Reduced commuter exposure to PM2.5 and PAHs in response to improved emission standards in bus rapid transit systems in Mexico

We evaluated impacts of progressive technological updates to bus rapid transit (BRT) systems on in-cabin concentrations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), and the various polyaromatic hydrocarbons (PAHs) to which commuters were exposed. PM2.5 samples were collected and real-time concentrations measured from October 2017 to March 2020 inside cabins of BRT buses equipped with Euro IV, V and VI diesel emission standards in the Mexico City Metropolitan Area (MCMA). For effective comparison, similar samplings and measurements were carried out on trains in the MCMA underground (MCU) system. Peak in-cabin PM2.5 concentrations decreased significantly (p < 0.05) by 35% from Euro IV to Euro V buses, and by 80% from Euro IV to Euro VI buses. PM2.5 concentrations inside Euro VI buses were significantly lower (p < 0.05) than in Euro IV and Euro V buses and in underground trains. The in-cabin excess (ICE) of PM2.5 relative to ambient concentrations was significantly (p < 0.05) higher for Euro IV than for Euro V buses during morning the traffic peak, and consistently higher than for Euro VI buses. Indeed, ICEs calculated for Euro VI buses were always lower than those for electricity-powered underground trains. The frequency of hotspots decreased from Euro IV to Euro VI buses due to the combined effect of low emissions and closed, air-conditioned cabins. Concentrations of total PAHs including carcinogenic species also decreased from Euro IV to Euro V buses and were below limits of detection aboard Euro VI buses. This work shows that in real-life conditions, advanced diesel technologies and cabin design significantly reduce commuters' exposure to PM2.5 and to toxic PAH compounds.

Cetuximab Plus Concurrent Radiotherapy in Patients With Nasopharyngeal Carcinoma

BACKGROUND/AIM

Several reports have evaluated the efficacy and safety of concurrent radiotherapy with cetuximab (BRT) in patients with nasopharyngeal carcinoma (NPC). Combination therapy with cetuximab can be a treatment option for NPC. Although clinical data regarding the efficacy and safety of BRT without induction chemotherapy (ICT) or adjuvant chemotherapy is essential for the development of new therapeutic strategies, such data are rarely reported.

PATIENTS AND METHODS

We retrospectively investigated a series of patients with NPC treated in our institution to evaluate the efficacy and safety of BRT. Eleven patients with newly diagnosed NPC were identified from an inpatient database from July 2015 to April 2018. Seven patients who received BRT were reviewed.

RESULTS

All patients completed BRT without cessation of treatment. Six (85.7%) patients achieved a complete response and one (14.3%) achieved stable disease. The response rate was 85.7%. All patients with ≤T3 disease achieved a complete response. Both patients with T3 disease developed local recurrence, and one of the four patients with T1-2 disease developed distant metastases. The 1- and 3-year overall survival rates were 85.7% and 47.6%, respectively. The most common adverse events (AEs) were pharyngeal mucositis (100%), radiation dermatitis (100%), anorexia (28.6%), weight loss (28.6%), acneiform rash (28.6%), and dry mouth (28.6%). Grade 3 AEs were pharyngeal mucositis (42.9%), radiation dermatitis (28.6%), and anorexia (14.3%). No grade 4/5 AEs were observed.

CONCLUSION

BRT for NPC was tolerable, but our findings suggest that BRT without induction chemotherapy or adjuvant chemotherapy is insufficient at least for ≥T3 disease.

An integrated fuzzy MCDM model for prioritizing strategies for successful implementation and operation of the bus rapid transit system

The selection and prioritization of suitable strategies to address the challenges to the successful operation and implementation of the bus rapid transit (BRT) system is a common problem faced by practitioners and decision-makers. Recent research has widely discussed the issue, but such assessments have remained limited in the city of Dar es Salaam, Tanzania context, where there are mobility difficulties. The present study addresses this research gap and identifies the most critical challenges to BRT implementation and operation, and recommends the most appropriate strategy for overcoming them. Seven strategies are defined. To prioritize these strategies, five criteria are determined. An integrated multi-criteria decision-making model is introduced. Improved Fuzzy Step-Wise Weight Assessment Ratio Analysis based on the Bonferroni operator was used to determine the importance of the criteria. Measurement of alternatives and ranking according to compromise solution was applied to assess and rank the strategies. The results indicate that "frequent flooding at the Jangwani bridge bus terminal" and "long waiting time at bus stops" are the most critical challenges while the fourth alternative "strengthening the operation and management" is the appropriate strategy to be implemented for successful operation and implementation of the BRT system. After that, a five-phase sensitivity analysis is performed to observe the robustness of the proposed approach. The results indicate the flexibility and applicability of the proposed approach can address real-life problems. The proposed methodology in this work can be instrumental in assisting mass transit operators with the successful implementation and operation of the BRT system.

