Public transportation means as seen by citizens: Approaching the case of the Dominican Republic.

and middle-income countries, key constraints such as dense traffic flows, jams, and pollution constitute frequent issues that potentially explain many negative consequences in terms of (e.g.) efficiency, sustainability, and mobility safety. In this regard, recent evidence supports the idea that fostering public transportation is crucial to offering solutions for this difficult panorama. However, transport mode-related choices and shifts have been proven to depend highly on key perceptions and needs of potential users. The aim of this study was to analyze a set of key users' perceptions, usage, and perceived quality of public transportation in the Dominican Republic, as well as to explore the most relevant features for Dominicans from the "desired quality" paradigm. For this research at a national level, data retrieved from a nationwide sample of 1254 inhabitants of the Dominican Republic was used, proportional to the ONE census in terms of sex, age, habitat, and region. Overall, the results show that the general quality of transportation is 6.70 points out of 10. The use of public transportation in the Dominican Republic has a medium-low rating and is very focused on urban buses (41 %) and public cars (27.1 %). Nonetheless, the metro remains the most highly rated means of transport (M = 8.75). Concerning the quality variables analyzed, the highest scores are for accessibility (M = 7.08) and frequency of service (M = 6.99). Further, Dominicans focus on improving comfort, vehicle conditions, and safety. This study constitutes a first approximation to the desired quality of public transportation for Dominican Citizens, which may help policymakers scope user-based needs in public transportation systems and encourage a more frequent (and friendlier) public transport use in the country.

Urban Mobility Pattern Detection: Development of a Classification Algorithm Based on Machine Learning and GPS.

This study introduces an innovative algorithm for classifying transportation modes. It categorizes modes such as walking, biking, tram, bus, taxi, and private vehicles based on data collected through sensors embedded in smartphones. The data include date, time, latitude, longitude, altitude, and speed, gathered using a mobile application specifically designed for this project. These data were collected through the smartphone's GPS to enhance the accuracy of the analysis. The stopping times of each transport mode, as well as the distance traveled and average speed, are analyzed to identify patterns and distinctive features. Conducted in Cuenca, Ecuador, the study aims to develop and validate an algorithm to enhance urban planning. It extracts significant features from mobility patterns, including speed, acceleration, and over-acceleration, and applies longitudinal dynamics to train the classification model. The classification algorithm relies on a decision tree model, achieving a high accuracy of 94.6% in validation and 94.9% in testing, demonstrating the effectiveness of the proposed approach. Additionally, the precision metric of 0.8938 signifies the model's ability to make correct positive predictions, with nearly 90% of positive instances correctly identified. Furthermore, the recall metric at 0.83084 highlights the model's capability to identify real positive instances within the dataset, capturing over 80% of positive instances. The calculated F1-score of 0.86117 indicates a harmonious balance between precision and recall, showcasing the models robust and well-rounded performance in classifying transport modes effectively. The study discusses the potential applications of this method in urban planning, transport management, public transport route optimization, and urban traffic monitoring. This research represents a preliminary stage in generating an origin-destination (OD) matrix to better understand how people move within the city.

Shaping ability of three heat-treated NiTi systems in Vertucci's type III root canals of mandibular incisors: An ex vivo study.

Introduction: The anatomical configuration classified as Vertucci's type III is described as the second most prevalent in mandibular incisors. Methods: Thirty-six Vertucci's type III mandibular incisors were evaluated by micro-computed tomography (micro-CT) and divided into 3 groups (n = 12) according to the root canal preparation protocol (HyFlex CM [HCM], HyFlex EDM [HEDM], and Sequence Rotary File [SRF]). The teeth were scanned before and after performing 0.25 mm and 0.40 mm apical diameter preparations. The canal volume, dentin thickness, percentage of accumulated debris and untouched canal areas, transportation, and centering ability were measured. The data were statistically analyzed by ANOVA, Tukey, Kruskal-Wallis, and Dunn tests (P < 0.05). Results: The volume increase was more evident in the apical third. After 0.40 mm preparation, the SRF system provided a higher reduction (P < 0.05) in dentin thickness on the buccal surface 1 mm from the apex. There was higher canal transportation in the bucco-lingual direction. The 0.40 mm apical preparation reduced the percentage of untouched canal areas. The apical third had the highest percentage of untouched canal areas. The cervical third had the lowest volume of accumulated debris. Conclusions: Increasing the apical preparation to a diameter of 0.40 mm with the HCM, HEDM, and SRF systems in Vertucci's type III root canals of mandibular incisors proved to be safe and effective, reducing untouched canal areas. Clinical relevance: Root flattening can be intense to the point of generating a root canal bifurcation. Despite the decrease in the root canal diameter, a greater enlargement of the apical region is necessary and safe.

Uncovering physical activity trade-offs in transportation policy: A spatial agent-based model of Bogotá, Colombia.

