Effects of residential socioeconomic polarization on high blood pressure among nursing home residents.

OBJECTIVE: Neighborhood concentration of racial, income, education, and housing deprivation is known to be associated with higher rates of hypertension. The objective of this study is to examine the association between tract-level spatial social polarization and hypertension in a cohort with relatively equal access to health care, a Veterans Affairs nursing home. METHODS: 41,973 long-term care residents aged ≥65 years were matched with tract-level Indices of Concentration at the Extremes across four socioeconomic domains. We modeled high blood pressure against these indices controlling for individual-level cardiovascular confounders. RESULTS: We found participants who had resided in the most disadvantaged quintile had a 1.10 (95% 1.01, 1.19) relative risk of high blood pressure compared to those in the other quintiles for the joint measuring race/ethnicity and income domain. CONCLUSIONS: We achieved our objective by demonstrating that concentrated deprivation is associated with worse cardiovascular outcomes even in a population with equal access to care. Measures that jointly consider economic and racial/ethnic polarization elucidate larger disparities than single domain measures.

Spatial distribution of zero-dose children in Ethiopia: evidence for a targeted intervention from a large-scale cross-sectional evaluation survey.

Background: Ethiopia is the fourth leading contributor to the global total of zero-dose children (those who lack the first dose of diphtheria-tetanus-pertussis containing vaccine) and has substantial regional variations in zero-dose children. This study explored the spatial pattern of zero-dose children aged 12-35 months in Ethiopia. Methods: A survey was conducted in pastoralist regions, developing regions, newly-established regions, conflict-affected areas, underserved urban populations, hard-to-reach areas, internally displaced populations, and refugees. Spatial autocorrelation was measured using the Global Moran'sIstatistic. Getis-Ord Gi* statistics was applied to calculate the spatial variability of the high and low prevalence rates of zero-dose children. The spatial interpolation technique was also applied to estimate unknown values that fall between known values. Inverse distance weighting interpolation method was used to predict the risk of zero-dose children. ArcGIS version 10.8 was used for the spatial analysis. Results: A total of 3,646 children aged 12-35 months were included in the study. The spatial distribution of zero-dose children in Ethiopia was non-random (Global Moran'sI = 0.178971, p < 0.001). According to the hotspot analysis, western, eastern and northern parts of Somali and western and central parts of Afar regions had the highest load of zero-dose children (hotspot areas) followed by the Northeastern part of Amhara and southeastern part of Oromia regions. On the other hand, Southern Nations, Nationalities, and Peoples, Sidama, and the Eastern part of the Southwest Ethiopia peoples regions were identified as cold spot areas. The spatial interpolation analysis corresponded with the hotspot analysis results where western and central parts of Afar and western, eastern and northern parts of Somali regions were identified as high-risk areas for zero-dose children. However, Addis Ababa, Dire Dawa, Harari, Southern Nations, Nationalities, and Peoples, Sidama, Southwest Ethiopia Peoples, and parts of Oromia were found to be low-risk areas for zero-dose children. Conclusion: The spatial analysis identified that zero-dose children had a significant spatial variation across the study areas. High clusters of zero-dose children were detected in Afar and Somali regions. Implementing routine and mop-up vaccination campaigns in the identified hotspot areas will help Ethiopia to improve coverage and reduce immunization inequalities.

International Migration, Refugees, and Spread of Tuberculosis in Brazil: Analysis of Clusters, Trends, and Associated Factors (2010-2021).

BACKGROUND: International migration is a global phenomenon with significant implications on the health-disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. METHOD: This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. RESULTS: A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. CONCLUSIONS: It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.

Is entrepreneurship a key factor in the development of European countries? A proposal for an innovation readiness environment (IRE) index.

