Explore the vast range of titles available.

Background: Despite Japan’s universal health insurance system, health disparities have increased since the 1990s. However, the impact of area deprivation on various aspects of child health remains understudied.Methods: This population-based cohort study followed 38,554 children born in Japan (May 10–24, 2010) from birth to age 5.5 years. Using an outcome-wide approach, Bayesian three-level logistic regression models (individuals in municipalities within eight major regions) assessed associations between municipality-level Area Deprivation Index (ADI) at birth and multiple preschool health outcomes (hospitalizations for all causes; respiratory infections; gastrointestinal diseases; Kawasaki disease; medical visits for asthma, allergic rhinitis, atopic dermatitis, food allergy, injury, intussusception; prevalence of overweight/obesity), adjusting for individual-level factors.Results: Higher ADI was associated with increased risk of all-cause hospitalization (adjusted odds ratio [aOR] per 1-standard-deviation increase in ADI, 1.04; 95% credible interval [CrI], 1.01–1.07), respiratory infections (aOR, 1.08; 95% CrI, 1.04–1.13), gastrointestinal diseases (aOR, 1.11; 95% CrI, 1.03–1.20), asthma (aOR, 1.10; 95% CrI, 1.01–1.19). Overweight/obesity at age 5.5 years also increased with higher ADI (aOR, 1.11; 95% CrI, 1.06–1.16). Higher ADI was inversely associated with Kawasaki disease (aOR, 0.86; 95% CrI, 0.77–0.96), though not robust in sensitivity analysis. Geographic clustering was observed for all outcomes, particularly at municipality level.Conclusion: We found persistent municipal-level health inequalities across various childhood health outcomes in Japan, despite its universal health insurance system. These findings suggest that policymakers should address health inequalities through comprehensive strategies targeting broader social determinants beyond health care access.

In Ontario, Canada, little is currently known about the extent to which un-immunized children may cluster geographically. Our objectives were to: describe the geographic distribution of fully un-immunized children; identify geographic clusters (hotspots) of un-immunized children; and to characterize the contribution of spatial effects and covariates on hotspots, where found. Our analytic cohort consisted of Ontario students aged 7–17 years in the 2016–2017 school year. We defined students as un-immunized if they had zero doses of any vaccine and a non-medical exemption recorded in Ontario’s registry. We calculated unadjusted proportions of un-immunized students by Census Subdivision (CSD) and then used a sequential approach to identify hotspots starting first with hotspot identification at the CSD level and then probed identified hotspots further by Dissemination Area (DA) and including covariates. Hotspots were identified using the Besag-York-Mollie Bayesian spatial model and were defined as areas with >95% probability of having two times the proportion of un-immunized students, relative to the province overall. We identified 15,208 (0.94%) un-immunized children within our cohort consisting of more than 1.61 million students. Unadjusted proportions of un-immunized students varied greatly by geography, ranging from 0% to 21.5% by CSD. We identified 16 hotspot CSDs which clustered in five distinct areas, all of which were located in southern Ontario. The contribution of covariates and spatial effects on the risk of having un-immunized students varied greatly across hotspot areas. Although the provincial proportion (0.94%) of un-immunized students is small, geographical clustering of such students is evident in Ontario and in some areas presents an important risk for future outbreaks. Further qualitative work within these hotspot areas would be a helpful next step to better characterize the factors associated with vaccine refusal in these communities.

Background: Despite Japan’s universal health insurance system, health disparities have increased since the 1990s. However, the impact of area deprivation on various aspects of child health remains understudied.Methods: This population-based cohort study followed 38,554 children born in Japan (May 10–24, 2010) from birth to age 5.5 years. Using an outcome-wide approach, Bayesian three-level logistic regression models (individuals in municipalities within eight major regions) assessed associations between municipality-level Area Deprivation Index (ADI) at birth and multiple preschool health outcomes (hospitalizations for all causes; respiratory infections; gastrointestinal diseases; Kawasaki disease; medical visits for asthma, allergic rhinitis, atopic dermatitis, food allergy, injury, intussusception; prevalence of overweight/obesity), adjusting for individual-level factors.Results: Higher ADI was associated with increased risk of all-cause hospitalization (adjusted odds ratio [aOR] per 1-standard-deviation increase in ADI, 1.04; 95% credible interval [CrI], 1.01–1.07), respiratory infections (aOR, 1.08; 95% CrI, 1.04–1.13), gastrointestinal diseases (aOR, 1.11; 95% CrI, 1.03–1.20), asthma (aOR, 1.10; 95% CrI, 1.01–1.19). Overweight/obesity at age 5.5 years also increased with higher ADI (aOR, 1.11; 95% CrI, 1.06–1.16). Higher ADI was inversely associated with Kawasaki disease (aOR, 0.86; 95% CrI, 0.77–0.96), though not robust in sensitivity analysis. Geographic clustering was observed for all outcomes, particularly at municipality level.Conclusion: We found persistent municipal-level health inequalities across various childhood health outcomes in Japan, despite its universal health insurance system. These findings suggest that policymakers should address health inequalities through comprehensive strategies targeting broader social determinants beyond health care access.

