A GIS-Based Multi-Criterion Decision-Making Method to Select City Fire Brigade: A Case Study of Wuhan, China

Rapid urban expansion has brought new challenges to firefighting, with the speed of firefighting rescue being crucial for the safety of property and life. Thus, fire prevention and rescuing people in distress have become more challenging for city managers and emergency responders. Unfortunately, existing research does not consider the negative effects of the current spatial distribution of fire-risk areas, land cover, location, and traffic congestion. To address these shortcomings, we use multiple methods (including geographic information system, multi-criterion decision-making, and location–allocation (L-A)) and multi-source geospatial data (including land cover, point-of-interest, drive time, and statistical yearbooks) to identify suitable areas for fire brigades. We propose a method for identifying potential fire-risk areas and to select suitable fire brigade zones. In this method, we first remove exclusion criteria to identify spatially undeveloped zones and use kernel density methods to evaluate the various fire-risk zones. Next, we use analytic hierarchy processes (AHPs) to comprehensively evaluate the undeveloped areas according to the location, orography, and potential fire-risk zones. In addition, based on the multi-time traffic situation, the average traffic speed during rush hour of each road is calculated, a traffic network model is established, and the travel time is calculated. Finally, the L-A model and network analysis are used to map the spatial coverage of the fire brigades, which is optimized by combining various objectives, such as the coverage rate of high-fire-risk zones, the coverage rate of building construction, and the maintenance of a sub-five-minute drive time between the proposed fire brigade and the demand point. The result shows that the top 50% of fire-risk zones in the central part of Wuhan are mainly concentrated to the west of the Yangtze River. Good overall rescue coverage is obtained with existing fire brigades, but the fire brigades in the north, south, southwest, and eastern areas of the study area lack rescue capabilities. The optimized results show that, to cover the high-fire-risk zones and building constructions, nine fire brigades should be added to increase the service coverage rate from 93.28% to 99.01%. The proposed method combines the viewpoint of big data, which provides new ideas and technical methods for the fire brigade site-selection model.

Disparity in Access to Oncology Precision Care: A Geospatial Analysis of Driving Distances to Genetic Counselors in the U.S.

In the US, the growing demand for precision medicine, particularly in oncology, continues to put pressure on the availability of genetic counselors to meet that demand. This is especially true in certain geographic locations due to the uneven distribution of genetic counselors throughout the US. To assess these disparities, access to genetic counselors of all specialties is explored by geography, cancer type, and social determinants of health. Geospatial technology was used to combine and analyze genetic counselor locations and cancer incidence at the county level across the US, with a particular focus on tumors associated with BRCA mutations including ovarian, pancreatic, prostate and breast. Access distributions were quantified, and associations with region, cancer type, and socioeconomic variables were investigated using correlational tests. Nationally, in 2020, there were 4,813 genetic counselors, or 1.49 genetic counselors per 100,000 people, varying between 0.17 to 5.7 per 100,000 at the state level. Seventy-one percent of U.S. residents live within a 30-minute drive-time to a genetic counselor. Drive-times, however, are not equally distributed across the country – while 82% of people in metropolitan areas are 30 minutes from a genetic counselor, only 6% of people in nonmetro areas live within 30 minutes’ drive time. There are statistically significant differences in access across geographical regions, socioeconomics and cancer types. Access to genetic counselors for cancer patients differs across groups, including regional, socioeconomic, and cancer type. These findings highlight areas of the country that may benefit from increased genetic counseling provider supply, by increasing the number of genetic counselors in a region or by expanding the use of telegenetics a term used to describe virtual genetic counseling consults that occur via videoconference. Policy intervention to allow genetic counselors to bill for their services may be an effective route for increasing availability of genetic counselors’ services However, genetic counselors in direct patient care settings also face other challenges such as salary, job satisfaction, job recognition, overwork/burnout, and appropriate administrative/clinical support, and addressing these issues should also be considered along with policy support. These results could support targeted policy reform and alternative service models to increase access to identified pockets of unmet need, such as telemedicine. Data and analysis are available to the public through an interactive dashboard1.