This study investigates the complex interplay among innovation, research and development (R&D), and entrepreneurship within the context of European nations. The focus of the study is also on the contributory role of tertiary educational institutions in nurturing entrepreneurial activities. To deepen the understanding of these multifaceted relationships and their subsequent impact on regional economies, the research introduces a novel metric termed the Innovation Readiness Environment (IRE) index. This index combines various indicators such as R&D expenditure, patenting rates, firm size, and educational levels, thereby providing a framework for evaluating the innovative capabilities and entrepreneurial success of firms in a given region. Utilization of this index offers policymakers and stakeholders a nuanced understanding of the regional innovation ecosystem, facilitating the identification of both strengths and deficiencies. This, in turn, enables the formulation of targeted policy interventions to enhance both innovation and entrepreneurship. One salient conclusion drawn from this study is the pivotal role of tertiary education in catalysing entrepreneurial ventures. The findings posit that higher levels of entrepreneurial education significantly supplement an individual's likelihood of entrepreneurial success by imparting the requisite skills and knowledge indispensable in a competitive business milieu. Higher education institutions, by fostering an environment conducive to innovation, emerge as critical agents in the cultivation of entrepreneurial acumen and the stimulation of economic expansion. The study further incorporates a spatial analytical framework to elucidate the regional specificities of innovation at the pan-European scale.

The present research examines the interconnected roles of innovation, research and development, and entrepreneurship in European countries, particularly emphasising how higher education contributes to entrepreneurial activity. Through the introduction of the Innovation Readiness Environment (IRE) index, the study provides a structured way to measure various aspects like research spending, patent rates, and educational levels in a region. The IRE index is intended to guide policymakers and other key stakeholders. The index is a tool for comprehensively assessing regional strengths and weaknesses in innovation and entrepreneurship. Furthermore, the study underscores the crucial role of higher education in fostering entrepreneurial skills, thereby enhancing the probability of entrepreneurial success. As a result, it appears that universities are not just places for acquiring knowledge; they serve as incubators for new ideas and start-ups, contributing to broader economic growth.

Spatiotemporal assessment of the nexus between urban sprawl and land surface temperature as microclimatic effect: implications for urban planning.

Rapid urbanisation has led to significant environmental and climatic changes worldwide, especially in urban heat islands where increased land surface temperature (LST) poses a major challenge to sustainable urban living. In the city of Abha in southwestern Saudi Arabia, a region experiencing rapid urban growth, the impact of such expansion on LST and the resulting microclimatic changes are still poorly understood. This study aims to explore the dynamics of urban sprawl and its direct impact on LST to provide important insights for urban planning and climate change mitigation strategies. Using the random forest (RF) algorithm optimised for land use and land cover (LULC) mapping, LULC models were derived that had an overall accuracy of 87.70%, 86.27% and 93.53% for 1990, 2000 and 2020, respectively. The mono-window algorithm facilitated the derivation of LST, while Markovian transition matrices and spatial linear regression models assessed LULC dynamics and LST trends. Notably, built-up areas grew from 69.40 km2 in 1990 to 338.74 km2 in 2020, while LST in urban areas showed a pronounced warming trend, with temperatures increasing from an average of 43.71 °C in 1990 to 50.46 °C in 2020. Six landscape fragmentation indices were then calculated for urban areas over three decades. The results show that the Largest Patch Index (LPI) increases from 22.78 in 1990 to 65.24 in 2020, and the number of patches (NP) escalates from 2,531 in 1990 to an impressive 10,710 in 2020. Further regression analyses highlighted the morphological changes in the cities and attributed almost 97% of the LST variability to these urban patch dynamics. In addition, water bodies showed a cooling trend with a temperature decrease from 33.76 °C in 2000 to 29.69 °C in 2020, suggesting an anthropogenic influence. The conclusion emphasises the urgent need for sustainable urban planning to counteract the warming trends associated with urban sprawl and promote climate resilience.

'Nowhere and no one is safe': spatial analysis of damage to critical civilian infrastructure in the Gaza Strip during the first phase of the Israeli military campaign, 7 October to 22 November 2023.

