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"Wang, Fahui"
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Measurement, Optimization, and Impact of Health Care Accessibility: A Methodological Review
Despite spending more than any other nation on medical care per person, the United States ranks behind other industrialized nations in key health performance measures. A main cause is the deep disparities in access to care and health outcomes. Federal programs such as the designations of Medically Underserved Areas/Populations and Health Professional Shortage Areas are designed to boost the number of health professionals serving these areas and to help alleviate the access problem. Their effectiveness relies first and foremost on an accurate measure of accessibility so that resources can be allocated to truly needy areas. Various measures of accessibility need to be integrated into one framework for comparison and evaluation. Optimization methods can be used to improve the distribution and supply of health care providers to maximize service coverage, minimize travel needs of patients, limit the number of facilities, and maximize health or access equality. Inequality in health care access comes at a personal and societal price, evidenced in disparities in health outcomes, including late-stage cancer diagnosis. This review surveys recent literature on the three named issues with emphasis on methodological advancements and implications for public policy.
Journal Article
Cancer incidence data at the ZIP Code Tabulation Area level in the United States interpolated by Monte Carlo simulation with multiple constraints
High-quality cancer data are fundamental for public health research and policy, but cancer data for small geographic units and population subgroups in the United States are rarely available due to small-sample suppression rules, spatial coarsening, and data incompleteness. These limitations hinder high-resolution spatial analyses and precision public health interventions. This study provides a high-resolution cancer incidence dataset for the U.S., generated through a multi-constraint Monte Carlo simulation framework that reconstructs suppressed county-level cancer data and systematically disaggregates them to ZIP Code Tabulation Areas (ZCTAs), guided by demographic constraints. This method integrates population subgroup structures and macro-level incidence rates as constraints, ensuring consistency and reliability across spatial scales. The resulting dataset spans multiple geographic units, from state and county levels to ZCTAs, enabling comprehensive analyses of cancer burden, in-depth spatial analyses, and precision public health interventions across multiple scales.
Journal Article
Analyzing Population Density Disparity in China with GIS-automated Regionalization: The Hu Line Revisited
The famous ‘Hu Line’, proposed by Hu Huanyong in 1935, divided China into two regions (southeast and northwest) of comparable area size but drastically different in population. However, the classic Hu Line was derived manually in absence of reliable census data and computational technologies of modern days. It has been subject to criticism of lack of scientific rigor and accuracy. This research uses a GIS-automated regionalization method, termed REDCAP (Regionalization with Dynamically Constrained Agglomerative Clustering and Partitioning), to reconstruct the demarcation line based on the 2010 county-level census data in China. The results show that the logarithmic transformation of population density is a better measure of attributive homogeneity in derived regions than density itself, and produces two regions of nearly identical area size and greater contrast in population. Specifically, the revised Hu Line by Hu Huanyong in 1990 had the southeast region with 94.4% of total population and 42.9% of total land, and our delineation line yields a southeast region with 97.4% population and 50.8% land. Therefore, the population density ratio of the two regions is 27.1 by our line, much higher than the ratio of 22.4 by the Hu Line, and thus outperforms the Hu Line in deriving regions of maximum density contrast with comparable area size. Furthermore, more regions are delineated to further advance our understanding of population distribution disparity in China.
Journal Article
A big data approach to mitigating the MAUP in measuring excess commuting
Excess commuting, defined as the inefficiency resulting from spatial mismatches between residential and employment locations, poses significant challenges for urban planning and transportation systems. This study uses big data from individual vehicle trips collected in Tampa, Florida, to quantify excess commuting more accurately than traditional zonal approaches. Through the application of Linear Programming (LP) and Integer Linear Programming (ILP) models, this research measures minimum and actual commuting patterns across different spatial scales—census tract, block group, and individual trip levels. The findings reveal a clear scale effect associated with the Modifiable Areal Unit Problem (MAUP), as smaller spatial units consistently yield shorter minimum commuting distances and times and the ILP model at the individual trip level yields the least. By directly analyzing actual trips rather than simulated data, this approach provides a more precise and realistic assessment of excess commuting. The results underscore the values of methodological improvements and individual-level data in refining our understanding of excess commuting and supporting more efficient urban planning and policymaking.
Journal Article
Heavy-Duty Vehicle Braking Stability Control and HIL Verification for Improving Traffic Safety
The braking failure of heavy vehicles under long downhill or curved conditions may cause traffic crash and reduce road traffic efficiency. Therefore, to improve the traffic safety and braking stability of vehicles under special road conditions, a braking dynamic model and control system based on the interval uncertainty analysis are proposed, and the safety of the active control model is verified by experiments (HIL). Firstly, the interval uncertain dynamic model is established based on the Monte Carlo method, and the braking failure simulation analysis of the right front wheel of heavy vehicles is carried out in the set of three uncertain intervals. Secondly, the fuzzy PID and sliding mode controller based on yaw and centroid error are designed to find the optimal control strategy from the two kinds of control strategies for HIL experiments. Finally, the actual control effect and feasibility of these control algorithms for heavy vehicle braking under special road conditions are verified by HIL experiments. The experimental results show that under the action of the fuzzy PID control strategy, the running stability of the vehicle is significantly improved compared with no control, which effectively reduces the risk of vehicle braking failure and improves the active safety and stability of the vehicle.
