Tel Aviv Research Articles

Holy(day) land: wellness, healing and relaxation in Mandatory Palestine

ABSTRACT Leisure, wellness and recreation – new trends in Western countries in the nineteenth century – migrated to Palestine and took root during the British Mandate period. Where the land’s visitors had once come for the holy sites, local agents now took advantage of the land’s nature, climate, and views to attract a new type of tourism. Wellness tourism developed in various locations, initiated by both local authorities and private companies. Three case studies illustrate the diversity of the emerging culture: beach life, as demonstrated in the evolution of Tel Aviv’s shoreline; healing waters, such as Tiberias’s hot springs industry; and wellness resorts established on kibbutzim. Each exploited its own natural resources and demographic to draw in a new type of tourist, inspired by the success of similar tourism in Europe.

Utilizing Artificial Intelligence for Predicting Postoperative Complications in Breast Reduction Surgery: A Comprehensive Retrospective Analysis of Predictive Features and Outcomes.

Breast reduction is a common procedure with growing rates in the USA, aimed at alleviating the physical and psychological burdens of macromastia. Despite high success rates, it carries a risk of complications, with incidence rates ranging from 6.2% to 43%. The authors developed a machine learning model using gradient-boosting decision trees to predict severe breast reduction complications up to 30 days following surgery requiring inpatient care. This retrospective study included 322 cases of breast reduction surgery performed at the Tel Aviv Medical Center from 2017 to 2024. Model performance was evaluated using 5-fold cross-validation, and key metrics such as area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity were reported. An interpretability tool was also created to visualize complication risks based on clinical features. Severe complications occurred in 7.4% of cases. Key predictive factors included specimen weight, SN-N distance, and liposuction volume. The model achieved an AUC-ROC of 0.83, with an accuracy of 0.93, negative predictive value of 0.95. The interpretability tool clearly visualized complication risks, aiding preoperative counseling. This is the first study to use AI to predict severe complications in breast reduction surgery. Our AI model, with an AUC-ROC of 0.83 and NPV of 0.95, offers a reliable tool for surgical planning and patient education. Further validation across diverse populations is recommended to confirm its clinical utility.

The personal and the national: Lessons learned in the aftermath of the October 7 attacks in Israel.

On October 7, 2023, terrorist organizations led by Hamas, launched an extensive attack on Israel. Within days following the initial attack, there was a clear need to provide psychological support to individuals who were exposed to the horrors of the October 7 attacks. Tel-Aviv Sourasky Medical Center - Ichilov, a tertiary medical center, launched an emergency mental health service to provide psychological first aid to the first-line victims of the war. As the fighting spread, the services were extended to the entire population. The intervention we provided was guided by an integrated approach that promotes introspection and connectedness to one's environment and community, enhancing cognitive functions, emotional regulation and utilizing available resources to reduce distress. The main themes that emerged shifted between feelings of helplessness and a sense of agency; a breach in basic trust and renewed trust, guilt and self-compassion; anger, abandonment and alienation versus solidarity and connecting to the present and the future, despair versus hope and loss versus acceptance and connectedness. The following account reflects our experiences from the unique cooperation between the Mount Sinai Medical Center in New York and the Tel Aviv Medical Center in Israel starting from the days following the October 7 attacks, as well as lessons learned at the individual and system level discussed in light of previous literature and experience.