BACKGROUND: Transportation policies can impact health outcomes while simultaneously promoting social equity and environmental sustainability. We developed an agent-based model (ABM) to simulate the impacts of fare subsidies and congestion taxes on commuter decision-making and travel patterns. We report effects on mode share, travel time and transport-related physical activity (PA), including the variability of effects by socioeconomic strata (SES), and the trade-offs that may need to be considered in the implementation of these policies in a context with high levels of necessity-based physical activity. METHODS: The ABM design was informed by local stakeholder engagement. The demographic and spatial characteristics of the in-silico city, and its residents, were informed by local surveys and empirical studies. We used ridership and travel time data from the 2019 Bogotá Household Travel Survey to calibrate and validate the model by SES. We then explored the impacts of fare subsidy and congestion tax policy scenarios. RESULTS: Our model reproduced commuting patterns observed in Bogotá, including substantial necessity-based walking for transportation. At the city-level, congestion taxes fractionally reduced car use, including among mid-to-high SES groups but not among low SES commuters. Neither travel times nor physical activity levels were impacted at the city level or by SES. Comparatively, fare subsidies promoted city-level public transportation (PT) ridership, particularly under a 'free-fare' scenario, largely through reductions in walking trips. 'Free fare' policies also led to a large reduction in very long walking times and an overall reduction in the commuting-based attainment of physical activity guidelines. Differential effects were observed by SES, with free fares promoting PT ridership primarily among low-and-middle SES groups. These shifts to PT reduced median walking times among all SES groups, particularly low-SES groups. Moreover, the proportion of low-to-mid SES commuters meeting weekly physical activity recommendations decreased under the 'freefare' policy, with no change observed among high-SES groups. CONCLUSIONS: Transport policies can differentially impact SES-level disparities in necessity-based walking and travel times. Understanding these impacts is critical in shaping transportation policies that balance the dual aims of reducing SES-level disparities in travel time (and time poverty) and the promotion of choice-based physical activity.

Seguridad de equipos de procuramiento de órganos y tejidos en Chile. ¿Qué esperamos?

Las tasa de trasplantes en Chile es baja en comparación con otros países. Si bien se han hecho importantes avances para aumentar este número, existe poca claridad en cuanto a protocolos de seguridad de los equipos de procuramiento de órganos. A nivel internacional existen diferentes tragedias que han marcado este trabajo, la más conocida es la ocurrida en Michigan, donde un equipo médico perdió la vida al caer sobre el lago en un transporte por un trasplante de pulmón. Años después de la tragedia se conocieron los reiterados reclamos por parte del personal médico en relación a la falta de seguridad durante los traslados. Si bien el procuramiento de órganos tiene un riesgo asociado inherente, este se debe mantener al mínimo. Para avanzar en esto se confeccionó una guía de seguridad donde participaron las organizaciones de trasplante más importantes de Estados Unidos. Se emitieron recomendaciones, donde se regula el transporte aéreo, terrestre, seguros y el futuro de esta actividad. En Chile la orientación técnica que regula el procuramiento, no especifica ninguno de estos puntos y no existe información pública disponible, dejando la seguridad a disposición de las instituciones locales. Si bien es importante reconocer el esfuerzo nacional por mejorar el número de trasplantes año a año, es necesario avanzar en mejorar la seguridad de los equipos de procuramiento, y no esperar que ocurra una tragedia, para generar cambios necesarios, particularmente en un país con una geografía desafiante como Chile.

The transplant rate in Chile is low compared to other countries. Although significant advances have been made to increase this number, there is little clarity regarding safety protocols for organ procurement teams. Internationally, various tragedies have marked this work, the most famous being the one that occurred in Michigan, where a medical team lost their lives when they crashed into a lake during transport for a lung transplant. Years after the tragedy, repeated complaints by medical personnel came to light concerning the lack of safety during transfers. Although organ procurement inherently carries associated risks, these should be kept to a minimum. In 2020, a safety guide was created to make progress with participation from the most crucial transplant organizations in the United States. Recommendations were issued regulating air and ground transportation, insurance, and the future of transplant activity. In Chile, technical guidelines that regulate procurement need to specify crucial safety metrics, and there is no publicly available information or recommendations, leaving safety to the discretion of local institutions. While it is essential to recognize the national effort to improve the number of transplants year after year, it is necessary to advance in improving the safety of procurement teams and not wait for a tragedy to occur to generate the required changes, particularly in a country with challenging geography like Chile.

Destinos e distâncias da caminhada recreativa e utilitária: estudo empírico na cidade de Londrina-Paraná / Destinations and distances of recreational and utilitarian walking: empirical study in the city of Londrina-Paraná