BACKGROUND: Since the Hamas attacks in Israel on 7 October 2023, the Israeli military has launched an assault in the Gaza Strip, which included over 12,000 targets struck and over 25,000 tons of incendiary munitions used by 2 November 2023. The objectives of this study include: (1) the descriptive and inferential spatial analysis of damage to critical civilian infrastructure (health, education, and water facilities) across the Gaza Strip during the first phase of the military campaign, defined as 7 October to 22 November 2023 and (2) the analysis of damage clustering around critical civilian infrastructure to explore broader questions about Israel's adherence to International Humanitarian Law (IHL). METHODS: We applied multi-temporal coherent change detection on Copernicus Sentinel 1-A Synthetic Aperture Radar (SAR) imagery to detect signals indicative of damage to the built environment through 22 November 2023. Specific locations of health, education, and water facilities were delineated using open-source building footprint and cross-checked with geocoded data from OCHA, OpenStreetMap, and Humanitarian OpenStreetMap Team. We then assessed the retrieval of damage at and with close proximity to sites of health, education, and water infrastructure in addition to designated evacuation corridors and civilian protection zones. The Global Moran's I autocorrelation inference statistic was used to determine whether health, education, and water facility infrastructure damage was spatially random or clustered. RESULTS: During the period under investigation, in the entire Gaza Strip, 60.8% (n = 59) of health, 68.2% (n = 324) of education, and 42.1% (n = 64) of water facilities sustained infrastructure damage. Furthermore, 35.1% (n = 34) of health, 40.2% (n = 191) of education, and 36.8% (n = 56) of water facilities were functionally destroyed. Applying the Global Moran's I spatial inference statistic to facilities demonstrated a high degree of damage clustering for all three types of critical civilian infrastructure, with Z-scores indicating < 1% likelihood of cluster damage occurring by random chance. CONCLUSION: Spatial statistical analysis suggests widespread damage to critical civilian infrastructure that should have been provided protection under IHL. These findings raise serious allegations about the violation of IHL, especially in light of Israeli officials' statements explicitly inciting violence and displacement and multiple widely reported acts of collective punishment.

Geospatial analysis and prevalence of Schistosoma mansoni and soil-transmitted helminth infections in an endemic area in Eastern Brazilian Amazon.

OBJECTIVES: This study evaluated the occurrence of Schistosoma mansoni and soil-transmitted helminths in an endemic area in the Eastern Brazilian Amazon, analysing prevalence and spatial distribution. METHODS: The study was conducted in four localities of Primavera Municipality, in Pará state. Data was obtained from the Decit 40/2012 project and the participants were divided into five age range categories for evaluation: children, adolescents, young adults, adults and elderly individuals. For the diagnostic tests, Kato-Katz slides were prepared to detect S. mansoni and soil-transmitted helminths eggs. The spatial distribution map and the Kernel Density Estimation were performed to assess the presence and location of infections. RESULTS: Stool samples revealed the presence of hookworms, S. mansoni, Ascaris lumbricoides and Trichuris trichiura eggs. Mono-, bi- and poly-parasitic infections were observed, with a significant prevalence of hookworm monoparasitism. CONCLUSIONS: The high frequency of children infected with soil-transmitted helminths confirms their significance as an ongoing public health problem in the poorest municipalities of Brazil. The Geographic Information System plays a crucial role in environmental surveillance and in the control of epidemics and endemic diseases, enabling accurate assessment and informed decision-making for their control.

Analysis of spatial and demographic factors associated with chikungunya in Espírito Santo state, Brazil.

BACKGROUND: Chikungunya (CHIK) emerged in Brazil in 2014 and since then several epidemics have been observed. This study aims to describe the spatial, social and demographic characteristics of individuals affected by CHIK in Espírito Santo state. METHODS: A cross-sectional study was performed using data from individuals with a confirmed diagnosis of CHIK in Espírito Santo state, Brazil, from 2018 to 2020. Monthly incidence was calculated and annual spatial distribution maps were constructed. Statistical analysis using the χ2 test identified associations between disease occurrence and sociodemographic variables. RESULTS: In the period and area analysed, a CHIK epidemic occurred in 2020, with an incidence of 219.8 cases per 100 000 inhabitants. The southern and central regions of Espirito Santo state harboured a risk five times greater than the others in the epidemic region. Females (odds ratio [OR] 1.65 [95% confidence interval {CI} 1.58 to 1.72]), black people (OR 1.22 [95% CI 1.13 to 1.33]), individuals with ≤11 y of education (OR 1.48 [95% CI 1.37 to 1.61]) and the elderly (OR 7.49 [95% CI 6.53 to 8.59]) had a greater risk for the disease. CONCLUSIONS: CHIK stands as an emerging public health problem in Brazil since its introduction in 2014. Espírito Santo suffered a substantial epidemic in 2020, possibly due to outbreaks in neighbouring states. The population at risk should be prioritized in healthcare, considering the morbidity potential of the disease.