The Birth and Life of Buildings: High-Resolution Analysis of Historical Building Trends through the Digitised Municipal Archive of Tel Aviv-Yafo

Inconsistent temporal definitions of key events in a building's lifecycles, and especially of its "birth" date, usually impede a large-scale, high-resolution analysis of building trends and construction fluxes based on municipal building datasets. This study addresses this shortcoming by proposing a reproducible ontological dating formulation of major construction activities during a building's lifecycle using the building permit as the most common, reliable, and consistent indicator of a building's age. We tested this approach by analysing the Tel Aviv-Yafo Municipality's Engineering Administration Archive, which consists of around 5.3 million digitised documents spanning between 1920-2020 and arranged in more than 28,000 building files. We combined permit data with supporting taxation and construction completion documents to automatically extract the date of "birth" or major reconstruction of each of the dataset buildings. The resulting dataset enabled us to generate detailed diachronic maps of urban growth at the resolution of an individual building. Despite challenges such as data discrepancies and archival gaps, this analytical method highlights the value of working directly with raw administrative metadata to uncover valuable insights into historical transformations in the built environment. It also demonstrates the utility of building permits as critical indicators of economic and architectural activities. By applying this approach to urban-scale building datasets, it is possible to predict building ages with reasonable accuracy and, thus, to enhance the understanding of urban growth and transformation dynamics.

Data solutionism at work: When public institutions meet data-driven firms

In recent years, public institutions have turned to data-driven firms for solutions to the many complex operational challenges they face. This study explores the growing ties between public institutions and data-driven firms by focusing on the case of the Tel Aviv Municipality and a (data-driven) startup accelerator it established in the city. Based on semi-structured interviews with the Municipality staff and with representatives of the data-driven firms in the accelerator, I present a grounded framework that outlines the characteristics of the resulting collaboration and describes the mechanisms that facilitate and contain the dynamic thereof. The framework contributes to existing research on tech companies’ involvement in public organizations by suggesting two analytical dimensions, which I term orientation and action. On both, I note various tensions, which are bound to be endemic to collaborations between a public institution and a data firm, and which account for two main motivations behind the Municipality’s actions vis-a-vis its partner data-driven firms, driven by both market imperatives and its overarching aim to benefit the public.

The Middle East remains in a State of military-political Turbulence

The article analyzes the crisis situation in the Middle East that has developed by the end of 2024. The author believes that the main destabilizing factors in the situation in this region are the unresolved Palestinian problem and the intervention of external forces in the Israeli-Palestinian confl ict. A special feature of the new outbreak of violence in the Gaza Strip, southern Lebanon and, in general, the region was the active participation in the war with Israel of non-state actors in the person of radical Islamist groups: Hamas, Islamic Jihad (banned in Russia), Hezbollah, Ansar Allah and the like. Tehran views these groups as an "axis of resistance" to Israel and provides them with fi nancial, material and military assistance. Washington, in turn, is increasing military assistance to Israel. A signifi cant event in the Middle East was the overthrow of the Bashar al-Assad regime in Syria and, as a result, a change in the entire confi guration of military and political forces in the region. Against the backdrop of Iran's weakening position in the Arab East, the positions of Turkey and the Persian Gulf monarchies have noticeably strengthened there. The United States and Israel indirectly benefi ted from the change of power in Damascus. The author considers several scenarios and options for further developments in the Middle East. In his opinion, much will depend on the ability of the Israeli authorities to peacefully resolve the Palestinian problem and on the level of confrontation between the two regional powers: Iran and Israel. The direct exchanges of missile and bomb strikes and drone strikes between these countries that took place in 2024 may continue in 2025, and massive strikes by the Israeli Air Force, with US support, on nuclear, missile and other strategically important Iranian facilities are not excluded. At the same time, information about the creation of nuclear weapons in Iran may become a "red line" for Tel Aviv and Washington. The author believes that the task of the world community and, above all, the UN structures, is to prevent such a development of events, which is fraught with a nuclear catastrophe.