Pesquisas indicam correlatos ambientais distintos para caminhada utilitária e recreativa. Este estudo teve como objetivo identificar locais, destinos e distância percorrida em caminhadas recreativas e uti-litárias, e comparar espacialmente a percepção sobre os locais caminhados. Para isso, foi realizado um estudo observacional transversal, conduzido em Londrina, Brasil. Os dados foram coletados através de questionário aplicado na plataforma Survey123, que contemplou pessoas maiores de 18 anos que reportassem ao menos uma rota de caminhada realizada no município de Londrina. A análise dos deslocamentos reportados foi feita pela estimativa de densidade de Kernele as distâncias de cami-nhada foram analisadas através do coeficiente de correlação ponto-bisserial ­ rpb. A espacialização dos dados perceptivos, obtidos através do questionário Neighborhood Environment Walkability Scale­ NEWS, foi realizada pela identificação de agrupamentos significativos através do indicador Gi*. A amostra totalizou 182 participantes e 305 deslocamentos a pé, dos quais, 61 classificados como ca-minhada recreativa e 244 como utilitária. Os locais de maior densidade de deslocamentos recreativos possuem ampla infraestrutura para pedestres, enquanto os de concentração de deslocamentos utili-tários são caracterizados pela diversidade de uso do solo. A caminhada recreativa registrou distância média de 3.955,3 ± 2.503,5m sendo que, para a caminhada utilitária, a média foi 1.247,0 ± 1.034,0m. A correlação ponto-bisserial obteve rpb = 0,611 e p<0,001, moderada a forte, indicando correlação po-sitiva entre a realização de viagens recreativas e uma maior distância média de caminhada. A pesquisa contribui para a investigação do comportamento de caminhada pela associação de variáveis objetivas e subjetivas e pela captura dos trajetos de deslocamento a pé.

Studies indicate distinct environmental correlates for utilitarian and recreational walking. This study aimed to identify the locations, destinations and the distance traveled in recreational and utilitarian walks, and to compare spatially the perception about the walked places. To achieve this, a cross-sectional observational study was conducted in Londrina, Brazil. Data was collected through a questionnaire applied on the Survey123 platform, including people aged 18 or over that reported at least one walking route performed in Londrina. The route analysis was made by Kernel density estimation and walking distances were analyzed through the point-bisserial correlation coefficient - rpb. The spatialization of perception data, obtained through the Neighborhood Environment Walkability Scale - NEWS form, was performed by identifying significant clus-ters through the Gi* indicator. The sample totaled 182 participants who reported 305 walk routes, of which 61 were classified as recreational walking and 244 as utilitarian. The places of higher recreational walking density have ample infrastructure for pedestrians, and the places with utilitarian walking concentration are characterized by the diversity of land use. Recreational walking recorded mean distance of 3.955.3 ± 2.503.5m, and for utilitarian walking, the average was 1.247.0 ± 1.034.0m. The point-bisserial correlation obtained rpb = 0.611 and p<0.001, moderate to strong, indicating a positive correlation between recreational trips and a greater average walking distance. This research contributes to the investigation of walking behav-ior through the association of objective and subjective variables and through the capture of walking routes.

Planned expansion of transportation infrastructure in Brazil has implications for the pattern of agricultural production and carbon emissions.

High transportation costs have been a barrier to the expansion of agriculture in the interior of Brazil. To reduce transportation costs, Brazil launched the National Logistics Plan, aiming to expand its railway network by up to 91 % by 2035. Such a large-scale infrastructure investment raises concerns about its economic and environmental consequences. By combining geospatial estimation of transportation cost with a grid-resolving, multi-scale economic model that bridges fine-scale crop production with its trade and demand from national and global perspectives, we explore impacts of transportation infrastructure expansion on agricultural production, land use changes, and carbon emissions both locally and nationally in Brazil. We find that globally, the impacts on output and land use changes are small. However, within Brazil, the plan's primary impacts are impressive. PNL2035 results in the reduction of transportation costs by 8-23 % across states (depending on expansion's extent) in the interior Cerrado biome. This results in cropland expansion and increases in terrestrial carbon emissions in the Cerrado region. However, the increase in terrestrial carbon emissions in the Cerrado is offset by spillover effects elsewhere in Brazil, as crop production shifts away from the Southeast-South regions and accompanying change in the mix of transportation mode for farm products from roadway to more emission-efficient railway. Furthermore, we argue that the transportation infrastructure's impact on the enhanced mobility of labor and other agricultural inputs would further accentuate the regional shift in agricultural production and contribute to carbon emission mitigation. Upon its completion, PNL2035 is expected to result in the reduction of net national emissions by 1.8-30.7 million metric ton of CO2-equivalent, depending on the impacts on labor and purchased input mobility. We conclude that the omission of spillover effects due to infrastructure expansion can lead to misleading assessments of transport policies.

A cohort study examining individual factors influencing cycling as a transportation mode in São Paulo, Brazil.

The aim of this study is to explore the relationship between individual-level factors and cycling for transportation in a cohort of participants living in São Paulo city, Brazil. The same participants (n = 1,431 adults) were interviewed in 2014/2015 (Wave 1) and 2020/2021 (Wave 2) as part of the 'São Paulo Health Survey-ISA: Physical Activity and Environment'. For the longitudinal transport cycling binary outcome, participants who reported cycling at both time-points and those who were cycling at Wave 2 only were coded as a positive longitudinal pattern for cycling. Those who were not cycling at either Waves, and those who were cycling at Wave 1 only, were grouped into a negative pattern for cycling. The relationship between the longitudinal patterns for transport cycling and sociodemographics, health characteristics, and behaviors at Wave 1 were tested using bivariate analysis, and the significant individual-level factors were then examined in a multivariable binary logistic regression model. The odds of being classified in the positive cycling pattern were lower for women [OR = 0.09; 95 % CI = 0.04---0.19], and higher for persons aged 30 - 39 [OR = 3.25; 95 % CI = 1.38---7.66], those who owned a bicycle [OR = 2.00; 95 % CI = 1.13---3.54], and those who engaged in ≥ 120 min/week of transport walking [OR = 2.07; 95 % CI = 1.24---3.47] or leisure-time physical activity [OR = 1.77; 95 % CI = 1.02---3.06]. Cycling interventions and promotion should target women, the mid-aged and involve facilitating bicycle access. Advocacy for physical activity interventions is needed to influence transport cycling.

