The absence of effective access to opportunities and services is a key contributor to poor socio-economic and health outcomes in underserved neighborhoods in many cities. The city of Columbus, Ohio, ...USA is attempting to enhance residents' accessibility by providing new public transit services. These new services include a major Transit System Redesign (TSR) of the conventional bus network and the introduction of a new bus rapid transit, named CMAX. Using a high-resolution space-time accessibility measure, we analyze whether these new public transit services will change residents' accessibility to job and healthcare in an underserved neighborhood of Columbus. Also, we assess whether enhancing the CMAX service to reduce delays (e.g., reserved lane, off-board payment system) will improve accessibility. The high-resolution space-time accessibility measure in this study uses published public transit schedules via the General Transit Feed Specification (GTFS). We use multiple departure times during a day to account for the temporal fluctuations of accessibility based on the transit schedule changes. We also consider the operating hours of job opportunities and healthcare services. Results suggest that the TSR yields ambiguous benefits for accessibility to jobs and healthcare. However, the new CMAX service and its potential upgrades lead to a substantial increase in both job and healthcare accessibility. The results can be used for city officials and urban planners to evaluate the effectiveness of public transit innovations in improving accessibility.
•Lack of access to opportunities contributes to poor social and health outcomes.•Columbus, OH introduced a transit route and schedule redesign and bus rapid transit.•We analyze impacts on accessibility to opportunities in a deprived neighborhood.•Detailed route and schedule data allow high resolution accessibility analysis.•The new bus rapid transit has a much greater impact on accessibility.
Nanotechnology platforms, such as nanoparticles, liposomes, dendrimers, and micelles have been studied extensively for various drug deliveries, to treat or prevent diseases by modulating ...physiological or pathological processes. The delivery drug molecules range from traditional small molecules to recently developed biologics, such as proteins, peptides, and nucleic acids. Among them, proteins have shown a series of advantages and potential in various therapeutic applications, such as introducing therapeutic proteins due to genetic defects, or used as nanocarriers for anticancer agents to decelerate tumor growth or control metastasis. This review discusses the existing nanoparticle delivery systems, introducing design strategies, advantages of using each system, and possible limitations. Moreover, we will examine the intracellular delivery of different protein therapeutics, such as antibodies, antigens, and gene editing proteins into the host cells to achieve anticancer effects and cancer vaccines. Finally, we explore the current applications of protein delivery in anticancer treatments.
A variety of engineered nanoparticles, including lipid nanoparticles, polymer nanoparticles, gold nanoparticles, and biomimetic nanoparticles, have been studied as delivery vehicles for biomedical ...applications. When assessing the efficacy of a nanoparticle-based delivery system, in vitro testing with a model delivery system is crucial because it allows for real-time, in situ quantitative transport analysis, which is often difficult with in vivo animal models. The advent of tissue engineering has offered methods to create experimental models that can closely mimic the 3D microenvironment in the human body.
This review paper overviews the types of nanoparticle vehicles, their application areas, and the design strategies to improve delivery efficiency, followed by the uses of engineered microtissues and methods of analysis. In particular, this review highlights studies on multicellular spheroids and other 3D tissue engineering approaches for cancer drug development. The use of bio-engineered tissues can potentially provide low-cost, high-throughput, and quantitative experimental platforms for the development of nanoparticle-based delivery systems.
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•This paper overviews the designs, analyses, and applications of various nanoparticles studied for drug delivery.•The emphasis is on in vitro engineered tissue models used for the evaluation of nanoparticle transport.•The in vitro models allow for in situ quantitative transport analysis, which is often difficult with in vivo models.•Tissue mechanical characteristics and structural heterogeneity are emerging topics for the study of nanoparticle delivery.
This study aimed to investigate the impact of health information technology (IT) on the Case Mix Index (CMI). This study was a retrospective cohort study using hospital financial data from the Office ...of Statewide Health Planning and Development (OSHPD) in California. A total of 309 unique hospitals were included in the study for 7 years, from 2009 to 2015, resulting in 2,135 hospital observations. The effects of health information technology (IT) on the Case Mix Index (CMI) was evaluated using dynamic panel data analysis to control endogeneity issues. This study found that more health IT adoption could lead to a lower CMI by improving coding systems. Policy makers, researchers, and healthcare providers must be cautious when interpreting the effect of health IT on the CMI. To encourage the adoption of health IT, the cost savings and reimbursement reductions resulting from health IT adoption should be compared. If any profit loss occurs (i.e., the cost savings is less than reimbursement reduction), more incentives should be provided to healthcare providers.
Background
Data breaches are an inevitable risk to hospitals operating with information technology. The financial costs associated with data breaches are also growing. The costs associated with a ...data breach may divert resources away from patient care, thus negatively affecting hospital productivity.
Objective
After a data breach, the resulting regulatory enforcement and remediation are a shock to a hospital’s patient care delivery. Exploiting this shock, this study aimed to investigate the association between hospital data breaches and productivity by using a generalized difference-in-differences model with multiple prebreach and postbreach periods.
Methods
The study analyzed the hospital financial data of the California Office of Statewide Health Planning and Development from 2012 to 2016. The study sample was an unbalanced panel of hospitals with 2610 unique hospital-year observations, including general acute care hospitals. California hospital data were merged with breach data published by the US Department of Health and Human Services. The dependent variable was hospital productivity measured as value added. The difference-in-differences model was estimated using fixed effects regression.
Results
Hospital productivity did not significantly differ from the baseline for 3 years after a breach. Data breaches were not significantly associated with a reduction in hospital productivity. Before a breach, the productivity of hospitals that experienced a data breach maintained a parallel trend with control hospitals.