Prevalence of Breast Cancer-Related Lymphedema in Israeli Women Following Axillary Procedures

Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer treatment, leading to physical and psychological morbidity. While widely studied globally, the prevalence and risk factors for BCRL in Israeli patients remain unexplored. This study’s objectives were to determine the prevalence of BCRL in Israeli women treated for breast cancer, validate the Hebrew-translated Norman Questionnaire (NQ) for BCRL screening, and identify risk factors associated with the condition. Methods: A single-center study was conducted at Tel Aviv Sourasky Medical Center, including 181 patients who underwent unilateral axillary lymph node interventions between 2015 and 2018. Participants completed the Hebrew-translated NQ, which was validated through clinical evaluation and circumference-based volume measurements in a subset of 20 patients. Prevalence rates and risk factors were analyzed using multivariate modeling. Results: The prevalence of BCRL was 20%, with rates varying by procedure: 8.9% for sentinel lymph node biopsy, 19.6% for lymph node sampling, and 37.5% for axillary lymph node dissection (ALND). Of the 35 patients with BCRL, only 14% had been previously diagnosed. Risk factors included ALND (OR = 97.31), a higher lymph node excision count (OR = 0.81), and referral to physiotherapy (OR = 133.50). The Hebrew NQ demonstrated strong validity (rs = 0.852; p < 0.001). Conclusions: This is the first study to estimate BCRL prevalence in Israeli women, highlighting underdiagnosis and the need for improved early detection. The Hebrew NQ is a reliable screening tool, enabling timely referral and intervention. Early diagnosis is crucial for optimizing treatment outcomes and improving the quality of life of BCRL patients.

P0223 In Vitro Fertilization in Women with Inflammatory Bowel Disease – Clinical Characteristics and Outcomes

Abstract Background Inflammatory Bowel Disease (IBD) most commonly affects women of reproductive age. While considered effective, there are limited data concerning IBD and pregnancy-related outcomes in patients receiving in vitro fertilization (IVF). This study compares the characteristics and outcomes of pregnant women with IBD who conceived spontaneously with those who required IVF. Methods This retrospective study included pregnant women with IBD who visited the IBD Mom Clinic at the Tel Aviv Sourasky Medical Center (TLVMC). The cohort consists of two groups - women who conceived spontaneously (IBD-spon) or through IVF therapy (IBD-IVF). Demographics, clinical characteristics, as well as pregnancy and IBD-related outcomes were collected from electronic medical records. Results A total of 269 IBD pregnancies from September 2017 to December 2023 were reviewed; 53 women (19.7%) conceived via IVF. Among the IBD-IVF group, there was a lower rate of Crohn’s disease (54.7% vs 67%, P=0.02), similar rate of ulcerative colitis (35.8% vs 31%, p=0.347) and lower rate of patients with pouch (9.4% vs 1.9%, p=0.005). Disease duration was longer in IBD-IVF (10.5 ± 6.9 vs. 8.3 ± 6.0 years, p<0.05) and the IBD-IVF group was significantly older (mean 34.5 ± 5.4 years vs. 31.6 ± 4.4 years, p<0.001) and independently associated with a 10% increase in IVF conception likelihood per additional year of age (OR=1.10, p<0.001). Patients with CD who received IVF had higher rates of peri-anal involvement compared to those who conceived spontaneously (37.9% vs. 19.5% p<0.05). Table 1 summarizes these findings. First-trimester fecal calprotectin levels were elevated in the IBD-IVF group (684.1 ± 1003.5 vs. 373.8 ± 529.6 μg/g, p<0.001). Despite that, no significant differences in IBD exacerbations, advanced therapy adjustments, or hospitalizations were observed. Adverse pregnancy outcomes were more frequent in the IBD-IVF group. These includes lower mean fetal weight (2999.7 ± 493 vs. 3185.6 ± 524.6 g, p=0.05), spontaneous abortions (9.4% vs. 1.9%, p=0.03), and pregnancy losses before 20 weeks (7.5% vs. 1.5%, p=0.03), as detailed in Table 2. Conclusion In this study, significantly higher rates of adverse pregnancy outcomes were observed in patients conceiving through IVF. Older age was independently associated with IVF conception. No increased adverse IBD-related outcomes were observed. These data suggest that the complications in the IVF group, are more related to underlying maternal risk factors and emphasize the importance of close monitoring and follow-up in this population.