Purpose Cutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma. Previous studies have reported geographic clustering of CTCL based on the residence at the time of diagnosis. We explore geographic clustering of CTCL using both the residence at the time of diagnosis and past residences using data from the New Jersey State Cancer Registry. Methods CTCL cases ( n  = 1,163) diagnosed between 2006–2014 were matched to colon cancer controls ( n  = 17,049) on sex, age, race/ethnicity, and birth year. Jacquez's Q-Statistic was used to identify temporal clustering of cases compared to controls. Geographic clustering was assessed using the Bernoulli-based scan-statistic to compare cases to controls, and the Poisson-based scan-statisic to compare the observed number of cases to the number expected based on the general population. Significant clusters ( p  < 0.05) were mapped, and standard incidence ratios (SIR) reported. We adjusted for diagnosis year, sex, and age. Results The Q-statistic identified significant temporal clustering of cases based on past residences in the study area from 1992 to 2002. A cluster was detected in 1992 in Bergen County in northern New Jersey based on the Bernoulli (1992 SIR 1.84) and Poisson (1992 SIR 1.86) scan-statistics. Using the Poisson scan-statistic with the diagnosis location, we found evidence of an elevated risk in this same area, but the results were not statistically significant. Conclusion There is evidence of geographic clustering of CTCL cases in New Jersey based on past residences. Additional studies are necessary to understand the possible reasons for the excess of CTCL cases living in this specific area some 8–14 years prior to diagnosis.

Background It is known that geographic location plays a role in developing lung cancer. The objectives of this study were to examine spatio-temporal patterns of lung cancer incidence in Pennsylvania, to identify geographic clusters of high incidence, and to compare demographic characteristics and general physical and mental health characteristics in those areas. Method We geocoded the residential addresses at the time of diagnosis for lung cancer cases in the Pennsylvania Cancer Registry diagnosed between 2010 and 2017. Relative risks over the expected case counts at the census tract level were estimated using a log-linear Poisson model that allowed for spatial and temporal effects. Spatio-temporal clusters with high incidence were identified using scan statistics. Demographics obtained from the 2011–2015 American Community Survey and health variables obtained from 2020 CDC PLACES database were compared between census tracts that were part of clusters versus those that were not. Results Overall, the age-adjusted incidence rates and the relative risk of lung cancer decreased from 2010 to 2017 with no statistically significant space and time interaction. The analyses detected 5 statistically significant clusters over the 8-year study period. Cluster 1, the most likely cluster, was in southeastern PA including Delaware, Montgomery, and Philadelphia Counties from 2010 to 2013 (log likelihood ratio = 136.6); Cluster 2, the cluster with the largest area was in southwestern PA in the same period including Allegheny, Fayette, Greene, Washington, and Westmoreland Counties (log likelihood ratio = 78.6). Cluster 3 was in Mifflin County from 2014 to 2016 (log likelihood ratio = 25.3), Cluster 4 was in Luzerne County from 2013 to 2016 (log likelihood ratio = 18.1), and Cluster 5 was in Dauphin, Cumberland, and York Counties limited to 2010 to 2012 (log likelihood ratio = 17.9). Census tracts that were part of the high incidence clusters tended to be densely populated, had higher percentages of African American and residents that live below poverty line, and had poorer mental health and physical health when compared to the non-clusters (all  p  < 0.001). Conclusions These high incidence areas for lung cancer warrant further monitoring for other individual and environmental risk factors and screening efforts so lung cancer cases can be identified early and more efficiently.

