Major Urban Centers Research Articles

Pandemic-Resilient Urban Centers: A New Way of Thinking for Industrial-Oriented Urbanization in Ethiopia

In Ethiopia, the flourishing of industrial parks in the suburbs of major urban centers is a recent phenomenon. The outbreak of COVID-19 has had an adverse impact on the emerging industrial parks and prospects of cluster cities. The aim of this article is to explore the different urban planning measures employed during the pandemic and to propose sound planning methods for the development of sustainable industrial-oriented urban centers. In Ethiopia, industrial-oriented urbanization started in the 1920s with the advent of the railway line. Currently, more than 25 industrial park-based cluster cities have flourished adjacent to cities. A number of initiatives have been undertaken by major stakeholders in these cluster cities to combat COVID-19. Their efforts, however, were made difficult because urban planners were not proactive and did not have foresight in the selection of sites that can mitigate the impact of COVID-19 or other similar pandemics. The researchers believe the problem could have been addressed if the planners used a science-based, human-focused, computer-aided decision-making approach, i.e., space syntax. Therefore, this article recommends that planners become proactive and work in collaboration with different stakeholders for the creation of resilient and livable industrial parks-oriented urban centers.

Canadian Public Health Laboratory Network guidelines for the use of point-of-care tests for Treponema pallidum in Canada.

Over the past few years, the increase in infectious syphilis outbreaks in major urban centres and remote or rural locations in Canada, often affecting hard-to-reach patient populations, has renewed an interest and urgency in studying the use of point-of-care tests (POCTs) that can provide test results at the time and place of primary health care delivery, obviating the repeat visit necessary with traditional syphilis serology or molecular diagnostic tests. In 2015, the Canadian Public Health Laboratory Network released its first laboratory guideline for the use of POCTs in the diagnosis of syphilis in Canada. Although Canada has no licensed POCT, two POCTs (Syphilis Health Check and the DPP® HIV Syphilis System) have received US Food and Drug Administration (FDA) approval under premarket approval applications. Most syphilis POCTs detect antibodies to treponemal antigens, so their results cannot be used to differentiate between active and past infection. The only POCT that detects antibodies to both treponemal and non-treponemal antigens does not yet have Health Canada or FDA approval. In this updated guideline, the current landscape of POCTs for syphilis, with an emphasis on data from low-prevalence countries, is described. Individual operators should consider the questions of where, when, how, and why a POCT is used before its actual implementation. Training in the operation and interpretation, quality control, proficiency program, safety, and careful documentation of the process and results are especially important for the successful implementation of POCTs.

60 Running Water While Bathing Is a Risk Factor for Pediatric Scald Burns

IntroductionScalds are the most common mechanism of burn in children, and a significant proportion of these injuries are associated with bathing. Burns sustained while bathing present a unique opportunity for injury prevention; previous studies have examined lowering water heater temperatures, however reputable infant bathing educational resources do not explicitly recommend avoiding running water and the risks that it could pose. In an effort to inform prevention programs, this study seeks to determine the incidence and circumstances of running water in bathing scald burns at our institution.MethodsA retrospective review was performed of records from an American Burn Association verified center over a ten year period (1/1/2010 to 12/31/2019). This center treats both children and adults and is affiliated with an academic hospital in a major urban center. The burn database was queried for scald injuries in children less than three years involving bathing. The Child Advocacy and Protective Services team provides inpatient consultation for all children less than three years old with burn injuries allowing us to analyze the specific events surrounding the bathing scald burns in this cohort.ResultsA total of 123 patients met inclusion criteria. Three bathing safety risk factors were specifically noted in the chart review: (1) running water, (2) lack of caregiver presence for duration of bathing, and (3) failure of caregiver to check water temperature before bathing. Of the cases identified, 107 (87%) had clear documentation of running water as part of the history of injury, 66 (54%) cases involved failure of caregiver to check the water temperature before bathing and 53 (43%) cases did not have a caretaker present for the duration of the bath. In cases with only one risk factor, running water was identified in 34 (94%) out of 36 cases, and in cases with one or two risk factors, running water remained the primary risk factor with 38 (90%) out of 42 cases. When looking at the combination of risk factors, only three (2%) cases had no risk factors while 77 (63%) involved two or more risk factors.ConclusionsThe vast majority of bathing burn injuries in this series involved running water. In addition, a significant number of scald burns occurred from running water alone, even without the other identified risk factors. Conversely, only 2% of scald burns associated with bathing featured none of these three risk factors, suggesting that these injuries could be greatly impacted by safe bathing education.