Oral health disparities in early childhood and intergenerational gaps among noncitizen migrants, Arabs, and Jews in South Tel Aviv, Israel

IntroductionDisparities in oral health are related to dental care knowledge, domestic oral hygiene practices and socioeconomic status. This cross-sectional study aimed to compare the oral hygiene and dental care practices of migrant, Arab, and Jewish children residing in Tel Aviv, Israel, and assess the influence of parental dental practices.MethodsData were collected from parents of children aged 3 to 6 years. Parents completed their own and their children’s oral health status, oral hygiene practices, dietary habits and dental care knowledge.ResultsOf the 504 children, 153 (30.4%) were migrants, 117 (23.2%) were Arabs, and 234 (46.4%) were Jews. Twice-daily tooth brushing was reported by 57.5% of migrant children, 47% of Arab children, and 63.7% of Jewish children (p = 0.001). Compared with Arab and Jewish children, migrant children had higher rates of tooth filling and urgent dental interventions under general anesthesia (22.9%, 11.1%, and 9%, respectively; p < 0.001). The parent‒child association for twice-daily tooth brushing was strong overall (69.8%), particularly among migrants (70.9%) and Jews (72.3%), but weaker among Arabs (63.0%), p < 0.01.ConclusionMigrant children exhibited better tooth brushing habits than Arab children did but required more urgent dental interventions, highlighting gaps in preventive care. The strong parent‒child link in oral hygiene, particularly among migrants and Jews, suggests that culturally sensitive, family-focused interventions could help reduce these disparities and improve dental health outcomes for underserved populations.

The mindful use of psychiatric medication: Report from the Tel Aviv Psychoactive Clinic Project and a proposed model for psychiatric care

AbstractBackground and aimsThe recent resurgence of psychedelic research has led to increased interest in extra-pharmacological factors shaping drug effects (set and setting). Habitually discussed in the context of psychedelic therapy, the relevance of set and setting to determining the outcome of non-psychedelic psychiatric interventions receives strong theoretical and empirical support in the literature. Unfortunately, there has been little research on the subject. The current study addresses this lacuna and investigates the potential of using non-pharmacological interventions to improve the outcomes of psychiatric care including safety, satisfaction, efficacy, and non-habituation.Methods110 participants (patients prescribed with psychiatric medication) took part in workshops focused on 1) Relaxation (Anxiolytics) 2) [n = 70] Focus (Stimulant ADHD Medication) [n = 40]. Workshops included a) an educational section designed to increase participants' understanding of their medical conditions and prescribed medications b) an experiential section that included the guided, mindful ingestion of the prescribed drug in a supportive setting including reinforcing cues and the practice of non-pharmacological techniques for coping with underlying medical conditions.ResultsSurvey questionnaires (n = 33) indicated a significant improvement in participants' understanding of their medical conditions and the properties of their prescribed medication. Semi-structured interviews demonstrated a strong interest in the idea of mindful use of medication, benefit from the communal setting of ingestion, as well as recurring themes of greater satisfaction with- and improved ability to derive benefit from the use of prescribed drug.ConclusionsThe results of this pilot study demonstrate the impressive potential of providing patients with extra-pharmacological tools to improve the outcomes of prescription drug use and supports the need for further study.

Does trading mechanism shape cross-market integration? Evidence from stocks and corporate bonds on the Tel Aviv Stock Exchange

Does trading mechanism shape cross-market integration? Evidence from stocks and corporate bonds on the Tel Aviv Stock Exchange