PurposeThis paper examines whether technological changes that promote communications between investors and managers help bridge the gap in the cost of equity capital among firms in different regions.Design/methodology/approachWe use the online interaction platforms of listed firms in China and utilize brokerage presence (BP) to capture the geographic distribution of financial factors. We explore whether online interactions would reduce the cost of equity to a greater extent for firms located in low brokerage presence regions (hereafter “low-BP firms”) than those in high brokerage presence regions (hereafter “high-BP firms”).FindingsWe find low-BP firms benefit more from an improved information environment created by online interactions. We also find that posts about low-BP firms are more value-relevant and useful in processing corporate disclosures. Further, a higher number of interactions significantly enhances more informational efficiency for low-BP firms, and the effect of reducing the gap in financing costs is more pronounced when corporate information is complex.Originality/valueWe conclude that online interactions alleviate geography-induced information frictions and create a relatively level playing field for firms located in all regions.

Bovine coronavirus (BCoV) is widespread in cattle and wild ruminant populations throughout the world. The virus causes neonatal calf diarrhea and winter dysentery in adult cattle, as well as upper and lower respiratory tract infection in young cattle. We isolated and deep sequenced whole genomes of BCoV from calves with respiratory distress in the south–west of France and conducted a comparative genome analysis using globally collected BCoV sequences to provide insights into the genomic characteristics, evolutionary origins, and global diversity of BCoV. Molecular clock analyses allowed us to estimate that the BCoV ancestor emerged in the 1940s, and that two geographically distinct lineages diverged from the 1960s–1970s. A recombination event in the spike gene (breakpoint at nt 1100) may be at the origin of the genetic divergence sixty years ago. Little evidence of genetic mixing between the spatially segregated lineages was found, suggesting that BCoV genetic diversity is a result of a global transmission pathway that occurred during the last century. However, we found variation in evolution rates between the European and non-European lineages indicating differences in virus ecology.

The existence of dietary inequalities is well-known. Dietary behaviours are impacted by the food environment and are thus likely to follow a spatial pattern. Using 12 months of transaction records for around 50,000 ‘primary’ supermarket loyalty card holders, this study explores fruit and vegetable purchasing at the neighbourhood level across the city of Leeds, England. Determinants of small-area-level fruit and vegetable purchasing were identified using multiple linear regression. Results show that fruit and vegetable purchasing is spatially clustered. Areas purchasing fewer fruit and vegetable portions typically had younger residents, were less affluent, and spent less per month with the retailer.

The recycling of e-waste by the informal sector has brought countries in the Global South raw materials (e.g. metals and plastics), second-hand electronic equipment and components, and economic opportunities in conjunction with appalling environmental pollutions and health problems. Despite the longstanding international and national legislation regulating transnational trade and domestic recycling, informal e-waste economies are still clustering in many Global South countries. This study offers historically and geographically specific explanations of this conundrum, by interrogating the multi-scalar regulatory frameworks in which the informal e-waste economies and their pollutions are embedded, by drawing on China, particularly the former global e-waste hub-Guiyu town, as the case study. We argue that the contested and problematic application of current international and national legislation in regulating e-waste is in part pertaining to the slippery definition of what counts as “e-waste” and its paradoxical nature as both resources and pollutants. At the global scale, trajectories of global e-waste flows are shaped by the multitude of loopholes, contradictions and ambiguous articles left by the Basel Convention and by different countries’ disparate attitudes towards the e-waste trade. At the national scale, the ambiguities and contradictions in the Basel Convention have been passed on to and shaped China’s national e-waste regulatory frameworks. China’s equivocal legislation, paradoxical attitude, and formal enterprises’ weak competence contribute to the rise of informal e-waste recycling in Guiyu. Yet, China’s e-waste regime has been greatly restructured within the past decade, with formal recycling enterprises playing an increasingly significant role.

The effects of geographic distance and technological distance on knowledge spillovers have been well acknowledged in the literature, but the two distances were mostly discussed in parallel. Taking advantage of the context of multilocation firms in technology clusters, we consider the joint role of geographic and technological distances by focusing on a salient feature of clusters: firms’ concern about knowledge appropriation. Specifically, we analyze how a firm’s choice of technological distance from local entities is affected by the competitive environment in the cluster as well as its intra-firm technological structure across clusters. Empirical findings based on the global semiconductors industry support our theory that, with stronger local competition, an innovating entity will increase its technological distance from neighbors to reduce unintended knowledge spillovers. However, the technological distance is smaller when the entity is part of a multilocation firm, has a larger technological distance from other locations within the firm and has stronger intra-firm integration across locations. We argue that these features limit knowledge spillovers and, hence, reduce firms’ reliance on technological distance as a strategy for knowledge appropriation.