Hypertension during transfer is associated with poor outcomes in unstable patients with ruptured abdominal aortic aneurysm.

OBJECTIVE: Limited data exist for optimal blood pressure (BP) management during transfer of patients with ruptured abdominal aortic aneurysm (rAAA). This study evaluates the effects of hypertension and severe hypotension during interhospital transfers in a cohort of patients with rAAA in hemorrhagic shock. METHODS: We performed a retrospective, single-institution review of patients with rAAA transferred via air ambulance to a quaternary referral center for repair (2003-2019). Vitals were recorded every 5 minutes in transit. Hypertension was defined as a systolic BP of ≥140 mm Hg. The primary cohort included patients with rAAA with hemorrhagic shock (≥1 episode of a systolic BP of <90 mm Hg) during transfer. The primary analysis compared those who experienced any hypertensive episode to those who did not. A secondary analysis evaluated those with either hypertension or severe hypotension <70 mm Hg. The primary outcome was 30-day mortality. RESULTS: Detailed BP data were available for 271 patients, of which 125 (46.1%) had evidence of hemorrhagic shock. The mean age was 74.2 ± 9.1 years, 93 (74.4%) were male, and the median total transport time from helicopter dispatch to arrival at the treatment facility was 65 minutes (interquartile range, 46-79 minutes). Among the cohort with shock, 26.4% (n = 33) had at least one episode of hypertension. There were no significant differences in age, sex, comorbidities, AAA repair type, AAA anatomic location, fluid resuscitation volume, blood transfusion volume, or vasopressor administration between the hypertensive and nonhypertensive groups. Patients with hypertension more frequently received prehospital antihypertensives (15% vs 2%; P = .01) and pain medication (64% vs 24%; P < .001), and had longer transit times (36.3 minutes vs 26.0 minutes; P = .006). Episodes of hypertension were associated with significantly increased 30-day mortality on multivariable logistic regression (adjusted odds ratio [aOR], 4.71; 95% confidence interval [CI], 1.54-14.39; P = .007; 59.4% [n = 19] vs 40.2% [n = 37]; P = .01). Severe hypotension (46%; n = 57) was also associated with higher 30-day mortality (aOR, 2.82; 95% CI, 1.27-6.28; P = .01; 60% [n = 34] vs 32% [n = 22]; P = .01). Those with either hypertension or severe hypotension (54%; n = 66) also had an increased odds of mortality (aOR, 2.95; 95% CI, 1.08-8.11; P = .04; 58% [n = 38] vs 31% [n = 18]; P < .01). Level of hypertension, BP fluctuation, and timing of hypertension were not significantly associated with mortality. CONCLUSIONS: Hypertensive and severely hypotensive episodes during interhospital transfer were independently associated with increased 30-day mortality in patients with rAAA with shock. Hypertension should be avoided in these patients, but permissive hypotension approaches should also maintain systolic BPs above 70 mm Hg whenever possible.

Food environment of bus terminals in the Rio de Janeiro metropolitan region / Ambiente alimentar de terminais rodoviários da região metropolitana do Rio de Janeiro

ABSTRACT PURPOSE To describe and analyze the healthiness of formal and informal food establishments in bus terminals of the metropolitan region of the state of Rio de Janeiro. METHOD An audit was conducted in 156 formal and 127 informal food establishments located in 14 bus terminals of the five most populous cities of the metropolitan region of Rio de Janeiro. Proportions of types of establishments and means (95%CI) of food availability indicators in formal and informal settings were calculated. For the formal setting, prices, proportions of accepted payment methods, days and hours of operation, and food categories with displayed advertising were described. RESULTS The healthiness of food establishments in bus terminals was low (less than 36%). On average, ultra-processed food subgroups were 250% more available for purchase than fresh or minimally processed food. Purchasing food at these places was convenient because several forms of payment were available, and the opening hours of the establishments followed the peaks of movement. In addition, 73.3% of the advertising referred to ultra-processed drinks, and the cost-benefit of buying ultra-processed food was better than fresh or minimally processed food. CONCLUSION The food environment of bus terminals in the metropolitan region of Rio de Janeiro promotes unhealthy eating. Regulatory public policies should focus on initiatives to limit the wide availability and advertising of ultra-processed food in spaces of great circulation of people.