CHARTING NEW PATHS: LGBTQIA+ GERIATRICS FELLOWSHIPS

Abstract Background As the global population aged 65 and older continues to grow, so does the number of individuals identifying as LGBTQIA+. Despite this increase LGBTQIA+ health content are often overlooked in medical education, leading to significant disparities in care. Recognizing this gap, the American Geriatrics Society emphasized addressing LGBTQIA+ health disparities as early as 2015. Methods Our pilot program, a collaboration between the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai in New York and the Tel Aviv Medical Center (TAMC), is designed to address disparities in LGBTQIA+ healthcare. As part of this initiative, a geriatric resident from TAMC completed a four-month observership at Mount Sinai, receiving specialized training tailored to LGBTQIA+ healthcare for older adults. The hands-on curriculum allowed the resident to shadow various services, including geriatric and palliative care, rehabilitation, and specialized clinics such as the Institute for Advanced Medicine and the Center for Transgender Medicine. In addition, the resident engaged in one-on-one educational sessions focused on LGBTQIA+ care. Results The outcomes of this pilot program include the creation of a tailored and replicable curriculum for geriatric residency that can be applied to other programs, scholarly peer-reviewed publications, sustainable collaborations, partnerships with advocacy organizations, and the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic. Conclusions Pilot programs like ours hold significant promise for advancing LGBTQIA+ health education and improve the quality of care for older LGBTQIA+ adults, as evidenced by the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic.

Attention to Israel’s war on Gaza and stock price behavior: evidence from the Tel Aviv market

PurposePublic interest in global events has become a robust driver of investor behavior and market dynamics. This paper assesses the potential influence of attention to the 2023 Israel–Palestine war on the Tel Aviv stock market performance. Our investigation includes both the aggregate market and major sectors.Design/methodology/approachLeveraging the Google Trends service, we track search interest for a rich list of 20 terms closely linked to the ongoing conflict. Subsequently, we employ principal component analysis to construct a proxy indicator for war-related attention. To examine the potential influence of this attention on stock price returns and volatility, we adopt an EGARCH-X(p, q) framework, incorporating proxy factors to mitigate potential model under-specification issues.FindingsThe results suggest that increased attention to Israel’s invasion of Gaza is associated with negative returns and heightened volatility across most sectors. Additionally, the finance and technology sectors appear to be the most vulnerable, whereas the industrials and real estate sectors show comparatively lower levels of impact.Practical implicationsGiven the observed negative effects of public attention to geopolitical conflicts on stock price dynamics, investors should consider incorporating geopolitical risk assessments into their investment strategies. Understanding how the Israel–Palestine conflict affects market behavior can help investors and fund managers make more informed decisions, including diversifying their asset portfolios to reduce risk or adjusting their positions in sectors most susceptible to such events.Originality/valueTo our best knowledge, this paper presents the first attempt to leverage the ongoing Israel–Palestine war as a compelling example to assess how public awareness of, and reactions to, interstate conflicts impinge on financial market returns and volatility.

The Restaurant Meal Delivery Problem with Ghost Kitchens

Restaurant meal delivery has been rapidly growing in the last few years. The main operational challenges are the temporally and spatially dispersed stochastic demand that arrives from customers all over town as well as the customers’ expectation of timely and fresh delivery. To overcome these challenges, a new business concept emerged: ghost kitchens. This concept proposes synchronized food preparation of several restaurants in a central facility. Ghost kitchens can bring several advantages, such as fresher food because of the synchronization of food preparation and delivery and less delay because of the consolidated delivery of orders. Exploiting these advantages requires effective operational strategies for the dynamic scheduling of food preparation and delivery. The goal of this paper is providing these strategies and investigating the value of ghost kitchens. We model the problem as a sequential decision process. For the complex decision space of scheduling order preparations, consolidating orders to trips, and scheduling trip departures, we propose a large neighborhood search (LNS) procedure based on partial decisions and driven by analytical properties. Within the LNS, decisions are evaluated via a value function approximation, enabling anticipatory and real-time decision making. In a comprehensive computational study, we demonstrate the effectiveness of our method compared with benchmark policies and highlight the advantages of ghost kitchens compared with conventional meal delivery. Funding: G. Neria’s research is partially supported by the Israeli Smart Transportation Research Center, the Council for Higher Education in Israel, and the Shlomo Shmeltzer Institute for Smart Transportation at Tel Aviv University. F. D. Hildebrandt’s research is funded by the Deutsche Forschungsgemeinschaft (DFG) German Research Foundation [Grant 413322447]. M. Tzur’s research is partially supported by the Israeli Smart Transportation Research Center. M. W. Ulmer’s work is funded by the DFG Emmy Noether Programme [Grant 444657906]. We gratefully acknowledge their support. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2024.0510 .