Telehealth to increase access to transplant survivorship care for allogeneic stem cell transplant recipients regardless of distance to transplant center or neighborhood income.

e13615 Background: Transplant Survivorship Clinic at our institution serves to improve outcomes and overall health of allogeneic transplant survivors. The COVID19 pandemic allowed for growth of telemedicine in our program. We examine the patterns of use of telehealth and hypothesize that the use of telemedicine allowed continued access to care compared to the era prior to availability. We compared our transplant survivorship clinic data from July- December 2020, when telehealth was well established and compared to July-December 2019. Methods: All patients seen by the survivorship team for end of treatment visits, graft versus host disease assessments and survivorship visits annually between July-December 2019 and July-December 2020 were included. Their zip codes were used to get direct distance to survivorship clinic, average drive time, driving distance and average household income as in zip-codes.com database. Results: Total number of office visits in July-Dec 2019 was 163 visits (0% via telehealth) and in July-Dec 2020 was 228 (66.2% via telehealth). All encounters (telehealth and office visits) were lower in July and August 2020 compared to July and August 2019 but higher in months of September -December 2020 compared to 2019. Comparing all encounters during 7/2019-12/2019 to 7/2020-12/2020, there was no statistically significant difference in median age (58yr vs 60 yr), gender (males: 58% vs 59%), race (non-white: 11% vs 8.7%), median years from transplant (4yr vs 3 yrs), median income of patient neighborhood ($63,735 vs $60,465) and average drive time to center from zip code (40 min vs 51min). Comparison of patients who chose telehealth vs. office visit is summarized in table. While there was no statistically significant difference in age when comparing all encounters in 2019 and 2020, those who chose telehealth were younger (55yrs vs 60yrs, p=0.003). Conclusions: There were higher patient encounters in the 2020 period compared to 2019. Most of these 2020 encounters were via were telehealth, demonstrating the role of telehealth in increasing access. Younger patients appeared to choose telehealth, but telehealth served patients up to the age of 77 yrs. Utilization of telehealth appeared to be irrespective of demographics such as gender, neighborhood income and driving distance to the center. Comparison of telehealth vs office visit for July-December 2019 and 2020.[Table: see text]

A gene drive does not spread easily in populations of the honey bee parasite Varroa destructor

Varroa mites (Varroa destructor) are the most significant threat to beekeeping worldwide. They are directly or indirectly responsible for millions of colony losses each year. Beekeepers are somewhat able to control Varroa populations through the use of physical and chemical treatments. However, these methods range in effectiveness, can harm honey bees, can be physically demanding on the beekeeper, and do not always provide complete protection from Varroa. More importantly, in some populations Varroa mites have developed resistance to available acaricides. Overcoming the Varroa mite problem will require novel and targeted treatment options. Here, we explore the potential of gene drive technology to control Varroa. We show that spreading a neutral gene drive in Varroa is possible but requires specific colony-level management practices to overcome the challenges of both inbreeding and haplodiploidy. Furthermore, continued treatment with acaricides is necessary to give a gene drive time to fix in the Varroa population. Unfortunately, a gene drive that impacts female or male fertility does not spread in Varroa. Therefore, we suggest that the most promising way forward is to use a gene drive which carries a toxin precursor or removes acaricide resistance alleles.

Atlantic equatorial deep jets in Argo float data

<p>Equatorial deep jets (EDJ) are strong zonal currents in the deep tropical oceans that alternate in direction with depth and<br>time. In the Atlantic below the thermocline, they are the dominant variability on interannual timescales. They propagate<br>energy upwards and are suggested to impact surface climate variables on interannual timescales. They are also<br>important for the distribution of tracer in the mid-depth tropical ocean, for example by enhanced oxygen ventilation of<br>the eastern deep oxygen minimum zones, both through advection by the EDJ themselves and because the EDJ<br>nonlinearly drive time mean flow. Observations of equatorial deep jets are available but scarce, given the EDJs’ location<br>at depth and their long periodicity of several years. In the last few years, Argo floats have added a significant amount of<br>measurements at intermediate depth. We therefore perfomed a new EDJ scale analysis based on Argo float<br>measurements, the results of which we show here. At 1000 m depth, very weak or no EDJ signals can be detected in the<br>Indian and Pacific Oceans. In the Atlantic, however, the EDJ signal is strong at 1000 m depth, allowing us to obtain<br>good estimates of their frequency, amplitude, phase, zonal wavelength, and meridional structure.</p>

Racial Segregation, Testing Site Access, and COVID-19 Incidence Rate in Massachusetts, USA