Mapping the risk distribution of Borrelia burgdorferi sensu lato in China from 1986 to 2020: a geospatial modelling analysis

Lyme borreliosis, recognized as one of the most important tick-borne diseases worldwide, has been increasing in incidence and spatial extent. Currently, there are few geographic studies about the distribution of Lyme borreliosis risk across China. Here we established a nationwide database that involved Borrelia burgdorferi sensu lato (B. burgdorferi) detected in humans, vectors, and animals in China. The eco-environmental factors that shaped the spatial pattern of B. burgdorferi were identified by using a two-stage boosted regression tree model and the model-predicted risks were mapped. During 1986−2020, a total of 2,584 human confirmed cases were reported in 25 provinces. Borrelia burgdorferi was detected from 35 tick species with the highest positive rates in Ixodes granulatus, Hyalomma asiaticum, Ixodes persulcatus, and Haemaphysalis concinna ranging 20.1%−24.0%. Thirteen factors including woodland, NDVI, rainfed cropland, and livestock density were determined as important drivers for the probability of B. burgdorferi occurrence based on the stage 1 model. The stage 2 model identified ten factors including temperature seasonality, NDVI, and grasslands that were the main determinants used to distinguish areas at high or low-medium risk of B. burgdorferi, interpreted as potential occurrence areas within the area projected by the stage 1 model. The projected high-risk areas were not only concentrated in high latitude areas, but also were distributed in middle and low latitude areas. These high-resolution evidence-based risk maps of B. burgdorferi was first created in China and can help as a guide to future surveillance and control and help inform disease burden and infection risk estimates.

Improving Decision-Making for Population Health in Nonhealth Sectors in Urban Environments: the Example of the Transportation Sector in Three Megacities-the 3-D Commission

Noncommunicable diseases (NCDs) represent a significant global public health burden. As more countries experience both epidemiologic transition and increasing urbanization, it is clear that we need approaches to mitigate the growing burden of NCDs. Large and growing urban environments play an important role in shaping risk factors that influence NCDs, pointing to the ineluctable need to engage sectors beyond the health sector in these settings if we are to improve health. By way of one example, the transportation sector plays a critical role in building and sustaining health outcomes in urban environments in general and in megacities in particular. We conducted a qualitative comparative case study design. We compared Bus Rapid Transit (BRT) policies in 3 megacities-Lagos (Africa), Bogotá (South America), and Beijing (Asia). We examined the extent to which data on the social determinants of health, equity considerations, and multisectoral approaches were incorporated into local politics and the decision-making processes surrounding BRT. We found that all three megacities paid inadequate attention to health in their agenda-setting, despite having considerable healthy transportation policies in principle. BRT system policies have the opportunity to improve lifestyle choices for NCDs through a focus on safe, affordable, and effective forms of transportation. There are opportunities to improve decision-making for health by involving more available data for health, building on existing infrastructures, building stronger political leadership and commitments, and establishing formal frameworks to improve multisectoral collaborations within megacities. Future research will benefit from addressing the political and bureaucratic processes of using health data when designing public transportation services, the political and social obstacles involved, and the cross-national lessons that can be learned from other megacities.

Modeling of photolytic degradation of sulfamethoxazole using boosted regression tree (BRT), artificial neural network (ANN) and response surface methodology (RSM); energy consumption and intermediates study

This study explores the boosted regression trees (BRT), artificial neural network (ANN) and response surface methodology (RSM) to model and optimize the operational variables for the simulation of the Photolytic degradation of Sulfamethoxazole (SMX) and concurrent total organic carbon (TOC) removal, based on the experimental data set. Four candidate variables involving initial pH (2-11), initial SMX concentration (50-200 mg L^-1), temperature (15-45 °C) and time (6-120 min) were considered for simultaneous optimization of SMX and TOC degradation. The result revealed that all the three models are statistically considerable as the values of R, R², adj-R² are >0.85, thus be deemed to work well in data fitting, prediction, and optimization, nevertheless, the values of R, R², adj-R², RMSE, MAE and AAD are far better for ANN and BRT than RSM method. The ∼100% SMX degradation conditions were found to be as follows: treatment time: 25 min, pH: 2.0, temperature: 35 °C and SMX concentration: 50 mg L^-1, while the maximum possible removal of TOC under the given conditions was ∼25%. The percentage contribution (PC) of each variable was deduced by ANOVA analysis of proposed quadratic models which indicated that time and pH are important factors than temperature and SMX concentration. The photolytic intermediates and inorganic ions of SMX, were identified and a potential route of transformation was also proposed.