RESUMO OBJETIVO Descrever e analisar a saudabilidade dos estabelecimentos com venda formal e informal de alimentos em terminais rodoviários da região metropolitana do Rio de Janeiro. MÉTODOS Realizou-se auditoria em 156 estabelecimentos formais e 127 pontos informais de venda de alimentos localizados em 14 terminais rodoviários das cinco cidades mais populosas da região metropolitana do Rio de Janeiro. Foram calculadas proporções de tipos de estabelecimentos e médias (IC95%) de indicadores de disponibilidade de alimentos nos ambientes formal e informal. Para o ambiente formal, foram descritos preços, proporções das formas de pagamento aceitas, dias e horários de funcionamento e categorias de alimentos com propaganda exposta. RESULTADOS A saudabilidade dos pontos de venda de alimentos nos terminais rodoviários era baixa (inferior a 36%). Em média, estavam disponíveis para compra 250% mais subgrupos de alimentos ultraprocessados do que in natura ou minimamente processados. Adquirir comida nesses locais era conveniente porque diversas formas de pagamento estavam disponíveis e os horários de funcionamento dos estabelecimentos acompanhavam os picos de movimentação. Além disso, 73,3% das propagandas se referiam a bebidas ultraprocessadas e o custo-benefício da compra de alimentos ultraprocessados era melhor que o de alimentos in natura ou minimamente processados. CONCLUSÃO O ambiente alimentar dos terminais rodoviários da região metropolitana do Rio de Janeiro promove uma alimentação não saudável. Políticas públicas de regulação devem se concentrar em iniciativas que limitem a ampla disponibilidade e publicidade de alimentos ultraprocessados nesses espaços de grande circulação de pessoas.

Desigualdades regionais no acesso ao parto hospitalar no Estado do Rio de Janeiro, Brasil: redes de deslocamento, distância e tempo (2010-2019) / Regional inequalities in access to hospital birth in the state of Rio de Janeiro, Brazil: travel networks, distance, and time (2010-2019) / Desigualdades regionales en el acceso al parto hospitalario en el estado de Río de Janeiro, Brasil: redes de desplazamiento, distancia y tiempo (2010-2019)

Resumo: A dificuldade de acesso aos serviços de atenção ao parto está associada à mortalidade infantil e neonatal e à morbimortalidade materna. Neste estudo, dados do Sistema Único de Saúde (SUS) foram utilizados para mapear a evolução da acessibilidade geográfica ao parto hospitalar de risco habitual no Estado do Rio de Janeiro, Brasil, correspondentes a 418.243 internações nos biênios 2010-2011 e 2018-2019. Foram estimados os fluxos de deslocamento, as distâncias percorridas e o tempo de deslocamento intermunicipal entre o município de residência e de internação das gestantes. Houve um crescimento de 15,9% para 21,5% na proporção de gestantes que precisaram se deslocar. A distância percorrida aumentou de 24,6 para 26km, e o tempo de deslocamento de 76,4 para 96,1 minutos, com grande variação entre as Regiões de Saúde (RS). As gestantes residentes na RS Centro Sul se deslocaram mais frequentemente (37,4-48,9%), e as residentes nas RS Baía da Ilha Grande e Noroeste percorreram as maiores distâncias (90,9-132,1km) e levaram mais tempo para chegar ao hospital no último biênio (96-137 minutos). A identificação dos municípios que receberam gestantes de muitos outros municípios e daqueles que atenderam maior volume de gestantes (núcleos e polos de atração, respectivamente) refletiu a indisponibilidade e as disparidades no acesso aos serviços. As desigualdades regionais e a redução da acessibilidade alertam para a necessidade de adequar a oferta à demanda e de revisar a distribuição dos serviços de atenção ao parto no Rio de Janeiro. O estudo contribui para as pesquisas e o planejamento sobre o acesso a serviços de saúde materno-infantil, além de servir como referência para outros estados do país.

Abstract: Difficult access to birth care services is associated with infant and neonatal mortality and maternal morbidity and mortality. In this study, data from the Brazilian Unified National Health System (SUS) were used to map the evolution of geographic accessibility to hospital birth of usual risk in the state of Rio de Janeiro, Brazil, corresponding to 418,243 admissions in 2010-2011 and 2018-2019. Travel flows, distances traveled, and intermunicipal travel time between the pregnant women's municipality and hospital location were estimated. An increase from 15.9% to 21.5% was observed in the number of pregnant women who needed to travel. The distance traveled increased from 24.6 to 26km, and the travel time from 76.4 to 96.1 minutes, with high variation between Health Regions (HR). Pregnant women living in HR Central-South traveled more frequently (37.4-48.9%), and those living in the HRs Baía da Ilha Grande and Northwest traveled the largest distances (90.9-132.1km) and took more time to get to the hospital in 2018-2019 (96-137 minutes). The identification of municipalities that received pregnant women from many other municipalities and municipalities that treated a higher number of pregnant women (hubs and attraction poles, respectively) reflected the unavailability and disparities in access to services. Regional inequalities and reduced accessibility highlight the need to adapt supply to demand and review the distribution of birth care services in the state of Rio de Janeiro. This study contributes to research and planning on access to maternal and child health services and can be used as a reference study for other states in the country.