The U.S. has merely 4% of the world population, but contains 25% of the world’s COVID-19 cases. Since the COVID-19 outbreak in the U.S., Massachusetts has been leading other states in the total number of COVID-19 cases. Racial residential segregation is a fundamental cause of racial disparities in health. Moreover, disparities of access to health care have a large impact on COVID-19 cases. Thus, this study estimates racial segregation and disparities in testing site access and employs economic, demographic, and transportation variables at the city/town level in Massachusetts. Spatial regression models are applied to evaluate the relationships between COVID-19 incidence rate and related variables. This is the first study to apply spatial analysis methods across neighborhoods in the U.S. to examine the COVID-19 incidence rate. The findings are: (1) Residential segregations of Hispanic and Non-Hispanic Black/African Americans have a significantly positive association with COVID-19 incidence rate, indicating the higher susceptibility of COVID-19 infections among minority groups. (2) Non-Hispanic Black/African Americans have the shortest drive time to testing sites, followed by Hispanic, Non-Hispanic Asians, and Non-Hispanic Whites. The drive time to testing sites is significantly negatively associated with the COVID-19 incidence rate, implying the importance of the accessibility of testing sites by all populations. (3) Poverty rate and road density are significant explanatory variables. Importantly, overcrowding represented by more than one person per room is a significant variable found to be positively associated with COVID-19 incidence rate, suggesting the effectiveness of social distancing for reducing infection. (4) Different from the findings of previous studies, the elderly population rate is not statistically significantly correlated with the incidence rate because the elderly population in Massachusetts is less distributed in the hotspot regions of COVID-19 infections. The findings in this study provide useful insights for policymakers to propose new strategies to contain the COVID-19 transmissions in Massachusetts.

Change biases identify the features that drive time perception

[This paper has not been peer reviewed. Please do not copy or cite without author's permission.] Time perception is malleable, and the perceived duration of stimuli can be strongly affected by the sensory response they evoke. Such ‘temporal illusions’ provide a window on how different sensory systems contribute to our sense of time. Evidence suggests that the sensory response to different features affects time perception to different extents, mediated by the level of arousal or surprise that they evoke. This, however, makes it difficult to disentangle effects of the sensory response itself from the derived arousal or surprise effects. Here, we demonstrate that time perception is differentially affected by different stimulus features when arousal and surprise are kept constant. In four temporal discrimination experiments, participants judged the duration of an interval marked by two briefly presented visual markers. Markers either repeated or changed along one of six feature dimensions, in a manner fully predictable to participants. Repetitions and changes would modulate sensory response magnitudes due to neural repetition suppression. Results showed that intervals were perceived as longer when markers changed in location, size or numerosity. Conversely, changes in face identity, orientation or luminance did not affect time perception. These results point to neural and functional selectivity in the way different stimulus features affect time perception.

Does inpatient health services utilization vary by remoteness in the medical financial assistance population? Evidence from Shaanxi province, China

Background Medical Financial Assistance (MFA) provides health insurance and financial support for millions of low income and disabled Chinese people, yet there has been little systematic analysis focused on this vulnerable population. This study aims to advance our understanding of MFA recipients’ access to health care and whether their inpatient care use varies by remoteness. Methods Data were collected from the Surveillance System of Civil Affairs of Shaanxi province in 2016. To better proxy remoteness (geographic access), drive time from the respondent’s village to the nearest county-level or city-level hospital was obtained by a web crawler. Multilevel models were used to explore the impacts of remoteness on inpatient services utilization by MFA recipients. Furthermore, the potential moderating role of hospital grade (i.e. the grade of medical institution where recipient’s latest inpatient care services were taken in the previous year) on the relationship between geographic access and inpatient care use was explored. Results The analytical sample consisted of 9516 inpatient claims within 73 counties of Shaanxi province in 2016. We find that drive time to the nearest hospital and hospital grade are salient predictors of inpatient care use and there is a significant moderation effect of hospital grade. Compared to those with shortest drive time to the nearest hospital, longer drive time is associated with a longer inpatient stay but fewer admissions and lower annual total and out-of-pocket (OOP) inpatient costs. In addition, these associations are lower when recipients are admitted to a tertiary hospital, for annual total and OOP inpatient expenditures, but higher for length of the most recent inpatient stay no matter what medical treatments are taken in secondary or tertiary hospitals for the most remote recipients. Conclusion Our results suggest that remoteness has a significant and negative association with the frequency of inpatient care use. These findings advance our understanding of inpatient care use of the extremely poor and provide meaningful insights for further MFA program development as well as pro-poor health strategies.