Confronting Canada’s overdose crisis: what’s the deal with decriminalization?

The current overdose epidemic in Canada has only been exacerbated by the COVID-19 pandemic. Deaths from overdose are increasing, and urgent response and action are needed to save the lives of people who use drugs. The concept of ‘decriminalizing drugs’ is not new, but discourse around it has been increasing recently, with major urban centres calling on the Canadian government to take action. This commentary discusses the meaning of decriminalization, recent progress that has been made in Canada, and its possible implications on the lives of people who use drugs.

COVID-19 Vaccine Acceptance and Hesitancy among Health Care Workers (HCWs) In Two Major Urban Centers in Khyber-Pakhtunkhwa, Pakistan.

COVID-19 Vaccine Acceptance and Hesitancy among Health Care Workers (HCWs) In Two Major Urban Centers in Khyber-Pakhtunkhwa, Pakistan.

Factors predicting incarceration history and incidence amongBlack and Latino men who have sex with men (MSM)residing in a major urban center.

We analyzed data from a cohort of Black and Latino men who have sex with men (MSM) in order to identify correlates of prevalent and incident incarceration, including potential predictors related to their status as sexual and gender minorities (SGMs). Baseline and follow-up self-administered survey data were examined from Los Angeles County participants’ ages 18–45 years at enrollment who were either HIV negative or living with HIV, but recruited to over represent men who used drugs and men with unsuppressed HIV infection. Multivariable logistic regression models were developed to identify predictors of baseline incarceration history and of incident incarceration over study follow-up among 440 and 338 participants, respectively. Older age, Black race, low socioeconomic status, homelessness, stimulant use, and depression symptoms were associated with baseline incarceration history. The only SGM-related factor associated with baseline incarceration history was having experienced violence based on sexual orientation identity. Just one statistically significant, independent positive predictor of incident incarceration was identified: prior incarceration, whereas having four or more friends that could lend money was a statistically significant protective factor against incident incarceration. Fundamental Cause Theory provides a useful framework to explain identified predictors of incarceration. Addressing poverty, housing instability, inadequate access to health care, and their root causes is critical to reducing incarceration rates in this population, as is expanded access to both diversion and anti-recidivism programs and to evidence-based treatment for stimulant use disorders.

How much efficiency improvement can a spatiotemporal window generate for shared mobility? A case study in New York City

The popularity of shared mobility services has increased in recent years. A complete door-to-door mode is typically deployed. However, the efficiency of the underlying resource utilization is limited in this mode. The space window, a recently developed concept, has the potential to optimize the underlying resource utilization. In this article, the impacts of this concept on the performance of shared mobility in major urban centres, e.g. New York City (NYC), is investigated. To this end, a dynamic routing framework with a spatiotemporal window in L1-norm and a dispatching mechanism are introduced. The operation data demonstrates a 15% reduction of the total distance travelled and the number of vehicles needed if passengers walk a few blocks. These results indicate that a spatiotemporal window holds the promise of a more environmentally friendly, energy efficient and intelligently shared mobility platform with alleviated congestion.

Advertising and Profitability; Evidence from Selected SMES in Uyo

Financial constraints, as well as a lack of managerial skills, equipment and technology, regulatory concerns, access to international markets, and unfair competition, are all reasons that impede the development of SMEs. SMEs require advertising strategies to ensure their long-term viability and growth in an ever-changing and competitive business environment. In this study, more attention will be paid to the question and relevance of advertising as a form of promotion to improve profitability. 50 small and medium scale enterprises were selected from Uyo. The survey was carried out in major urban center which is Uyo. This area was chosen because the tempo of economic activities being carried out by SMEs to meet the demands of the consumers is very high. The data used for this study were majorly primary and these were obtained from the field through the use of questionnaire. From the data gotten, Cronbach alpha was then used to test for the validity, consistency as well as the reliability of the data-set. All the constructs or items had Cronbach’s Alpha above the minimum acceptable reliability coefficient between 0.5 to 0.9 and therefore exhibits good internal consistency. Following the results, it is observed that the effect of advertising on profitability of the selected SMEs in Uyo metropolis is positive and significant. From the findings of this study, we conclude that advertising can significantly improve profitability of SMEs in AkwaIbom State.