Driving ability after right-sided inguinal hernia surgery

PURPOSE

To investigate driving ability (brake reaction time, BRT) after right-sided hernia repair. It was assumed that postoperatively BRT would be impaired as compared to the preoperative reference and healthy controls.

METHODS

BRT was prospectively collected from 30 patients undergoing hernia repair [Lichtenstein or total extraperitoneal endoscopic procedure (TEP)]. BRT was measured with a driving simulator preoperatively and on postoperative days 2 and 14. After receiving a visual stimulus, the patients had to apply the brake pedal with 160 N. The average of ten runs was used as the patient's BRT value.

RESULTS

Thirty patients completed all measurements. In the Lichtenstein group, BRT was significantly impaired as compared to the patient's preoperative values (p = 0.021). Two weeks after surgery BRT had returned to the preoperative level (p = 0.859). BRT in the Lichtenstein group was also significantly impaired 2 days postoperatively as compared to the BRT of 60 healthy controls (p = 0.001). In the TEP group, no impaired BRT was detected.

CONCLUSIONS

Based on our finding of significantly impaired BRT in patients following right-sided Lichtenstein hernia repair, it seems wise to recommend that such patients refrain from driving for 2 weeks after surgery. No such impairment was found in patients following TEP surgery. Consequently, it is deemed safe for them to resume driving 2 days after the procedure.

Bus commuter exposure and the impact of switching from diesel to biodiesel for routes of complex urban geometry

We report on commuters' exposure to black carbon (BC), PM_2.5 and particle number (PN, with aerodynamic diameter, d_a, in the range 0.01 <d_a< 1.0 μm) collected on-board diesel- and biodiesel-fuelled buses of the Bus Rapid Transit (BRT) system of the city of Curitiba, Brazil. Particulate concentrations measured at high sampling rates allowed the capture of fine gradients along the route and the comparison of in-cabin air pollution on buses of different technologies. Of all metrics, BC showed the largest discrepancies, with mean concentrations of 20.1 ± 20.0 μg m^-3 and 3.9 ± 26.0 μg m^-3 on diesel- and biodiesel-fuelled buses, respectively. Mean PM_2.5 concentrations were similar (31.6 ± 28.5 μg m^-3 and 29.0 ± 17.8 μg m^-3), whilst mean PN concentrations were larger on the biodiesel buses (56,697 ± 26,800 # cm^-3vs. 43,322 ± 32,243 # cm^-3). The results are in line with studies on biodiesel emission factors that reported lower BC mass but more particles with smaller diameters. Our hypothesis is that different emission factors of diesel and biodiesel engines reflected in differences of in-cabin particulate concentrations. We found that the passenger exposure during the bus commutes was affected not only by the fuel used but also by the street geometry along the route, with segments with canyon configurations resulting in peak exposure to particulates. The results suggest that i) switching from diesel to biodiesel may help abate commuters' exposure to BC particles on-board buses of the BRT system, whilst it would need to be complemented with after-treatment technologies to reduce emissions; ii) further reductions in exposure (to peaks in particular) could be achieved by changing bus routes to ones that avoid passing through narrow urban street canyons.

Work stress, fatigue and risk behaviors at the wheel: Data to assess the association between psychosocial work factors and risky driving on Bus Rapid Transit drivers

This Data in Brief (DiB) article presents a hierarchical multiple linear regression model that examine the associations between psychosocial work factors and risk behaviors at the wheel in Bus Rapid Transit (BRT) drivers (n=524). The data were collected using a structured self-administrable questionnaire made of measurements of wok stress (job strain and effort- reward imbalance), fatigue (need for recovery and chronic fatigue), psychological distress and demographics (professional driving experience, hours driven per day and days working per week). The data contains 4 parts: descriptive statistics, bivariate correlations between the study variables and a regression model predicting risk behaviors at the wheel and the entire study dataset. For further information, it is convenient to read the full article entitled “Stress-related Psychosocial Factors at Work, Fatigue, and Risky Driving Behavior in Bus Rapid Transport (BRT) Drivers”, published in Accident Analysis & Prevention.