Journal Article
Street Centrality and the Location of Economic Activities in Barcelona
The paper examines the geography of three street centrality indices and their correlations with various types of economic activities in Barcelona, Spain. The focus is on what type of street centrality (closeness, betweenness and straightness) is more closely associated with which type of economic activity (primary and secondary). Centralities are calculated purely on the street network by using a multiple centrality assessment model, and a kernel density estimation method is applied to both street centralities and economic activities to permit correlation analysis between them. Results indicate that street centralities are correlated with the location of economic activities and that the correlations are higher with secondary than primary activities. The research suggests that, in urban planning, central urban arterials should be conceived as the cores, not the borders, of neighbourhoods.
Journal Article
Review: Perovskite X-ray Detectors (1997–Present)
Perovskite materials have attracted extensive attention because of their superior performance in the fields of photoelectric detection, photovoltaics, light-emitting diodes, metal–air batteries, etc. However, their development and application in the field of X-ray detectors have not been reviewed. In this paper, research on perovskite-based X-ray detectors is analyzed using the bibliometric method. This analysis sample includes the literature from 1997 to the present. In addition, the research status of perovskite-based scintillators and direct X-ray detectors under different crystallization conditions and different preparation methods is discussed. Finally, several problems that need to be overcome in the future of perovskite-based X-ray detectors are put forward.
Journal Article
Testing an adapted obesity prevention intervention in under resourced schools: a pilot clustered randomized controlled trial
The purpose of this pilot study was to test an adapted childhood obesity prevention intervention called Preventing Obesity Using Digital-Assisted Movement and Eating (
ProudMe
) in under-resourced schools. Six schools were cluster-randomized to
ProudMe
(
n
= 33; at three schools) or waitlist control (
n
= 46; at three schools) conditions.
ProudMe
aimed to improve participants’ health behaviors and weight status through interventions in the school cafeteria (i.e.,
ProudMe
Cafeteria), physical education (PE) (i.e.,
ProudMe
PE), and through artificial-intelligence- (AI-) assisted behavioral counseling (i.e.,
ProudMe
Tech), and staff professional development (i.e.,
ProudMe
PD). Two implementation outcomes including penetration and fidelity were captured through mixed methods. We drew upon the Consolidated Framework for Implementation Research (CFIR) to identify facilitators and barriers underlying implementation. The intervention only resulted in highly positive implementation outcomes in the cafeterias, which subsequently resulted in improved cafeteria scores. Implementation outcomes were less desirable in
ProudMe
PE with moderate penetration and fidelity.
ProudMe
PD was well attended but
ProudMe
Tech was under-utilized. The pilot intervention as a whole did not show significant effects on student-level outcomes (
p
> 0.05). Multiple facilitators and barriers across CFIR domains emerged as influential factors for the pilot intervention’s implementation and preliminary effectiveness. This study generated mixed evidence concerning the
ProudMe
intervention. The lessons learned inform future intervention refinement.
Journal Article
Patient-centric analysis of Orientia tsutsugamushi spatial diversity patterns across Hainan Island, China
Scrub typhus, traditionally caused by Orientia tsutsugamushi, is a re-emerging public health concern within the Tsutsugamushi Triangle. Despite growing awareness, prevention strategies remain inadequate on Hainan Island, China, where scrub typhus poses a significant threat, especially in field-related environments.
Gene flow analysis of the tsa56 gene and multilocus sequence typing (MLST) were conducted on 156 previously confirmed scrub typhus cases from 2018 to 2021 across Hainan Island. By integrating published datasets, we identified 12 major sub-genotypes and traced their origins, revealing that these sub-genotypes share origins with isolates from Southeast Asia and coastal provinces and island of China, but also demonstrate unique local adaptations across all isolates. Alpha diversity index analysis was applied across administrative regions to identify hotspot regions. This analysis showed that nine out of the detected fourteen administrative regions, particularly along the northern and western coastlines and inland areas, exhibited relatively high genetic diversity, with the highest incidence observed in Qiongzhong, a centrally located city. Related major sequence types were mapped, and distances between locations were estimated, showing that identical MLST sequence types were observed to transfer across distances of 23 to 125 km between different sites on the island. Pathogen density was analyzed using quantitative real-time PCR targeting the tsa56 gene. Without accounting for potential confounding factors or dataset limitations, the Karp_B_2 sub-genotype showed a significant increasing trend in pathogen density with prolonged fever duration, while Gilliam sub-genotypes exhibited a slower or even declining trend.
These findings emphasize the urgent need for targeted public health interventions, particularly focusing on vulnerable populations in rural and agricultural areas of nine key administrative regions where high genetic diversity and pathogen spread were observed. Additionally, this study provides valuable insights into the transmission dynamics and infection progression of scrub typhus, using gene flow analysis and multilocus sequence typing to identify major sub-genotypes.
Journal Article