Microfinance and poverty reduction: Evidence from Djibouti

AbstractDoes access to microfinance improve household welfare? We seek the answer to this question using data on 2,060 borrower and nonborrower households based in six major urban centers of Djibouti. We construct a composite index of multidimensional poverty that captures various aspects of household well‐being, including ownership of agricultural and livestock assets, land, transportation, employment, quality of housing, and sanitation facilities. We carry out estimations using an instrumental variable–based empirical strategy and a number of econometric techniques. Our results show that neither access to microcredit nor its ostensibly productive use is significantly associated with poverty regardless of the duration of time since the loan was acquired. This holds for both access to and the amount of microcredit obtained. The results are robust across specifications and econometric techniques employed. The lack of significant beneficial effect of microfinance found in the study adds to the growing literature questioning the effectiveness of microfinance as a tool for poverty alleviation. The findings raise doubts on the usefulness of Djibouti's microfinance program.

Incidence of non-Hodgkin's lymphoma among adults in Sardinia, Italy.

The causes of the peculiar time trend in the incidence of non-Hodgkin's lymphoma (NHL) in most parts of the world and of its geographic distribution are still unknown. We used the data base of 1974-2003 incident cases of hematological malignancies to explore the time trend of NHL incidence in the region of Sardinia, Italy, and we used Bayesian methods to plot the probability of NHL incidence by residential unit on the regional map. In 1974-2003, 4109 NHL cases were diagnosed among resident adults in Sardinia, with an incidence rate of 13.38 x 10-5 (95% CI 12.97-13.80). NHL incidence showed an upward trend along the study period with an average annual percent change (APC) of 4.94 (95% CI -5.39-16.4), which did not vary by gender or by age-group. Cancer registry data, covering part of the region starting from 1993, suggest that the increasing trend did not persist in the subsequent years. Areas with the highest probability of an excess incidence tended to cluster in the north-eastern part of the region and in two major urban centers, with the low incidence areas located in the south, confirming previous observations. Prevalence of viral infections, environmental and occupational exposures, or socio-economic deprivation would not explain the peculiar geographic distribution we observed. These findings provide convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants of NHL in the risk areas.

Resource Extraction in a Marginal Space: Mining Revival and the Environment in Southern Tuscany and Northern Latium at the Turn of the Fifteenth and Sixteenth Centuries

Abstract At the end of the Middle Ages and at the beginning of Modern Times, the 'Maremma' and the 'Colline Metalliferi' in southern Tuscany experienced intense extractive activity. The minerals and water and forest resources available in the region allowed the production of metals (iron, copper, perhaps silver) and especially sulphates (alum, vitriol) which were massively exported, sometimes as far as Northern Europe. Located on the margins of three powerful states, i.e. the Papal States and the Republics of Florence and Siena, the area was far from major urban centres (Rome, Florence, Siena) but was the subject of sustained attention by urban elites such as the Medici, Spannocchi, Chigi and other families, to the detriment of rural communities. By cross-referencing the documentary sources of rural municipalities and territorial States (deliberations, notarised deeds, private accounts), the article aims to show how this marginal space became in a few decades a major economic and political issue within the peninsula; how it was exploited, thanks to specific structures of production and rural space governance; and finally how this development drove environmental degradation through disturbances in the Maremma river system.

Practice Profiles and Patterns of Ontario Family Medicine Residents 5 Years After Residency Examinations: An Exploratory Study.

The primary goal of family medicine residency training is for graduates to provide high-quality, safe, and effective patient care for the population they serve when they enter practice. This study explores (a) the practice profiles, 5 years into practice, of residents who completed family medicine training in Ontario, Canada; and (b) relationships between performance on the College of Family Physicians of Canada's (CFPC) Certification Examination in Family Medicine and quality of care provided 5 years into practice. We performed a retrospective study with secondary data analysis. We merged CFPC examination data sets with the ICES (Institute for Clinical Evaluative Sciences) administrative database. We included physicians who passed the examination between the years 2000 and 2010 and practiced in Ontario after graduation. Practice profile indicators included practice type, continuity and comprehensiveness of care, patient rostering and panel size, and rurality index. We explored11 indicators related to management of diabetes and cancer screening. We included a total of 1,983 physicians in the analyses. Five years after the examinations, 74.3% of the physicians were working in major urban centers, and 67.3% of the physicians were providing comprehensive primary care. We noted significant differences across the six medical schools in multiple practice profile indicators, and three indicators showed significant differences across the examination score quintiles. Graduates of Ontario family medicine residency programs were providing care to a broad spectrum of the population 5 years after passing the examination, and they performed similarly across quality-of-care indicators regardless of examination scores.