Conclusions
Hospital productivity was resilient against the shocks from a data breach. Nonetheless, data breaches continue to threaten hospitals; therefore, health care workers should be trained in cybersecurity to mitigate disruptions.
Health information technology (IT) has been championed as a tool that can transform health care delivery. We estimate the parameters of a value-added hospital production function correcting for ...endogenous input choices to assess the private returns hospitals earn from health IT. Despite high marginal products, the total benefits from expanded IT adoption are modest. Over the span of our data, health IT inputs increased by more than 210% and contributed about 6% to the increase in value-added. Not-for-profits invested more heavily and differently in IT. Finally, we find no compelling evidence of labor complementarities or network externalities from competitors' IT investment.
How does ChatGPT introduce transport problems and solutions in North America? By analyzing ChatGPT’s answers to four prompts related to transport issues and solutions in the United States and Canada, ...our results reveal that ChatGPT’s answers generally align well with transport researchers’ expectations. However, ChatGPT’s capability may be limited in providing trustworthy or sound solutions because of the potential issues (e.g., geographic biases, inaccuracy) in its training data. ChatGPT might be a decent starting point for discussing transport issues and solutions, but one should be aware of its limitations.
The piled raft has proved to be an economical foundation type compared to conventional pile foundations. However, there is a reluctance to consider the use of piled rafts on soft clay because of ...concerns about excessive settlement and insufficient bearing capacity. Despite these reasons, applications of piled rafts on soft clay have been increased recently. Current analysis methods for piled rafts on soft clay, however, are insufficient, especially for calculating the overall bearing capacity of the piled raft. This study describes the three-dimensional behavior of a piled raft on soft clay based on a numerical study using a 3D finite element method. The analysis includes a pile–soil slip interface model. A series of numerical analyses was performed for various pile lengths and pile configurations for a square raft subjected to vertical loading. Relatively stiff soil properties and different loading types were also used for estimating the bearing behavior of the piled raft. Based on the results, the effect of pile–soil slip on the bearing behavior of a piled raft was investigated. Furthermore, the proportion of load sharing of the raft and piles at the ultimate state and the relationship between the settlement and overall factor of safety was evaluated. The results show that the use of a limited number of piles, strategically located, might improve both bearing capacity and the settlement performance of the raft.
An Opioid Treatment Desert is an area with limited accessibility to medication-assisted treatment and recovery facilities for Opioid Use Disorder. We explored the concept of Opioid Treatment Deserts ...including racial differences in potential spatial accessibility and applied it to one Midwestern urban county using high resolution spatiotemporal data.
We obtained individual-level data from one Emergency Medical Services (EMS) agency (Columbus Fire Department) in Franklin County, Ohio. Opioid overdose events were based on EMS runs where naloxone was administered from 1/1/2013 to 12/31/2017. Potential spatial accessibility was measured as the time (in minutes) it would take an individual, who may decide to seek treatment after an opioid overdose, to travel from where they had the overdose event, which was a proxy measure of their residential location, to the nearest opioid use disorder (OUD) treatment provider that provided medically-assisted treatment (MAT). We estimated accessibility measures overall, by race and by four types of treatment providers (any type of MAT for OUD, Buprenorphine, Methadone, or Naltrexone). Areas were classified as an Opioid Treatment Desert if the estimate travel time to treatment provider (any type of MAT for OUD) was greater than a given threshold. We performed sensitivity analysis using a range of threshold values based on multiple modes of transportation (car and public transit) and using only EMS runs to home/residential location types.
A total of 6,929 geocoded opioid overdose events based on data from EMS agencies were used in the final analysis. Most events occurred among 26-35 years old (34%), identified as White adults (56%) and male (62%). Median travel times and interquartile range (IQR) to closest treatment provider by car and public transit was 2 minutes (IQR: 3 minutes) and 17 minutes (IQR: 17 minutes), respectively. Several neighborhoods in the study area had limited accessibility to OUD treatment facilities and were classified as Opioid Treatment Deserts. Travel time by public transit for most treatment provider types and by car for Methadone-based treatment was significantly different between individuals who were identified as Black adults and White adults based on their race.
Disparities in access to opioid treatment exist at the sub-county level in specific neighborhoods and across racial groups in Columbus, Ohio and can be quantified and visualized using local public safety data (e.g., EMS runs). Identification of Opioid Treatment Deserts can aid multiple stakeholders better plan and allocate resources for more equitable access to MAT for OUD and, therefore, reduce the burden of the opioid epidemic while making better use of real-time public safety data to address a public health epidemic that has turned into a public safety crisis.
The extent of subsurface damage on (0001) GaN wafers post different polishing treatments was quantified using depth-resolved cathodoluminescence spectroscopy (DRCLS). The band edge emission spectra ...were obtained from CLS with different electron energies, which manifested a significant non-radiative recombination resulted from polishing-induced subsurface damage. Cross-sectional transmission electron microscopy (XTEM) was also used to diagnose the extent of the subsurface damage layer. For the GaN polished with 1.00 and 0.25 μm diamonds abrasive, the extent of non-radiative subsurface damage is about 250 and 100 nm, corresponding to the calculated electron penetration depth at the accelerating voltage for the onset of band edge emission. In this study, the depth of subsurface damage estimated from CL spectra compared well with direct XTEM measurements in GaN substrate.
•Subsurface polishing defects of bulk gallium nitride substrates have been studied.•Estimated the subsurface damage depth.•The subsurface damage defects are due to plastic deformation and are non-radiative.
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