Immune Cytolytic Activity and Strategies for Therapeutic Treatment.

Intratumoral immune cytolytic activity (CYT), calculated as the geometric mean of granzyme-A (GZMA) and perforin-1 (PRF1) expression, has emerged as a critical factor in cancer immunotherapy, with significant implications for patient prognosis and treatment outcomes. Immune checkpoint pathways, the composition of the tumor microenvironment (TME), antigen presentation, and metabolic pathways regulate CYT. Here, we describe the various methods with which we can assess CYT. The detection and analysis of tumor-infiltrating lymphocytes (TILs) using flow cytometry or immunohistochemistry provide important information about immune cell populations within the TME. Gene expression profiling and spatial analysis techniques, such as multiplex immunofluorescence and imaging mass cytometry allow the study of CYT in the context of the TME. We discuss the significant clinical implications that CYT has, as its increased levels are associated with positive clinical outcomes and a favorable prognosis. Moreover, CYT can be used as a prognostic biomarker and aid in patient stratification. Altering CYT through the different methods targeting it, offers promising paths for improving treatment responses. Overall, understanding and modulating CYT is critical for improving cancer immunotherapy. Research into CYT and the factors that influence it has the potential to transform cancer treatment and improve patient outcomes.

From erosion to epidemics: Understanding the overlapping vulnerability of hydrogeomorphic hotspots, malaria affliction, and poverty in Nigeria.

Hydrogeomorphic changes, encompassing erosion, waterlogging, and siltation, disproportionately threaten impoverished rural communities. Yet, they are often marginalized in discussions of disasters. This oversight is especially concerning as vulnerable households with limited healthcare access are most susceptible to related diseases and displacement. However, our current understanding of how these risks intersect remains limited. We explore the complex relationships between hydrogeomorphic hazards, malaria incidence, and poverty in Nigeria. Through spatial analyses we expand traditional boundaries, incorporating factors such as healthcare access, migration patterns, dam locations, demographics, and wealth disparities into a unified framework. Our findings reveal a stark reality: most residents in hydrogeomorphic hotspots live in poverty (earnings per person ≤$1.25/day), face elevated malaria risks (80 % in malaria hotspots), reside near dams (59 %), and struggle with limited healthcare access. Moreover, exposure to hydrogeomorphic hotspots could double by 2080, affecting an estimated 5.8 million Nigerians. This forecast underscores the urgent need for increased support and targeted interventions to protect those living in poverty within these hazardous regions. In shedding light on these dynamics, we expose and emphasise the pressing urgency of the risks borne by the most vulnerable populations residing in these regions-communities often characterised by limited wealth and resilience.

Outpatient geriatric health care in the German federal state of Mecklenburg-Western Pomerania: a population-based spatial analysis of claims data.

BACKGROUND: Due to unidentified geriatric needs, elderly patients have a higher risk for developing chronic conditions and acute medical complications. Early geriatric screenings and assessments help to identify geriatric needs. Holistic and coordinated therapeutic approaches addressing those needs maintain the independence of elderly patients and avoid adverse effects. General practitioners are important for the timely identification of geriatric needs. The aims of this study are to examine the spatial distribution of the utilization of outpatient geriatric services in the very rural Federal State of Mecklenburg-Western Pomerania in the Northeast of Germany and to identify regional disparities. METHODS: Geographical analysis and cartographic visualization of the spatial distribution of outpatient geriatric services of patients who are eligible to receive basic geriatric care (BGC) or specialized geriatric care (SGC) were carried out. Claims data of the Association of Statutory Health Insurance Physicians in Mecklenburg-Western Pomerania were analysed on the level of postcode areas for the quarter periods between 01/2014 and 04/2017. A Moran's I analysis was carried out to identify clusters of utilization rates. RESULTS: Of all patients who were eligible for BGC in 2017, 58.3% (n = 129,283/221,654) received at least one BCG service. 77.2% (n = 73,442/95,171) of the patients who were eligible for SGC, received any geriatric service (BGC or SGC). 0.4% (n = 414/95,171) of the patients eligible for SGC, received SGC services. Among the postcode areas in the study region, the proportion of patients who received a basic geriatric assessment ranged from 3.4 to 86.7%. Several regions with statistically significant Clusters of utilization rates were identified. CONCLUSIONS: The widely varying utilization rates and the local segregation of high and low rates indicate that the provision of outpatient geriatric care may depend to a large extent on local structures (e.g., multiprofessional, integrated networks or innovative projects or initiatives). The great overall variation in the provision of BGC services implicates that the identification of geriatric needs in GPs' practices should be more standardized. In order to reduce regional disparities in the provision of BGC and SGC services, innovative solutions and a promotion of specialized geriatric networks or healthcare providers are necessary.