Multiproxy analysis in contaminated sediments from Niterói Harbour (Guanabara Bay), Brazil

Harbours are located in major urban centres around the world and are of great economic importance to the cities in their surroundings. However, the intense traffic of boats and ships can generate environmental impacts that can directly affect the local biota as well as the population that lives in surrounding areas. Therefore, this work aimed to analyse the surface sediment of the Niterói Harbour using chemical, biological and micropalaeontological tools to investigate the environmental condition of this important harbour in Rio de Janeiro State. The pseudototal trace metal data analysed in the surface samples showed values far above those of the greater Guanabara Bay background. These data were corroborated by a high mortality rate of Artemia sp. and elevated presence of the bacterium Vibrio fischeri, indicating a high rate of local pollution. Dinoflagellate cysts also showed a direct response to high values of pseudototal trace metals. The data obtained in this study emphasize a need for greater monitoring of ports since the experience gained through this study in a Brazilian harbour can serve as an example for the management of other harbours located in large urban centres around the world.

Abstract TMP32: Modeling Optimal Patient Transport In A Stroke Network Capable Of Telerobotic Endovascular Therapy

Introduction: Endovascular therapy (EVT) is the standard-of-care for large vessel occlusion stroke; yet, a substantial portion of the population lacks timely access to the treatment. Telerobotics has the potential to expand current stroke networks by offering remote EVT to more rural populations. Methods: We geospatially mapped all existing hospitals in California and then assessed hypothetical scenarios in which primary stroke centers between 50 and 100 miles from an existing EVT center offered remote EVT via robotics. Using an existing conditional probability model, we determined the transport scenarios (drip and ship, direct to robotic EVT center, or direct to conventional EVT center) resulting in best patient outcomes in diverse geographies across the state. Timing and the probability of receiving EVT (used as a surrogate for the probability of receiving successful reperfusion) were varied at robotic centers to assess impact on best predicted transport options. Results: 10 hospitals were converted to robotic EVT centers, resulting in enhanced patient access to timely EVT by routing patients in a rural catchment area of 113,063 km 2 directly to robotic EVT centers (figure). Slowing the door to arterial access time at the robotic centers by 30 minutes had a minor impact on optimized service arrangements (reducing the robotic catchment area to 110,555 km 2 ). However, decreasing the probability of receiving EVT at the robotic centers by 0.10 had a substantial impact, reducing the robotic EVT catchment area to 35,061 km 2 and nearly doubling the drip and ship catchment area. Discussion: Telerobotic EVT has the potential to enhance therapy for stroke patients outside of major urban centers. We found that the reduced probability of receiving EVT had a greater impact on the optimized size of robotic EVT center catchment areas compared to longer door to arterial access times. This modeling analysis can inform system planning for the potential advent of remote robotic EVT care.

Assessing Persistence in Spatial Clustering of Disease, with an Application to Drug Related Deaths in Scottish Neighbourhoods


 Background: The upward trend in drug related deaths in some countries is a major public health concern. Regarding geographic location within countries, many studies report spatial clustering in drug related deaths. We consider drug related deaths in Scottish small areas, and investigate probabilities that clusters of adjacent neighbourhoods have elevated risk. We focus especially on assessing persistence in spatial clustering, relevant to prioritising area based interventions. We assess impacts of area risk factors on drug deaths, finding a strong link to poverty, and a clear overlap between drug death clustering and spatial poverty clustering. 
 Methods: We analyse drug related deaths in 1279 Scotland neighbourhoods over two periods, 2009-13 and 2014- 18, during which drug related mortality in Scotland has more than doubled. A fully Bayesian approach is used to identify zones with high mortality risk in both a neighbourhood and its spatial lag (“high-high” clusters), and extended to identify recurring high risk clustering over more than one period. Estimation of mortality risks, and of cluster probabilities through periods, is developed in conjunction with a regression model including area risk factors such as deprivation. 
 Results: Persistent clustering is concentrated in major urban centres, for example, Glasgow and Dundee. Deprivation is the paramount observed risk factor underlying elevated mortality risk, and persistent clustering in drug related mortality shows strong overlaps with poverty clustering. Social fragmentation modifies the paramount influence of poverty on drug mortality risk. 
 Conclusion: Cluster persistence is a central feature in small area variability in drug related death risk in Scotland intermediate zones, especially in some urban areas. 

