Search

The urban population are increasingly suffering from rising transport costs, worsening air quality, longer commuting time, and traffic congestion. Although much scholarly attention has focused on modeling urban traffic congestion, news contents about traffic jam have rarely been examined systematically. This study selects 12 large metropolitan cities across Asia (Beijing, Bengaluru, Hong Kong, Jakarta, Kuala Lumpur, Manila, and Singapore), Oceania (Auckland and Sydney), Europe (London) and North America (Los Angeles and Toronto) for an in-depth content analysis. More than 40,000 pieces of congestion-related articles in the 2009–2018 period have been identified in the local news media of these cities. We apply techniques of text analytics to analyze underlying themes in relation to sustainable transport and congestion-mitigation measures. Also, a sentiment analysis is conducted to examine the level of frustration expressed. Results show that traffic congestion is no longer perceived to be primarily an economic issue. Concerns over the environmental impacts of traffic congestion were increasingly discussed. Based on the content analysis, cities in Asia mentioned a lot about congestion-related PM2.5 pollution and climate change was a recurrent theme among non-Asian cities. Economic cost related to traffic congestion has received much more attention in high-income cities. With regard to congestion mitigation measures, terms related to promoting public and active transport was the most popular, followed by restriction and regulation measures, and then intelligent transport system (ITS) or smart mobility adoption. It is noteworthy that road capacity expansion has attracted the lowest coverage. Generally, high-density cities discussed more about public and active transport in alleviating traffic jams; and police enforcement was seen as important in tackling traffic congestion across all cities. In relation to the sentiment, there is a positive association between the overall traffic congestion level and the congestion frustration level expressed in local news. [ABSTRACT FROM AUTHOR]

This study examines the nexus between high-speed rail (HSR) stations and city evolution from an urban science perspective. We analyzed 1627 HSR stations built from 1976 to 2021 in 533 Chinese and European cities. Node or activity clusters in cities are identified through the street network. Then, the urban forms of Chinese and European cities are compared and the Zipf's law is tested. We found that activity clusters in Europe tend to be more contiguous and clustered, suggesting a clear downtown. In Chinese cities, these clusters are more scattered, suggesting polycentric urban development. When the Zipf's law is applied to the size distribution of activity clusters, the rank-size rule is supported both at the aggregate and country levels. Generally, it takes roughly two decades for an HSR station to be able to mature in attracting related development, such as residence and businesses, to complete the exploration process of city evolution. Finally, contributory factors for the integration of HSR stations with the urban fabrics are examined. Apart from the size of the city, economic power, station features and the spatial pattern of activity clusters, the relative location of the HSR station in relation to the urban form matters. Our study contributes both to the HSR and urban science literature, and has practical implications for locational decisions about HSR stations. • Analyzed 1627 HSR stations built from 1976 to 2021 in 533 cities • Measured activity clusters from an urban science perspective • Urban forms of Chinese and European cities are compared and Zipf's law is tested. • Contributory factors for integration HSR stations with urban fabrics are identified. • City size, GDP, station features, and size of nearest node clusters matter [ABSTRACT FROM AUTHOR]

Traffic congestion has been a persistent problem in cities globally. Theoretically, commuting-related congestion can be relieved by promoting working from home (WFH). Amid the COVID-19 pandemic, WFH arrangement has been encouraged or enforced to reduce the spread of the coronavirus. Under these circumstances, it was reported that traffic congestion has been alleviated in many cities. However, changes in congestion patterns within a city have not been studied in-depth. In this study, we analysed the congestion index (CI) at peak hours, when commuting-related congestion is typically most serious, throughout different waves of the pandemic in Hong Kong. Results show that under WFH arrangement, peak-hour congestion has been alleviated. Within a day, morning peak congestion was more relieved. Spatially, significant drops in CI were found not only in the central business district and urban cores but also in some new town areas. This paper has significant implications for urban planners in creating more sustainable cities that duly consider the commuting needs of residents, and cautions against the optimism that WFH can relieve urban transport problems despite jobs-housing imbalance. While the WFH arrangement has potentials to ease commuting congestion, future e-working and transport measures need to take spatial and temporal dimensions into account. • Spatio-temporal dynamics of urban traffic congestion under COVID-19 were captured. • In Hong Kong, work from home had a bigger impact on morning than evening peak. • Morning peak congestion relief was not only limited to the CBD. • The two commuting peaks were identifiable even during work from home periods. • About 25% of planning units had lower peak-hour congestion under the "new normal". [ABSTRACT FROM AUTHOR]

Identifying congested areas for implementing road pricing is a complicated task, especially as traffic speed and other census data may not be readily available before a detailed feasibility study is commissioned. In this study, we introduce a spatial approach to identify areas with road traffic congestion within cities. The results obtained are validated against the empirical traffic speed data in four Asian cities, i.e. Bangkok, Hong Kong, Kuala Lumpur, Singapore, from 2018 to 2020. Moreover, the findings are also compared with a more detailed conventional method of using job density to identify areas of high traffic congestion. The comparisons show that the spatial approach is both efficient and effective. Through applying the method to London, Milan and Stockholm, the study also demonstrates other potential empirical applications in reviewing the boundaries of existing congestion charging zones. • A spatial approach in identifying potential road congestion charging zones is provided • Validity of the methodology is tested with traffic speed in four Asian cities • Effectiveness is compared with another methodology based on job density • Potential applications in cities with road congestion charging are discussed [ABSTRACT FROM AUTHOR]