MEDIA RESPONSE TO IRAN'S ATTACK ON ISRAEL IN TEL AVIV: AN ANALYSIS OF WESTERN, MIDDLE EASTERN, AND INDONESIAN MEDIA TEXTS

ABSTRACTThis study aims to analyze media texts against the Iranian attack on Israel in Tel Aviv, using a discourse analysis approach that focuses on how texts are constructed and meaning is produced. In the context of the conflict involving Iran and Israel, the media plays an important role in shaping public opinion and narratives about the events. Through the media text analysis approach, the focus is on media responses from the West, the Middle East, and Indonesia. By examining the choice of words, the narratives used, as well as the emphasis in media coverage, we can understand how these stories are presented and interpreted in different regional and cultural contexts. In addition, this research will also explore how the discourse affects the public understanding of the conflict in the Middle East and influences government policies and public attitudes towards the event. The findings of this study are expected to provide insight into the role of the media in shaping social and political reality, as well as highlight the importance of criticism of narratives dominated by certain interests.Keywords: Iran Attack, Israel, Tel Aviv, Media Response

The Israel‐Hamas War One Year Later: Mass Violence and Palestinian Dispossession

AbstractThis essay analyzes the Israeli offensive in the Gaza Strip as it has unfolded in the year since Hamas's October 7, 2023, attacks. It first details the death and destruction Tel Aviv has wrought over that period, the predictions for mass casualties to come, and the state‐sanctioned violence and theft faced by Palestinians not just in Gaza but across the occupied territories and Israel. It then examines why Washington's support of Tel Aviv has remained steadfast despite domestic and international condemnation, arguing that President Joe Biden's Zionist ideology has played a decisive role. The article further shows that Israel's interest in the territorial dispossession of Palestinians under the cover of war has led its right‐wing government to thwart efforts at a ceasefire that would return the hostages still held by Hamas. The analysis concludes with a reflection on the antiwar protests that continue to roil US campuses as Donald Trump returns to power.

A Bibliometric Analysis of the 100 Top-Cited Articles on Vertical Root Fractures.

The aim of this study was to perform a meticulous analysis and bibliometric evaluation of the top 100 most cited articles in vertical root fractures (VRFs).The bibliometric research method included 100 top-cited articles on VRFs retrieved from the Web of Science database. The key terms "vertical root fracture" OR "vertical root fractures" were used to retrieve the required dataset. The salient bibliometric indicators were analyzed. Microsoft Excel version 16 (Microsoft Corporation, Redmond, WA), VOSviewer (v.1.6.10, Centre for Science and Technology Studies, Leiden University, The Netherlands), and the SPSS Statistics version 20software (IBM Corp., Armonk, NY) were used for data analysis. The top 100 cited articles on VRFs were published between 1977 and 2022, and these articles were cited with an average of 69 citations. A slight rise (27%) in top-cited articles on VRFs was shown in the first half (1977-1999), but a substantial increase(73%) was recorded in the second half (2000-2022). The Journal of Endodontics published around half of the articles (n = 47). The United States contributed the most cited articles, followed by Brazil and Israel, whereas The Netherlands produced the most influential articles. The top-ranked author (Avaid Tames) and the university (Tel Aviv University) belonged to Israel. The most often occurring keywords were also analyzed to identify potential research subjects.There has been a notable increase in the number of highly cited publications (n = 52) about VRFs within the past 13 years (2010-2022). The United States stands out among the top countries due to its dominant overall research output. In the fields of endodontics, oral surgery, and restorative dentistry, this information would be helpful to researchers, practitioners, and academics.

