Cross-State Travel for Cancer Care and Implications for Telehealth Reciprocity.

Importance: Patients often travel for cancer care, yet the extent to which patients cross state lines for cancer care is not well understood. This knowledge can have implications for policies that regulate telehealth access to out-of-state clinicians.

Objective: To quantify the extent of cross-state delivery of cancer services to patients with cancer.

A multi-constraint Monte Carlo Simulation approach to downscaling cancer data.

This study employs an innovative multi-constraint Monte Carlo simulation method to estimate suppressed county-level cancer counts for population subgroups and extend the downscaling from county to ZIP Code Tabulation Areas (ZCTA) in the U.S. Given the known cancer counts at a higher geographic level and larger demographic groups at the same geographic level as constraints, this method uses the population structure as probability in the Monte Carlo simulation process to estimate suppressed data entries.

Characterizing the Traveling Oncology Workforce and Its Influence on Patient Travel Burden: A Claims-Based Approach.

Purpose: Oncology outreach is a common strategy for extending cancer care to rural patients. However, a nationwide characterization of the traveling workforce that enables this outreach is lacking, and the extent to which outreach reduces travel burden for rural patients is unknown.

Methods: This cross-sectional study analyzed a rural (nonurban) subset of a 100% fee-for-service sample of 355,139 Medicare beneficiaries with incident breast, colorectal, and lung cancers.

Broadband Data Forensics: Spatiotemporal Variations of the Download/Upload Speed Metric Commonly Used to Evaluate Potential Telehealth Accessibility.

The complicated task of evaluating potential telehealth access begins with the metrics and supporting datasets that seek toevaluate the presence and durability of broadband connections in a community. Broadband download/upload speeds are one of the popular metrics used to measure potential telehealth access, which is critical to health equity. An understanding of the limitations of these measures is important for drawing conclusions about the reality of the digital divide in telehealth access.

Refining 2SVCA Method for Measuring Telehealth Accessibility of Primary Care Physicians in Baton Rouge, Louisiana.

Equity in health care delivery is a longstanding concern of public health policy. Telehealth is considered an important way to level the playing field by broadening health services access and improving quality of care and health outcomes. This study refines the recently developed "2-Step Virtual Catchment Area (2SVCA) method" to assess the telehealth accessibility of primary care in the Baton Rouge Metropolitan Statistical Area, Louisiana.

Disparities in spatial accessibility of primary care in Louisiana: From physical to virtual accessibility.

Telehealth has been widely employed and has transformed how healthcare is delivered in the United States as a result of COVID-19 pandemic. While telehealth is utilized and encouraged to reduce the cost and travel burden for access to healthcare, there are debates on whether telehealth can promote equity in healthcare services by narrowing the gap among diverse groups. Using the Two-Step Floating Catchment Area (2SFCA) and Two-Step Virtual Catchment Area (2SVCA) methods, this study compares the disparities of physical and virtual access to primary care physicians (PCPs) in Louisiana.

Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States.

Unlabelled: Defining a reliable geographic unit pertaining to cancer care is essential in its assessment, planning, and management. This study aims to delineate and characterize the cancer service areas (CSA) accounting for the presence of major cancer centers in the United States. We used the Medicare enrollment and claims from January 1, 2014 to September 30, 2015 to build a spatial network from patients with cancer to cancer care facilities that provided inpatient and outpatient care of cancer-directed surgery, chemotherapy, and radiation.

Numerical and Experimental Study on Flame Dynamics of the Premixed Methane-Air Mixture at Different Ignition Positions in a Two-Side 45° Branch Tube.

The combustion characteristics of premixed methane-air flames in a half-open tube with a two-sided 45° branch structure at different ignition positions were investigated by experiments and large eddy simulations. The numerical results were compared with the experimental results to verify the correctness of the model. The results show that the simulation results are highly consistent with the experiment.

Multiscale analysis of cancer service areas in the United States.

The purpose of delineating Cancer Service Areas (CSAs) is to define a reliable unit of analysis, more meaningful than geopolitical units such as states and counties, for examining geographic variations of the cancer care markets using geographic information systems (GIS). This study aims to provide a multiscale analysis of the U.S.

The uneven reaction to combat the COVID-19 pandemic: Geovisualizing of fever clinics in mainland China.

The COVID-19 pandemic has exerted unprecedented impacts on the world. Since its onset, China has established a network of fever clinics as an effective strategy to aggressively isolate and screen possible patients with COVID-19 symptoms. This study presents two fever clinic maps that visualize the uneven responses to the COVID-19 pandemic at the city level in mainland China.

GIS-Automated Delineation of Hospital Service Areas in Florida: From Dartmouth Method to Network Community Detection Methods.

Since the Dartmouth hospital service areas (HSAs) were proposed three decades ago, there has been a large body of work using the unit in examining the geographic variation in health care in the U.S. for evaluating health care system performance and informing health policy.

The interaction of rurality and rare cancers for travel time to cancer care.