Resumen: La dificultad para acceder a los servicios de atención al parto está asociada con la mortalidad infantil y neonatal, y con la morbimortalidad materna. En este estudio, se utilizaron datos del Sistema Único de Salud (SUS) para mapear la evolución de la accesibilidad geográfica al parto hospitalario de riesgo habitual en el estado de Río de Janeiro, Brasil, correspondiente a 418.243 hospitalizaciones en los bienios 2010-2011 y 2018-2019. Se estimaron los flujos de desplazamiento, las distancias recorridas y el tiempo de desplazamiento intermunicipal entre el municipio de residencia y la hospitalización de las mujeres embarazadas. Hubo un aumento del 15,9% al 21,5% en la proporción de mujeres embarazadas que necesitaron desplazarse. La distancia recorrida aumentó de 24,6 a 26km y el tiempo de desplazamiento de 76,4 a 96,1 minutos, con gran variación entre las Regiones de Salud (RS). Las mujeres embarazadas residentes en la RS Centro Sul se desplazaron con mayor frecuencia (37,4-48,9%), y las residentes en las RS Baía da Ilha Grande y Noroeste recorrieron las mayores distancias (90,9-132,1km) y tardaron más en llegar al hospital en el últimos bienio (96-137 minutos). La identificación de los municipios que recibieron mujeres embarazadas de muchos otros municipios y de aquellos que atendieron a un mayor volumen de mujeres embarazadas (núcleos y polos de atracción, respectivamente) reflejó la indisponibilidad y las disparidades en el acceso a los servicios. Las desigualdades regionales y la reducida accesibilidad alertan sobre la necesidad de adaptar la oferta a la demanda, y de revisar la distribución de los servicios de atención al parto en el estado de Rio de Janeiro. El estudio contribuye a las investigaciones y a la planificación sobre el acceso a los servicios de salud materno-infantil, y puede servir como referencia para otros estados del país.

Human mobility and socioeconomic datasets of the Rio de Janeiro metropolitan area.

This data descriptor presents two main datasets and a set of auxiliary files. The mobility dataset presents a long-term study of human mobility in the Rio de Janeiro Metropolitan Area (RJMA) performed in the entire year of 2014 based on mobile phone data. The socioeconomic dataset presents selected socioeconomic variables of the Brazilian 2010 census. A set of auxiliary files is included to present georeferenced information and geographic features (shapefiles) and data used to validate the mobility estimates. The human mobility estimation was carried out using a methodology that allows direct integration with census data, based on an approximation of the geographic boundaries of census units by an aggregation of Voronoi polygons of the mobile phone antennas. The study area is the Brazilian local area 21, which includes the entire RJMA and four other municipalities. The mobility dataset is divided into two files: one is an estimation of the origin-destination (OD) matrix per day, and the other is a visitors' dataset where the number of visitors of each location is estimated in four shifts each day. The socioeconomic dataset presents information of 55 variables for each location, which have been used in different studies and present the longest human mobility dataset available for public use.

Patrones de actividad de mamíferos alrededor de la línea transportadora de gas natural de Camisea en la Reserva Comunal Machiguenga, Cusco, Perú

En el presente trabajo se estudia la actividad horaria de los mamíferos que habitan el área circundante a la línea transportadora de gas de Camisea que atraviesa la Reserva Comunal Machiguenga. Desde febrero del 2020 hasta enero del 2021, se realizó un registro fotográfico mediante cámaras trampa dispuestas a lo largo de la tubería de gas. Los patrones de actividad se estimaron mediante la función de densidad de Kernel. Durante el periodo de estudio, se registraron 25 especies de mamíferos. Se encontró que Dasyprocta kalinowskii y Eira barbara presentan un patrón de actividad diurno; mientras que Cuniculus paca, Tapirus terrestris, Dasypus spp. y Mazama spp. presentan un patrón predominantemente nocturno. Se sugiere que los patrones de actividad observados estarían influenciados por varios factores como la exclusión competitiva entre D. kalinowskii y C. paca, disponibilidad estacional del alimento para T. terrestris, variación de temperatura y precipitación para Dasypus spp., restricciones filogenéticas en Mazama spp., y segregación temporal con otros carnívoros para E. barbara. Se destaca la importancia de la colaboración entre las empresas del rubro energético, las comunidades nativas y las organizaciones gubernamentales.

The present study investigates the hourly activity patterns of mammals inhabiting the area surrounding the Camisea gas pipeline that crosses the Machiguenga Communal Reserve. From February 2020 to January 2021, a photographic record was conducted using camera traps placed along the gas pipeline. Activity patterns were estimated using Kernel density functions. During the study period, 25 mammal species were recorded. It was found that Dasyprocta kalinowskii and Eira barbara exhibit a diurnal activity pattern, whereas Cuniculus paca, Tapirus terrestris, Dasypus spp., and Mazama spp. display predominantly nocturnal behavior. It is suggested that observed activity patterns could be influenced by various factors such as competitive exclusion between D. kalinowskii and C. paca, seasonal food availability for T. terrestris, temperature and precipitation variations for Dasypus spp., phylogenetic constraints in Mazama spp., and temporal segregation with other carnivores for E. barbara. The significance of collaboration between energy industry companies, native communities, and governmental organizations is emphasized.

Environmental vs psychosocial barriers to active commuting to university: which matters more?

