Effectiveness of rapid rail transit system in Beijing.
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ABSTRACT:
SUBMITTER: Cheng HM
PROVIDER: S-EPMC5509145 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:Transit-oriented development (TOD) is a tool that aids in achieving sustainable urban development. It promotes economic, environmental, and social sustainability by integrating land use and transportation planning. Many researchers have investigated mass rapid transit (MRT) station regions for TOD in developed cities. However, in a developing city such as Dhaka, measuring node-based TOD (TOD index) during MRT construction has been disregarded in planning future land use. Furthermore, no prior research on quantitative TOD measurement in Dhaka exists. As a result, we developed a framework for both quantitative and spatial node-based TOD measurement based on the four Ds (density, diversity, destination accessibility, and design) of the TOD concept. With 17 stations under construction, MRT 6 was selected as our study area. The TOD index was measured by nine indicators based on the four criteria (4Ds), spatially in the geographic information system (GIS). After calculating the indicators, the TOD index for each station’s 800m buffer was estimated using the spatial multi-criteria analysis (SMCA). A sensitivity analysis of four TOD scenarios was performed to check the model’s robustness. Additionally, a heatmap of the TOD index for MRT 6 was created for informed planning and policymaking. Furthermore, statistically significant hotspots (both Getis Org Gi* and Anselen Local Moran Statistics) and hotspot clusters were identified. Finally, we illustrate the station-based ranking based on the maximum TOD score. In addition, a detailed spider-web of nine indicators for 17 stations depicts sustainable TOD planning. However, regarding density and diversity, sustainable development and (re)development policies should be implemented not only for MRT 6 but for all Dhaka’s TOD regions.
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Project description:Urbanization is an important factor contributing to the global spread of dengue in recent decades, especially in tropical regions. However, the impact of public transportation system on local spread of dengue in urban settings remains poorly understood, due to the difficulty in collecting relevant locality, transportation and disease incidence data with sufficient detail, and in suitably quantifying the combined effect of proximity and passenger flow. We quantify proximity and passenger traffic data relating to 2014-2015 dengue outbreaks in Kaohsiung, Taiwan by introducing a "Risk Associated with Metro Passengers Presence" (RAMPP), which considers the passenger traffic of stations located within a fixed radius, giving more weight to the busier and/or closer stations. In order to analyze the contagion risk associated with nearby presence of one or more Kaohsiung Rapid Transit (KRT) stations, we cluster the Li's (the fourth level administrative subdivision in Taiwan) of Kaohsiung based on their RAMPP value using the K-means algorithm. We then perform analysis of variance on distinct clusterings and detect significant differences for both years. The subsequent post hoc tests (Dunn) show that yearly incidence rate observed in the areas with highest RAMPP values is always significantly greater than that recorded with smaller RAMPP values. RAMPP takes into account of population mobility in urban settings via the use of passenger traffic information of urban transportation system, that captures the simple but important idea that large amount of passenger flow in and out of a station can dramatically increase the contagion risk of dengue in the neighborhood. Our study provides a new perspective in identifying high-risk areas for transmissions and thus enhances our understanding of how public rapid transit system contributes to disease spread in densely populated urban areas, which could be useful in the design of more effective and timely intervention and control measures for future outbreaks.
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Project description:BACKGROUND:Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients. METHODS:A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of "do not resuscitate" orders, and the survival of discharged CPA patients. RESULTS:The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001). CONCLUSIONS:The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.
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Project description:BACKGROUND/AIMS:The paucity of knowledge regarding gastrointestinal motility in patients with neuroendocrine tumors and carcinoid diarrhea re-stricts targeted treatment. 3D-Transit is a novel, minimally invasive, ambulatory method for description of gastrointestinal motility. The system has not yet been evaluated in any group of patients. We aimed to test the performance of 3D-Transit in patients with carcinoid diarrhea and to compare the patients' regional gastrointestinal transit times (GITT) and colonic motility patterns with those of healthy subjects. METHODS:Fifteen healthy volunteers and seven patients with neuroendocrine tumor and at least 3 bowel movements per day were inves-tigated with 3D-Transit and standard radiopaque markers. RESULTS:Total GITT assessed with 3D-Transit and radiopaque markers were well correlated (Spearman's rho = 0.64, P = 0.002). Median total GITT was 12.5 (range: 8.5-47.2) hours in patients versus 25.1 (range: 13.1-142.3) hours in healthy (P = 0.007). There was no difference in gastric emptying (P = 0.778). Median small intestinal transit time was 3.8 (range: 1.4-5.5) hours in patients versus 4.4 (range: 1.8-7.2) hours in healthy subjects (P = 0.044). Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012). Median frequency of pansegmental co-lonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045). CONCLUSIONS:Three-dimensional Transit allows assessment of regional GITT in patients with diarrhea. Patients with carcinoid diarrhea have faster than normal gastrointestinal transit due to faster small intestinal and colorectal transit times. The latter is caused by an increased frequency of pansegmental colonic movements.
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Project description:New rapid transit investments have been motivated by environmental, economic, and health benefits. Given transit's potential to increase active travel, recent research leverages transit changes for natural experiment studies to examine physical activity outcomes. We aimed to quantify the association size, critically examine existing literature, and make recommendations for future studies to advance research and policies on active travel, transportation, and physical activity. Studies of physical activity impacts following transit interventions were systematically reviewed using seven health and transport databases (May-July 2017). Two investigators extracted data on sample size, intervention, pre- and post-intervention physical activity, and relevant measurement information. Inconsistency of results and estimated overall mean physical activity change post-intervention were assessed. Forest plots were created from physical activity change in each study using a general variance-based random effects model. Of 18 peer-reviewed articles examining health behaviors, 15 addressed physical activity and five were natural experiment studies with pre- and post- intervention measurements. Studies varied by intervention, duration, outcome measurement, sampling location, and spatial method. Q (201) and I2 (98%) indicated high study heterogeneity. Among these five studies, after transit interventions, total physical activity decreased (combined mean - 80.4 min/week, 95% CI - 157.9, -2.9), but transport-related physical activity increased (mean 6.7 min/week, 95% CI - 10.1, 23.5). Following new transit infrastructure, total physical activity may decline but transport-related physical activity may increase. Positive transit benefits were location, sociodemographic, or activity-specific. Future studies should address context, ensure adequate follow-up, utilize controls, and consider non-residential environments or participants.
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