Climate change and land cover effects on water yield in a subtropical watershed spanning the yungas-chaco transition of Argentina.

The demand for mountain water resources is increasing, and their availability is threatened by climate change, emphasizing the urgency for effective protection and management. The upper Sali-Dulce watershed holds vital significance as it contributes the majority of the Sali-Dulce water resources, supporting a densely populated dry region in Northwestern Argentina, covering an area of 24,217 km2. However, the potential impact of climate change and land use/land cover change on water yield in this watershed remains uncertain. This study employs the InVEST Annual Water Yield model to analyze the average water yield in the watershed and evaluate its potential changes under future scenarios of climate and land use/land cover change. InVEST was calibrated using data from multiple river gauges located across the watershed, indicating satisfactory performance (R2 = 0.751, p-value = 0.0054). Precipitation and evapotranspiration were the most important variables explaining water yield in the area, followed by land use. Water yield showed a notable concentration in the montane area with 40% of the watershed accounting for 80% of the water yield, underscoring the importance of conserving natural land cover in this critical zone. Climate change scenarios project an increase in water yield ranging from 21 to 75%, while the effects of land cover change scenarios on water yield vary, with reforestation scenarios leading to reductions of up to 15% and expansions in non-irrigated agriculture resulting in increases of up to 40%. Additionally, water yield distribution may become more concentrated or dispersed, largely dependent on the type of land cover. The combined scenarios highlight the pivotal role of land cover in adapting to climate change. Our findings provide valuable insights for designing future studies and developing policies aimed at implementing effective adaptation strategies to climate change within the Salí-Dulce watershed.

Race, disadvantage, and violence: A spatial exploration of macrolevel covariates of police-involved homicides within and between US counties.

Efforts to explore the macrolevel determinants of police-involved homicides have expanded in recent years due in part to increased scrutiny and media attention to such events, and increased data availability of these events through crowdsourced databases. However, little empirical research has examined the spatial determinants of such events. The present study extends the extant macrolevel research on police-involved homicides by employing an underutilized spatial econometric model, the spatial Durbin model (SDM), to assess the direct and indirect county effects of racial threat, economic threat, social disorganization, and community violence on police killings within and between US counties from 2013 through 2020. Results indicate a direct inverse relationship between racial threat and police-involved homicides, no support for economic threat, and a direct positive association with two measures of social disorganization. Additionally, we find firearm availability exhibits significant direct and indirect spatial dependence on focal county police-involved homicides, reflecting spatial spillover processes. In essence, as firearm availability in neighboring counties increases, police-involved homicides within a focal county increase. The implications of these findings for racial threat, economic threat, social disorganization, and community violence are discussed.

Unveiling spatial complexity in solid tumor immune microenvironments through multiplexed imaging.

Deciphering cellular components and the spatial interaction network of the tumor immune microenvironment (TIME) of solid tumors is pivotal for understanding biologically relevant cross-talks and, ultimately, advancing therapies. Multiplexed tissue imaging provides a powerful tool to elucidate spatial complexity in a holistic manner. We established and cross-validated a comprehensive immunophenotyping panel comprising over 121 markers for multiplexed tissue imaging using MACSima™ imaging cyclic staining (MICS) alongside an end-to-end analysis workflow. Applying this panel and workflow to primary cancer tissues, we characterized tumor heterogeneity, investigated potential therapeutical targets, conducted in-depth profiling of cell types and states, sub-phenotyped T cells within the TIME, and scrutinized cellular neighborhoods of diverse T cell subsets. Our findings highlight the advantage of spatial profiling, revealing immunosuppressive molecular signatures of tumor-associated myeloid cells interacting with neighboring exhausted, PD1high T cells in the TIME of hepatocellular carcinoma (HCC). This study establishes a robust framework for spatial exploration of TIMEs in solid tumors and underscores the potency of multiplexed tissue imaging and ultra-deep cell phenotyping in unraveling clinically relevant tumor components.