OBJECTIVES: The aims of this study were (1) to examine the differences in the mode of commuting and barriers to active commuting to university between the sexes (men and women) and in different countries (Chile and Spain); and (2) to analyse the association between the mode of commuting and the perceived barriers for male and female university students in Chile and Spain. STUDY DESIGN: This cross-sectional study took place between April 2017 and May 2018 in Chile and Spain. METHODS: The study population included 2269 university students (53.0% women). The mode of commuting and barriers to active commuting to university were assessed by a self-reported questionnaire. Multinomial logistic regression analysis was used to examine the associations. RESULTS: In both sexes, public and private transport were the main modes of commuting used in Chile and Spain, respectively, followed by active commuting in all participants, except for female students in Spain. Women perceived more environmental and psychosocial barriers compared to men (Chile: P < 0.001; Spain: P = 0.006). Perceived environmental barriers showed higher significant differences between students in Chile and Spain (P < 0.05). Private commuters reported a larger proportion of psychosocial barriers compared to active commuters (Chile: men P = 0.001, women P < 0.001; Spain: men P < 0.001, women P = 0.036). CONCLUSIONS: The study findings suggest that the mode of commuting and the barriers to active commuting to university may be influenced by sex and country.

Determining the Impacts of COVID-19 on Urban Deliveries in the Metropolitan Region of Belo Horizonte Using Spatial Analysis.

The COVID-19 pandemic has changed lifestyles, with consequent impacts on urban freight movements. This paper analyzes the impacts of COVID-19 on urban deliveries in the Belo Horizonte Metropolitan Region, Brazil. The Lee index and the Local Indicator of Spatial Association were calculated using data on urban deliveries (retail and home deliveries) and COVID-19 cases. The results confirmed the negative impacts on retail deliveries and the positive impacts on home deliveries. The spatial analysis demonstrated that the most interconnected cities presented more similar patterns. At the beginning of the pandemic, consumers were considerably concerned about the virus spread, and the changes in consumption behavior were slow. The findings suggest the importance of alternative strategies to traditional retail. In addition, the local infrastructure should adapt to the increased demand for home deliveries during pandemics.

Decline in Traffic Congestion Increased Crash Severity in the Wake of COVID-19.

Highway fatalities are a leading cause of death in the U.S. and other industrialized countries. Using highly detailed crash, speed, and flow data, we show highway travel and motor vehicle crashes fell substantially in California during the response to the COVID-19 pandemic. However, we also show the frequency of severe crashes increased owing to lower traffic congestion and higher highway speeds. This "speed effect" is largest in counties with high pre-existing levels of congestion, and we show it partially or completely offsets the "VMT effect" of reduced vehicle miles traveled on total fatalities. During the first eleven weeks of the COVID-19 response, highway driving decreased by approximately 22% and total crashes decreased by 49%. While average speeds increased by a modest 2 to 3 mph across the state, they increased between 10 and 15 mph in several counties. The proportion of severe crashes increased nearly 5 percentage points, or 25%. While fatalities decreased initially following restrictions, increased speeds mitigated the effect of lower vehicle miles traveled on fatalities, yielding little to no reduction in fatalities later in the COVID period.

Estimation of trip purposes in public transport during the COVID-19 pandemic: The case of Santiago, Chile.

The COVID-19 pandemic strongly affected the mobility of people. Several studies have quantified these changes, for example, measuring the effectiveness of quarantine measures and calculating the decrease in the use of public transport. Regarding the latter, however, a low level of understanding persists as to how the pandemic affected the distribution of trip purposes, hindering the design of policies aimed at increasing the demand for public transport in a post-pandemic era. To address this gap, in this article, we study how the purposes of trips made by public transport evolved during the COVID-19 pandemic in the city of Santiago, Chile. For this, we develop an XGBoost model using the latest available origin-destination survey as input. The calibrated model is applied to the information from smart payment cards during one week in 2018, 2020, and 2021. The results show that during the week of maximum restriction, that is, during 2020, the distribution of trips by purpose varied considerably, with the proportion of trips to work increasing, recreational trips decreasing, and trips for health purposes remaining unchanged. In sociodemographic terms, in the higher-income communes, the decrease in the proportion of trips for work purposes was much greater than that in the communes with lower income. Finally, with the gradual return to in-person activities in 2021, the distribution of trip purposes returned to values similar to those before the pandemic, although with a lower total amount, which suggests that unless relevant measures are taken, the low use of public transportation could be permanent.

Estimating pandemic effects in urban mass transportation systems: An approach based on visibility graphs and network similarity.

The COVID-19 pandemic has caused unprecedented disruptions to urban systems worldwide, but the extent and nature of these disruptions are not yet fully understood when it comes to transportation. In this work, we aim to explore how social distancing policies have affected passenger demand in urban mass transportation systems with the goal of supporting informed decisions in policy planning. We propose an approach based on complex networks and clustering time series with similar behavior, investigating possible changes in similarity patterns during pandemics and how they reflect into a regional scale. The methods shown here proved useful in detecting that lines in central or peripheral regions present different dynamics, that bus lines have changed their behavior during pandemic so that similarity relations have changed significantly, and that when social distancing started, there was an abrupt shock in the properties of daily passenger time series, and the system did not return to its original behavior until the end of the evaluated period. The approach allows to track evolution of the community structure in different scenarios providing managers with tools to reinforce or destabilize similarities if needed.

