatives.

Modelling the impact of school reopening and contact tracing strategies on Covid-19 dynamics in different epidemiologic settings in Brazil.

We simulate the impact of school reopening during the COVID-19 pandemic in three major urban centers in Brazil to identify the epidemiological indicators and the best timing for the return of in-school activities and the effect of contact tracing as a mitigation measure. Our goal is to offer guidelines for evidence-based policymaking. We implement an extended SEIR model stratified by age and considering contact networks in different settings - school, home, work, and community, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening, and also estimate the number of hospitalization and deaths averted by the implementation of contact tracing. Reopening schools results in a non-linear increase in reported COVID-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects in reducing the total number of hospitalizations and deaths. Policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. While contact tracing strategies prevent new infections within school environments, they alone are not sufficient to avoid significant impacts on community transmission.

Geo-Spatial Dynamics of COVID-19 Pandemic Onset in Davao City

Davao City, a major urban center in the Philippines with its various landforms and population distribution has been affected by COVID-19. This study aimed to identify and locate areas with COVID-19 cases in Davao City, create a location map of COVID-19 cases in Davao City and determine association between number of COVID-19 cases and population density. Data were obtained from the Philippines Statistics Authority, Davao City LGU and, the Department of Health Davao Region. QGIS application was used to generate location maps of COVID-19 cases and Pearson r correlation was the statistical method used. Most of the COVID-19 occurrence are in Poblacion, Talomo, Agdao and Buhangin. areas with high population densities record the high occurrence of COVID-19 cases There is a high correlation between number of COVID-19 infection and population densities for this study. This indicates that dense population may have contributed to the spread of the COVID-19 infection in the city. The occurrence of population densities in Davao City should be addressed to prevent public health threats brought about by infectious diseases such as COVID-19.

Nocoastjazz

Nocoastjazz

Development and pilot test of a physician-focused cancer clinical trials communication training intervention

We describe the development and pilot test of a physician-focused, web-based training module designed to improve physician communication related to clinical trials in a diverse cancer patient population. Researchers and stakeholders developed the training module, which included a video explaining patient-centered communication strategies for discussing trials, and re-enactments of actual clinical interactions. For the pilot test, the module was provided to physician participants in the Partnering Around Cancer Clinical Trials (PACCT) trial at two major urban cancer centers. Questionnaires assessed change in beliefs, behavioral attitudes, knowledge and comfort; and perceptions of the module. Nineteen physicians participated in the pilot test. Most were experienced in discussing trials. Assessments of change were mixed regarding beliefs; they showed marginal improvement in attitudes, and significant improvement in knowledge, but no change in comfort. Feedback on the module was favorable. This stakeholder-developed physician communication training module was acceptable and effective, albeit in this small and highly-experienced physician sample. Future research should determine its effectiveness on communication in clinical settings. This is the first physician training module to focus on communicating about clinical trials in a diverse patient population. It offers a web-based format and re-enactments of naturally-occurring clinical interactions. Trial Registration Number: NCT02906241

The Survival of Ossetians in Turkey

The migration of North Caucasian peoples into Ottoman Anatolia during the early 1860s included some five thousand Muslim Ossetes who settled first in the Sarıkamış district and later moved further west. While today the descendants of these migrants may number as many as 60,000, most now live in the major urban centres of Istanbul and Ankara and have largely become assimilated into modern Turkish society. However, three villages in the Yozgat district east of Ankara, Boyalık, Karabacak and Poyrazli, have remained Ossetian-speaking up to the present day. This paper explores the circumstances though which the Ossetian language has survived in these villages 160 years after the migration, and what prospects exist for the continuation of a distinct Ossetian communal identity in Turkey.

Pandemic mobility, second homes and housing market change in a rural amenity area during COVID-19 – The Brecon Beacons National Park, Wales

The Covid-19 pandemic has been presented as a critical change driver for rural amenity areas, precipitating urban flight and a decentralisation of housing choice and investment. House prices in both near-urban and more distant rural markets saw considerable growth in 2020 and 2021, linked to a mix of second home investment, expanded demand for holiday letting, migration to exploit flexible-working opportunities, and homebuying for early retirement. These demand-side pressures, apparently accentuated by the pandemic, combine with supply-side constraints on development in rural areas (which can accommodate a limited amount of additional housing) to produce significant housing stress. However, processes affecting some areas, in different parts of the world, have arguably been generalised to all areas, and localised processes remain under-investigated. This monograph explores the experience of the Brecon Beacons National Park in Wales, UK – an amenity area with good connectivity to a number of major urban centres and therefore sources of extra-local housing demand. Focusing on second home buying, as a leading element of extra-local pressure in amenity areas, the monograph considers the particular circumstances of this area. It shows that a combination of amplified demand-side factors, linked to the pandemic, and heightened supply-side constraints, due to a phosphate crisis affecting the National Park’s major river catchments, requires a programme of actions that extends beyond the housing domain in order to resolve escalating housing market challenges and associated community and economic risks.