The Feeling of Safety by Pedestrians at Night: An Overlooked Aspect of Climate Change?

As the climate becomes more extreme and heat waves become more prevalent, the effects of climate change spill over into previously unnoticed areas. One such prominent result of global warming is the adverse effect of outdoor weather on pedestrians at night. To investigate this rather overlooked effect, we carried out a large-scale field study in 232 different locations in three different cities in Israel–Tel Aviv-Yafo (106 locations), Haifa (49 locations), and Beersheba (77 locations). The study, involving 30,216 observations on the feeling/s of safety (FoS) performed by 491 participants, started in August 2019 and lasted almost one year. As the study reveals, people feel safer, with all other factors being constant, when the temperature is moderate and humidity is high. According to the study findings, if temperature increases from 25 °C to 30 °C, illumination should be increased by ~20 lx to maintain the same level of FoS. However, if the temperature drops, less illumination can be supplied, which makes a case for smart illumination policies. As providing sufficient FoS is important for an active life outdoors, this study generates knowledge that can help support active and secure mobility in urban areas and beyond. As temperatures rise and humidity patterns change, our findings may have broad implications for urban areas worldwide, both in Israel and beyond.

Outcomes of ED chest pain visits: the prognostic value of negative but measurable high-sensitivity cardiac troponin (hs-cTn) levels.

Chest pain is a common condition in the emergency department (ED). High-sensitivity cardiac troponin (hs-cTn) assays are crucial for diagnosing acute coronary syndrome, but the implications of "negative but measurable" hs-cTn levels are not well understood. This study assesses the outcomes of patients with acute chest pain discharged from the ED based on their hs-cTn levels. This retrospective cohort study analyzed medical records of patients aged 18 and older presenting with chest pain to the Tel Aviv Sourasky Medical Center ED from 2017 to 2022. We compared patients with negative but measurable hs-cTn levels (3-50 ng/L) to those with very low hs-cTn levels (< 3 ng/L). Primary outcomes included 90- days coronary angiogram (CAG), and secondary outcomes were 7- days ED revisits, 14-days hospital admissions, and 30- days mortality. Of 32,162 eligible patients, 23,297 had hs-cTn levels ≤ 50 ng/L. Patients with negative but measurable hs-cTn levels had higher rates of 90-days CAG (1.8% vs. 0.5%, p < 0.001), 7-day ED revisits (5.2% vs. 3.3%, p < 0.001), 14-day hospital admissions (3.1% vs. 0.9%, p < 0.001), and 30-day mortality (0.3% vs. 0.01%, p < 0.001) compared to those with very low hs-cTn levels. Independent predictors for 90 days CAG included age ≥ 57 years, male sex, and hs-cTn ≥ 3.5 ng/L. Negative but measurable hs-cTn levels are linked to worse outcomes than very low hs-cTn levels in discharged ED patients. Closer follow-up and further cardiac evaluation may be warranted for these patients.

Prioritising Street Shade Intensification to Support Pedestrian Accessibility to Public Transport

This article presents a new methodology for urban-scale prioritisation of shade-inducing operations by quantifying the gap between the use intensity of public transport stops and the solar exposure of the streets leading to them. By cross-referencing a high-resolution dataset of travel ticket validation with shade maps quantifying the average street shade provision, we were able to calculate a new metric, the Shading Priority Index, which quantifies the relative importance of adding street shading in each statistical zone. The method was applied to Tel Aviv-Yafo, a major city in Israel. The calculation of the Shading Priority Index at the scale of a statistical zone in the city made it possible to expose significant differences between each zone, both in passenger quantities and outdoor shading conditions in the routes leading to transportation stops, and to identify key weak points in the climate-related accessibility of pedestrians to public transport.