Healthcare equity in focus: bridging gaps through a spatial analysis of healthcare facilities in Irbid, Jordan.

In the Irbid Governorate, Jordan, equitable healthcare facility distribution is vital to ensuring healthcare accessibility and improving public health outcomes. This study investigated the spatial distribution, accessibility, and conformity of healthcare facilities to the Ministry of Health standards to identify areas requiring improvement. Using geographic information systems (GIS), three spatial analyses were conducted: nearest neighbor analysis, buffer analysis, and service area analysis. These analyses comprehensively assessed the healthcare landscape, revealing a random spatial distribution pattern of healthcare facilities; and indicating an absence of structured organization. The buffer analysis revealed concentrations in specific regions, while others were underserved. The Service Area Analysis revealed significant healthcare access challenges, especially in remote areas. The healthcare resource distribution of the Irbid governorate fell short of national and international standards, emphasizing the need for improvements. To address these disparities, policymakers and healthcare authorities should focus on equitably redistributing resources, tailoring allocation to local needs, improving remote area infrastructure, and refining government policies. Continuous monitoring and evaluation are imperative to ensure alignment with international standards and achieve healthcare equity. The insights from this case study provide valuable guidance for regions facing similar healthcare distribution challenges.

Neighboring macrophage-induced alteration in the phenotype of colorectal cancer cells in the tumor budding area.

BACKGROUND: A higher number of tumor buds in the invasive front of colorectal cancer (CRC) specimens has been shown to contribute to a poor prognosis in CRC patients. Because macrophages (Mφs) have been demonstrated to alter the phenotype of cancer cells, we hypothesized that the phenotype of CRC cells in the tumor budding (TB) area might be changed by the interaction between CRC cells and Mφs. METHODS: We assessed the expression of topoisomerase 1 in CRC cells to estimate the acquisition of chemoresistance in CRC. To demonstrate the tumor-stromal interaction between CRC cells and Mφs, we assessed two histological findings, the number of Mφs per single CRC cell and the proximity between CRC cells and Mφs by histological spatial analysis using HALO software. RESULTS: The expression levels of topoisomerase 1 in CRC cells were decreased in deeper areas, especially in the TB area, compared to the surface area. Our histological spatial analysis revealed that 2.6 Mφs located within 60 µm of a single CRC cell were required to alter the phenotype of the CRC cell. Double-immunofluorescence staining revealed that higher Mφs were positive for interleukin-6 (IL-6) in the TB area and that AE1/AE3-positive CRC cells were also positive for phospho-STAT3 (pSTAT3) in the TB area; thus, the IL-6 receptor (IL-6R)/STAT3 signaling pathway in CRC cells was upregulated by IL-6 derived from neighboring Mφs. CONCLUSION: IL-6 secreted from the neighboring Mφs would alter the phenotype of CRC cells via IL-6R/STAT3 signaling pathway.

Melanoma Registry of the Spanish Academy of Dermatology and Venereology (REGESMEL): Description and Data in its First Year of Operation. / Registro de Melanoma de la Academia Española de Dermatología y Venereología (REGESMEL): descripción y datos en el primer año de funcionamiento.

INTRODUCTION: The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS: REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS: A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS: The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.

Construction of China's food security evaluation index system and spatiotemporal evolution.