Assessment of Socio-Economic Impacts of Stone Quarrying Activities in Narok Town Ward, Narok North Sub-County

Quarrying is an excavation process involving abstracting materials, which are neither fuel nor minerals in nature from rocks. The ever-increasing development and construction in major urban centres worldwide have necessitated the need for quarries to provide materials for construction. This has led to detrimental environmental and social economic impacts which are usually ignored at the expense of economic pursuit by developers. The study focused on assessing the socioeconomic impacts of stone quarrying in Narok Town Ward, Narok North Sub-County, Kenya. The target population were quarry workers, the residents and government agency officials dealing with environmental management. The study employed a descriptive research design where both quantitative and qualitative techniques were used. Stratified sampling and random sampling techniques were used during the study. Questionnaires, interviews, observations and photography were used to collect data during the survey. Descriptive statistics, percentages, frequencies and correlation were used to analyze data in Microsoft software MS Excel and SPSS. Findings have been presented descriptively, quantitatively and qualitatively. Quarrying activities in Narok Town ward have played an important role in the economic development and infrastructural development, however it has brought about negative social issues such as a change in social fabrics, conflicts, displacement, and health-related issues. The correlation coefficient (r=0.705, P<0.001) show a positive correlation between the severity of dust and respiratory illnesses among the respondents. The respondents strongly agreed that quarrying activities have led to the creation of employment in the area. The study recommends that Stakeholders should put efforts into the mitigation of negative outcomes of quarrying activities that lead to the disruption of livelihoods. Community education and sensitization on environmental and socioeconomic impacts and safety measures should be done to minimize the negative impacts of quarrying activities in the Narok Town ward

Modeling optimal patient transport in a stroke network capable of remote telerobotic endovascular therapy.

Telerobotic endovascular therapy (EVT) has the potential to decrease time to treatment and expand existing networks of care to more rural populations. It is currently unclear how its implementation would impact existing stroke networks. Conditional probability models were generated to predict the probability of excellent outcome for patients with suspected large vessel occlusion (LVO). A baseline stroke network was created for California using existing intravenous thrombolysis (IVT) centers and comprehensive stroke centers (CSCs) capable of IVT and EVT. Optimal transport decisions and catchment areas were generated for the baseline model and three hypothetical scenarios through conversion of IVT centers at various distances from a CSC into centers capable of telerobotic EVT [i.e., hospitals ≥15 and <50 miles from a CSC were converted (Scenario 1), ≥50 and <100 miles (Scenario 2), and ≥100 miles (Scenario 3)]. Procedural times and success rates were varied systematically. Telerobotic EVT centers decreased median travel time for LVO patients in all three scenarios. The estimated number of robotically treated LVOs per year in Scenarios 1, 2, and 3 were 2,172, 740, and 212, respectively. Scenario 1 (15-50 miles) was the most sensitive to robotic time delay and success rate, but all three scenarios were more sensitive to decreases in procedural success rate compared to time delay. Telerobotic EVT has the potential to improve care for stroke patients outside of major urban centers. Compared to procedural time delays in robotic EVT, a decrease in procedural success rate would not be well tolerated.

Abstract 14016: Marked Geographic Variation in Atrial Fibrillation Ablation Rates in a Universal Single Payer Health Care System

Introduction: Atrial fibrillation (AF) ablation is increasingly commonly performed for patients with symptomatic AF. In Canada, AF ablation occurs at specialized electrophysiology centers (“EP centers”), which are clustered in major urban centers. Hypothesis: People with AF who live closer to an EP center are more likely to undergo an AF ablation. Methods: Data was compiled from Ontario Health datasets (e.g. emergency department (ED) visits, hospital discharges, physician billing) and Canadian census data for people presenting to an ED in Ontario, Canada with a new diagnosis of AF between 2007-16. The primary outcome was ablation within one year of the index ED visit. Secondary outcomes include ablation at two years. Multivariate logistic regression was conducted to assess the relationship between distance to EP centers and likelihood of ablation. We also studied ablation frequency in relation to material deprivation (e.g. income, housing quality and education). Geospatial analyses were performed using QGIS. Results: Of the 135,681 people with newly diagnosed AF, 3911 (2.9%) had an ablation within one year of AF diagnosis and 5827 (4.3%) within two. There was a significant inverse relationship between a doubling of distance to the closest EP center and ablation within one year (OR: 0.93, 95% CI: 0.91-0.94), and two years (OR: 0.95, 95% CI: 0.94-0.97). Higher deprivation (measured in standard deviations from the mean) was associated with significantly less ablation at one year (OR: 0.89, 95% CI: 0.85-0.92). There was wide regional variation with relatively low rates near the largest urban center (Figure 1). Conclusions: Living further from an EP center and greater material deprivation are associated with lower AF ablation rates. Ablation rates vary by region, with the highest rates not consistently observed in areas most concentrated with EP centers. Figure 1. Age and sex adjusted AF ablation rates per 100,000 patients within a year of AF diagnosis in Ontario, Canada