Purpose: Geographic access to cancer care is known to significantly impact utilization and outcomes. Longer travel times have negative impacts for patients requiring highly specialized care, such as for rare cancers, and for those in rural areas. Scant population-based research informs geographic access to care for rare cancers and whether rurality impacts that access.

Flame Propagation Characteristics of Syngas-Air in the Hele-Shaw Duct with Different Equivalence Ratios and Ignition Positions.

In this paper, the effects of different ignition positions and equivalence ratios on the explosion characteristics of syngas in a half-open Hele-Shaw duct were investigated. The ignition points are set at distances of 0 and 500 mm from the closed end. Moreover, the research range of equivalence ratio is 0.

Rural-Urban Differences in Breast Cancer Surgical Delays in Medicare Beneficiaries.

Background: Delays between breast cancer diagnosis and surgery are associated with worsened survival. Delays are more common in urban-residing patients, although factors specific to surgical delays among rural and urban patients are not well understood.

Methods: We used a 100% sample of fee-for-service Medicare claims during 2007-2014 to identify 238,491 women diagnosed with early-stage breast cancer undergoing initial surgery and assessed whether they experienced biopsy-to-surgery intervals > 90 days.

Kinetic Analysis of Laminar Combustion Characteristics of a H/Cl Mixture at CO/N Dilution.

Garbage and biomass contain more chlorine, which reacts with H to form HCl gas during combustion or gasification, resulting in corrosion of metal walls. In this paper, based on the chlorine mechanism in Ansys Chemkin-Pro, the laminar combustion characteristics of H/Cl are simulated with different diluents CO/N under an initial temperature of 298 K, equivalence ratio range of 0.6-1.

Network Optimization Approach to Delineating Health Care Service Areas: Spatially Constrained Louvain and Leiden Algorithms.

Constructing service areas is an important task for evaluating geographic variation of health care markets. This study uses cancer care as an example to illustrate the methodology, with the nine-state Northeast Region of the U.S.

Incorporating broadband durability in measuring geographic access to health care in the era of telehealth: A case example of the 2-step virtual catchment area (2SVCA) Method.

The COVID-19 (coronavirus disease 2019) pandemic has expanded telehealth utilization in unprecedented ways and has important implications for measuring geographic access to healthcare services. Established measures of geographic access to care have focused on the spatial impedance of patients in seeking health care that pertains to specific transportation modes and do not account for the underlying broadband network that supports telemedicine and e-health. To be able to measure the impact of telehealth on healthcare access, we created a pilot augmentation of existing methods to incorporate measures of broadband accessibility to measure geographic access to telehealth.

Spatial Behavior of Cancer Care Utilization in Distance Decay in the Northeast Region of the U.S.

Purpose: Spatial behavior of patients in utilizing health care reflects their travel burden or mobility, accessibility for medical service, and subsequently outcomes from treatment. This paper derives the best-fitting distance decay function to capture the spatial behaviors of cancer patients in the Northeast region of the U.S.

Perceived urban green and residents' health in Beijing.

Green space serves urban residents in various functions including promoting health, but the roles of different types of green space are unclear. A survey titled "Healthy Neighborhood" was conducted in Beijing from May to July 2019 to examine and compare the associations between three types of perceived green space (park green, public-square green and utility green) and three aspects of residents' health (physical health, mental health and social health). Results from the multilevel modeling (MLM) analysis show that the perceived park green has a positive correlation with mental health, and all three types of perceived green space correlate with social health positively.

From 2SFCA to i2SFCA: integration, derivation and validation.

Uneven distributions of population and service providers lead to geographic disparity in access for residents and varying workload for staff in facilities. The former can be captured by spatial accessibility in the traditional two-step floating catchment area (2SFCA) method; and the latter can be measured by potential crowdedness in the newly developed inverted 2SFCA (or i2SFCA) method. Residents-based accessibility and facility crowdedness are two sides of the same coin in examining the geographic variability of resource allocation.

Numerical Simulation of the Effect of CH/CO Concentration on Combustion Characteristics of Low Calorific Value Syngas.

The composition of low calorific value synthesis gas varies greatly depending on the raw material and processing technology, which makes the combustion extremely complicated. The three mechanisms of the GRI-Mech 3.0, Li-Model, and FFCM-Mech are used to numerically simulate CH/CO/H/N air premixed combustion by using ANSYS CHEMKIN-PRO.

Experimental Study on the Explosion Characteristics of CH/O/N Mixtures with Different Oxygen Enrichment Coefficients and Ignition Positions.

In this paper, the flame propagation characteristics and overpressure oscillation characteristics of CH explosion were studied under different ignition positions (IPs) and oxygen enrichment conditions in a half-open tube. The distances between the IP and the closed end of the tube are 0, 250, 500, and 750 mm. The oxygen enrichment coefficient (φ) values used in the experiment are 0.

Effect of the Inclination Angle on Premixed Flame Dynamics in Half-Open Ducts.

The propagation of premix methane/air flames in long half-open ducts with different inclination angles θ between the sidewall and the horizon was numerically investigated using the laminar model. The numerical result was compared with the experimental and theoretical ones to validate the numerical model. The results show that the numerical results are in good agreement with them.