Urban Traffic Monitoring and Analysis Using Unmanned Aerial Vehicles (UAVs): A Systematic Literature Review

Unmanned aerial vehicles (UAVs) are gaining considerable interest in transportation engineering in order to monitor and analyze traffic. This systematic review surveys the scientific contributions in the application of UAVs for civil engineering, especially those related to traffic monitoring. Following the PRISMA framework, 34 papers were identified in five scientific databases. First, this paper introduces previous works in this field. In addition, the selected papers were analyzed, and some conclusions were drawn to complement the findings. It can be stated that this is still a field in its infancy and that progress in advanced image processing techniques and technologies used in the construction of UAVs will lead to an explosion in the number of applications, which will result in increased benefits for society, reducing unpleasant situations, such as congestion and collisions in major urban centers of the world.

Epidemiological analysis of cardiac trauma victims at a referral trauma hospital: a 5 year case series.

to describe, analyze, and trace the epidemiological profile for cardiac trauma victims on a referral trauma hospital of a major urban center. a case series study to review, describe, compile and analyze medical records of all patients sustaining traumatic cardiac injuries, from January 2015 to January 2020 admitted to the referral trauma hospital of Curitiba, Brazil. Patients sustaining traumatic heart injuries were identified using the hospitals database. Patients who died prior to reaching hospital care were excluded. all 22 cases were urban victims, mostly penetrating injuries (12 stab wounds, 9 gunshot wounds); 82% were male; mean age, 37.1 years. 17 cases (77%) occurred during night hours, 15 between Friday and Sunday, and 15 were admitted hemodynamically stable. Only 27% were diagnosed with FAST, the remainder requiring other imaging exams. About incisions, 14 had thoracotomies, 6 median sternotomies and in 2 cases both. Of injuries, 8 affected the right ventricle, 3 right atrium, 9 left ventricle, 1 right coronary sulcus and 1 anterior wall. All had cardiorrhaphy repair. 3 patients died, 17 were discharged and 2 were transferred. 17 received postoperative echocardiograms, revealing ejection fractions ranging 55.1% to 75%. Patients spent a mean of 9.6 days on ICU and a mean of 15.2 days of total hospital stay. The mortality rate was 14%. cardiac traumas predominantly occurred in adult males, due to violent causes, during night hours on weekends. The overall mortality rate found (14%), as well as total hospital stay, accords with the literature.

A cross-sectional study depicting prevalence of primary dysmenorrhea in adolescent females of Hyderabad: A major urban center of South India

A cross-sectional study depicting prevalence of primary dysmenorrhea in adolescent females of Hyderabad: A major urban center of South India

Mapping HIV-related services for women in Eastern Canada: A qualitative study.

Background:Geographic health disparities have been well described in parts of Canada; however, little is known about the experiences of women living with HIV in the Maritime Provinces. This article focuses on the complex health system women living with HIV navigate geographically to access care in New Brunswick and Nova Scotia, Canada.Method:This study includes interviews with 10 women living with HIV and 39 community-based workers whose organizations provide services to this group of women in New Brunswick and Nova Scotia. Purposive sampling was used to recruit both women living with HIV and community workers. Interviews were recorded and transcribed into a Microsoft word document. Transcripts were imported into NVivo 11 for thematic analyses and used to map the services women with HIV were accessing in their communities in ArcGIS 10.2 for Windows.Results:The study found that there are a number of barriers women with HIV face in the Maritime Provinces, including the low number of specialist physicians, long travel distances to major urban centers for care, and the loss of HIV-specific supports and resources. In response to these difficulties, community-based organizations are leading efforts in their communities to increase outreach programs and the number of available peer workers to improve the health outcomes of women living with HIV. Furthermore, it showed that women living with HIV and community workers were interested in creating a women-centered HIV care system in the Maritime Provinces, but were uncertain how to move forward with this initiative.Conclusion:There is a need for women-centered HIV services. This study proposes streamlining the healthcare pathway and decreasing obstacles to increase women’s access to care in the Maritime Provinces.

NEW MINTNAME “GEORGIA” (“JURZĀN”): RESEARCHING THE HISTORY OF GEORGIA AND THE ‘ABBĀSID NORTH IN THE 8TH-9TH CENTURIES

NEW MINTNAME “GEORGIA” (“JURZĀN”): RESEARCHING THE HISTORY OF GEORGIA AND THE ‘ABBĀSID NORTH IN THE 8TH-9TH CENTURIES