Food security is a vital material foundation for a nation's development and has been a topic of significant concern on the international stage in recent years. With a population exceeding 1.4 billion, China is not only a major producer but also a substantial consumer of food. Ensuring food security in China is not only a top priority for its socio-economic development but also a driving force in maintaining the stability of the global food supply chain and reducing the number of hungry people worldwide. However, a lack of comprehensive research into the Chinese food security system remains. This study addresses this gap by constructing a comprehensive evaluation framework encompassing four dimensions: food supply, accessibility, production stability, and sustainability. Utilizing the Moran's Index and generating LISA (Local Indicators of Spatial Association) maps, we analyze the spatial correlations of food security. The Dagum Gini coefficient and kernel density estimation are applied to assess heterogeneity and spatial disparities. Furthermore, this research employs the Exponential Smoothing (ETS) model to forecast food security trends. The findings reveal that the overall composite food security score exhibited fluctuations, initially increasing and reaching its peak of 0.407 in 2003, followed by a subsequent sharp decline after 2019. Spatially, food security exhibits correlations, with the Huang-Huai-Hai Plain and Northeast regions consistently showing high-high clustering. In contrast, the Western and Southern regions exhibit low-low clustering at specific periods. The Dagum Gini coefficient indicates that overall food security disparities are relatively small. However, these disparities have gradually expanded in recent years, with inter-group differences becoming predominant after 2005. As indicated by the kernel density estimation, the dynamic distribution of food security initially widens and then narrows, suggesting a shift from dispersed to concentrated data distribution. This phenomenon is accompanied by polarization and convergence trends, particularly evident after 2015. According to the ETS model, the study forecasts a substantial risk of declining food security in China over the next decade, largely influenced by the ongoing pandemic. In conclusion, this research provides a comprehensive assessment of the changing status of food security in China. It offers early warnings through predictive analysis, addressing the existing research gaps in the field of food security.

Weather and the City: Machine Learning for Predicting and Attributing Fine Scale Air Quality to Meteorological and Urban Determinants.

Urban air quality persists as a global concern, with critical health implications. This study employs a combination of machine learning (gradient boosting regression, GBR) and spatial analysis to better understand the key drivers behind air pollution and its prediction and mitigation strategies. Focusing on New York City as a representative urban area, we investigate the interplay between urban characteristics and weather factors, showing that urban features, including traffic-related parameters and urban morphology, emerge as crucial predictors for pollutants closely associated with vehicular emissions, such as elemental carbon (EC) and nitrogen oxides (NOx). Conversely, pollutants with secondary formation pathways (e.g., PM2.5) or stemming from nontraffic sources (e.g., sulfur dioxide, SO2) are predominantly influenced by meteorological conditions, particularly wind speed and maximum daily temperature. Urban characteristics are shown to act over spatial scales of 500 × 500 m2, which is thus the footprint needed to effectively capture the impact of urban form, fabric, and function. Our spatial predictive model, needing only meteorological and urban inputs, achieves promising results with mean absolute errors ranging from 8 to 32% when using full-year data. Our approach also yields good performance when applied to the temporal mapping of spatial pollutant variability. Our findings highlight the interacting roles of urban characteristics and weather conditions and can inform urban planning, design, and policy.

A spatial autocorrelation analysis of road traffic crash by severity using Moran's I spatial statistics: A comparative study of Addis Ababa and Berlin cities.

Methodological advancements in road safety research reveal an increasing inclination toward integrating spatial approaches in hot spot identification, spatial pattern analysis, and developing spatially lagged models. Previous studies on hot spot identification and spatial pattern analysis have overlooked crash severities and the spatial autocorrelation of crashes by severity, missing valuable insights into crash patterns and underlying factors. This study investigates the spatial autocorrelation of crash severity by taking two capital cities, Addis Ababa and Berlin, as a case study and compares patterns in low and high-income countries. The study used three-year crash data from each city. It employed the average nearest neighbor distance (ANND) method to determine the significance of spatial clustering of crash data by severity, Global Moran's I to examine the statistical significance of spatial autocorrelation, and Local Moran's I to identify significant cluster locations with High-High (HH) and Low-Low (LL) crash severity values. The ANND analysis reveals a significant clustering of crashes by severity in both cities, except in Berlin's fatal crashes. However, different Global Moran's I results were obtained for the two cities, with a strong and statistically significant value for Addis Ababa compared to Berlin. The Local Moran's I result indicates that the central business district and residential areas have LL values, while the city's outskirts exhibit HH values in Addis Ababa. With some persistent HH value locations, Berlin's HH and LL grid clusters are intermingled on the city's periphery. Socio-economic factors, road user behavior and roadway factors contribute to the difference in the result. Nevertheless, it is interesting to note the similarity of significant HH value locations on the outskirts of both cities. Finally, the results are consistent with previous studies and indicate the need for further investigation in other locations.