Síndrome pilórico en un body packer / Pyloric syndrome in a body packer

Introducción. El embalaje y transporte de estupefacientes dentro del organismo, o body packing, es una práctica frecuente en Centroamérica y el Caribe. Además del riesgo de muerte por la exposición a las sustancias tóxicas, existe el riesgo de complicaciones mecánicas con indicación de manejo quirúrgico. El Hospital de Engativá, por su cercanía al aeropuerto de Bogotá, D.C., Colombia, es el centro de referencia para el tratamiento de estos pacientes. Caso clínico. Un hombre de 65 años traído al hospital por un episodio emético con expulsión de cuatro cápsulas para el transporte de estupefacientes. Al examen físico se encontraron masas palpables en el hemiabdomen superior, sin abdomen agudo. La tomografía de abdomen informó un síndrome pilórico secundario a retención gástrica de cuerpos extraños. Fue llevado a laparotomía y gastrotomía logrando la extracción de 97 objetos cilíndricos de látex que contenían sustancias ilícitas. Discusión. En los body packer asintomáticos, la administración de soluciones laxantes es una estrategia terapéutica segura. Los casos reportados de obstrucción gastrointestinal son infrecuentes y se relacionan con la ingesta de un gran número de cápsulas, por lo que es necesario el tratamiento quirúrgico. Conclusión. El síndrome pilórico es una presentación infrecuente en un body packer. Se debe tener un alto índice de sospecha para garantizar un manejo oportuno

Introduction. Packaging and transportation of narcotic drugs inside a human body, or body packing, is a frequent practice in Central America and the Caribbean. In addition to the risk of death due to exposure to toxic substances, there is a risk of mechanical complications with an indication for surgical management. The Engativá Hospital, due to its proximity to the airport in Bogotá, D.C., Colombia, is the reference center for the treatment of these patients. Clinical case. A 65-year-old man brought to the hospital for an emetic episode with expulsion of four narcotic transport capsules. Physical examination revealed palpable masses in the upper abdomen, without an acute abdomen. Abdominal tomography revealed pyloric syndrome secondary to gastric retention of foreign bodies. He was taken to laparotomy and gastrotomy, achieving the extraction of 97 cylindrical latex objects that contained illicit substances. Discussion. In asymptomatic body packers, the administration of laxative solutions is a safe therapeutic strategy. Reported cases of gastrointestinal obstruction are infrequent and are related to the ingestion of a large number of capsules, for which surgical treatment is necessary. Conclusion. Pyloric syndrome is an uncommon presentation in body packers. A high index of suspicion is required to ensure timely management

Tratamiento médico del body packer o mulas de drogas

Introducción: Durante el año 2020, más de 284 millones de personas en el mundo se afectaron por el consumo de drogas. Estas se transportan en diferentes formas de embalaje o en el propio cuerpo y son los llamados correos humanos. Las personas que utilizan el interior del cuerpo con esos fines se describen con varios términos, entre ellos body packers o mulas de drogas. Es una práctica peligrosa, con graves consecuencias médico-legales. Se realizó una revisión bibliográfica de documentos indexados en las bases de datos SciELO, PubMed y Google académico. Se incluyeron los artículos a texto completo, en español, portugués e inglés, publicados desde 2018 hasta 2022, relacionados con el tema. Objetivo: Examinar las formas de enfrentar desde el punto de vista médico un problema de salud como el body packer. Desarrollo: En la actividad de body packer participan individuos de ambos sexos, de todos los grupos etarios. Las sustancias trasportadas son: cocaína, heroína, anfetaminas, marihuana, hachís y drogas sintéticas. Se portan entre 50 a 200 cápsulas con 5 a 10 kilogramos de la sustancia total. Para su evaluación son necesarios estudios imagenológicos que varían en sensibilidad y disponibilidad. Más del 80 % de los casos son asintomáticos, resuelven con estricta vigilancia y uso de polietilenglicol para la evacuación intestinal; el resto de los casos, desarrollan el síndrome de body packer, requieren tratamiento quirúrgico y apoyo con tratamiento sintomático y específico. Conclusiones: Para el body packer está prevista la realización de estudios imagenológicos, así como el tratamiento médico o quirúrgico según las formas clínicas que se presenten.

Introduction: During the year 2020, more than 284 million people in the world were affected by the consumption of drugs, which are transported in different forms of packaging or using the body itself, called human couriers; people who use the inside of their body for these purposes are described by various terms, including body packers or drug mules, a dangerous practice, with serious medical-legal consequences. A bibliographic review of documents indexed in the SciELO, PubMed and academic Google databases is carried out. Full text articles, in Spanish, Portuguese and English, published from 2018 to 2022, related to the topic were included. Objective: To examine the ways to deal with a health problem such as body packer from a medical point of view. Development: Individuals of both sexes, of all age groups, participate in the body packer activity. The transported substances are: cocaine, heroin, amphetamines, marijuana, hashish and synthetic drugs. Between 50 and 200 capsules with 5 to 10 kilograms of the total substance are carried. Imaging studies that vary in sensitivity and availability are necessary for its evaluation. More than 80% of cases are asymptomatic, resolve with strict surveillance and use of polyethylene-glycol for bowel evacuation; the rest of the cases develop body packer syndrome and require surgical treatment and support with symptomatic and specific treatment. Conclusions: For the body packer, imaging studies are planned, as well as medical or surgical treatment according to the clinical forms that occur.