Context: The annual consumption of opioid analgesics in the U.S. was more than 10 times the world average, whereas that in China was at a moderate level within Asia but much lower than the worldwide average. The opposite situations of opioid use in the U.S. and China revealed totally different problems in the developed versus developing world, that is, overuse versus underuse of opioids.Objectives: This study analyzed the clinical consumption, estimated the needs of pain treatment, and evaluated the adequacy of opioid analgesic consumption in mainland China and its seven regions.Methods: A retrospective analysis of the national and regional consumption of opioid analgesics in mainland China during 2006-2016 was conducted. The adequacy of consumption measure was used to gauge the overall adequacy of opioid analgesic consumption in morphine equivalents (MEs) for the treatment of moderate-to-severe pain in mainland China and compared with international data. Annual per capita consumption was adopted to measure the clinical consumption of opioid analgesics in MEs at a national level and across seven regions of mainland China. Needs of morphine for cancer pain treatment in mainland China and in its seven regions were estimated and compared with the clinical consumption of opioid analgesics in MEs.Results: The adequacy of consumption measure of mainland China ranged from 0.0041 to 0.0088 during 2006-2016, which was less than 1% of that in the reference countries. The poor North East region had only 10.85% of the cancer pain morphine needs fulfilled. The highest fulfillment rate was 36.02% in rich Southern China, which was 25.9% at the national level.Conclusion: The clinical consumption of opioid analgesics for the treatment of moderate-to-severe pain in mainland China was far below the international level. The annual per capita of clinical consumption was lower, and the adequacy of cancer pain treatment was poorer in less developed areas. All these findings call for actions to strengthen pain management. [ABSTRACT FROM AUTHOR]

Little information is available on the need for opioid analgesics based on demographic, economic and disease spectrum data, or on patient affordability of opioid analgesics, in different regions of China. This study analysed the level of, and trends in, opioid analgesic use in different regions of China from 2006 to 2016, calculated the need for opioid analgesics based on demographic, economic and disease spectrum data from the different regions, and analysed the gap between need and actual consumption. Patient affordability of opioid analgesics for cancer pain management was also measured. Opioid analgesic consumption data were obtained from the China Hospital Pharmaceutical Audit (CHPA) database of IQVIA (formerly Quintiles and IMS Health). We assessed the clinical need for opioid analgesics by calculating the morphine use density (MUD, daily defined doses of morphine per 100 000 population) and its growth rate from 2006 to 2016 in China and its seven regions. Regional need for opioid analgesics (in morphine equivalents) was estimated based on regional cancer registration data and standard treatment doses of opioids, as defined by international guidelines for cancer pain management. The study adopts WHO and Health Action International (HAI) methods to evaluate patient affordability of opioid analgesics for cancer pain management using standardized costs in daily defined doses (DDD). The national MUD increased from 1·45 DDD/100 000/day in 2006 to 6·93 DDD/100 000/day in 2016. Southern China had the highest MUD (9·67 DDD/100 000/day), and northwest China had the lowest MUD (3·28 DDD/100 000/day) in 2016. The actual use of morphine equivalents accounted for only 21·5% of the morphine required for cancer pain management at the national level; 26% in east, 36% in south, 11% in southwest, and 12% in northwest China. The DDD costs of all studied opioid analgesics ranged from CNY ¥10·80 to ¥848·88. Except for morphine injections, the out-of-pocket payments for a standard full course of treatment with opioid analgesics were more than the daily disposable income in all regions. Patient affordability of opioid analgesics is low according to the WHO and HAI method. Opioid analgesic use for the management of cancer pain was insufficient relative to needs in China, and varied markedly across regions with different levels of economic development. Long-term use may pose a heavy economic burden to patients. The findings call for actions to strengthen cancer pain management, and to improve the affordability of drugs. The Peking Union Medical College Education Fund. [ABSTRACT FROM AUTHOR]

Purpose: To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted. Methods: The primary outcome measure was visual analog scale scores assessed at 10, 15, 30, and 60 min after intrathecal injection. Secondary outcomes included duration of spinal analgesia, incidence of side effects in parturients, and neonatal Apgar scores. Results: Twelve randomized controlled trials, including data from 881 patients fulfilled the inclusion criteria. No clinically meaningful differences in pain reduction after intrathecal injection were found between the two analgesics. Sufentanil extended the duration of spinal analgesia by 25.40 min (95% CI 21.82 to 28.98 min; p < 0.00001) compared with fentanyl. The risk for pruritus, nausea, and vomiting among parturients was 82% for those using sufentanil (relative risk 0.82 [95% CI 0.67–0.99]; p = 0.04) and 48% for those using fentanyl (relative risk 0.48 [95% CI 0.29–0.80]; p = 0.005). Both the synthesis results and sensitivity analysis demonstrated no differences in the risk for respiratory depression between parturients using sufentanil versus fentanyl. The neonates in sufentanil group exhibited higher Apgar scores than the fentanyl group 5 min after delivery (weighted mean difference 0.10 [95% CI 0.05–0.16]; p = 0.0002). Conclusion: Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials. [ABSTRACT FROM AUTHOR]