Each of these contexts presents theoretical and methodological challenges for investigators. In this commentary, we focus primarily on biological and social-cultural contexts, discussing the theoretical and methodological challenges the investigators faced and the research strategies they used to address them, which have produced a unique compilation of “learning by doing” studies. We also touch briefly on the political context in which the Prospera program research was conducted. We conclude with statements that highlight the exceptional value of the journal supplement, not only with respect to the analysis of the interventions the studies cover and the sustained examination of a long-term program but also as a major contribution to the literature in implementation science in nutrition.This commentary on the Integrated Strategy for Attention to Nutrition (EsIAN) journal supplement begins with a discussion about the challenges that implementation researchers confront with respect to analyzing complex impact pathways. We note that the research on the implementation of the EsIAN component of Mexico's conditional cash transfer program was based implicitly or explicitly on a program impact pathway approach, which used both quantitative and qualitative methods to examine bottlenecks in program implementation. We then identify 5 categories of contexts that affect the impact, implementation, and survival of intervention programs:  The journal supplement  presents1) nutrition interventions at scale are often embedded in broader programs and their pathways to impact are complex, 2) they happen over long timeframes and in changing biological contexts, 3) they cannot be easily stopped and started, and 4) they often span large, diverse geographic and social-cultural areas. In this commentary, we discuss theoretical approaches to addressing some of the key challenges of doing nutrition implementation research at scale and examine how the investigators whose work is featured in the supplement addressed them in the context of Prospera.Knowledge about effective interventions to improve the nutrition of mothers and their children has grown rapidly in recent decades, but how to scale them up to reach the populations who need them most has been slow. There is an urgent need to generate and effectively communicate the evidence that will support countries to achieve coverage and effectiveness of a range of nutrition-relevant actions and result in sustained impact on nutrition outcomes. Nutrition implementation efforts and researchers face daunting challenges in addressing these needs: The systematic thinking that guided the research reported in the supplement is based implicitly or explicitly on a program impact pathway (PIP) . This coIn nutrition research, quantifying the flow in a PIP flow can be accomplished by structural path analyses to ascertain the magnitudes of mediation of the intervention from one pathway step to another. This can also be used to quantify “moderation”—which can be conceptualized as the role of facilitating and inhibiting factors on mediations. This is exemplified in the study reported by Zongrone et al. . The floPIP analysis can also be used to ascertain the coverage (C) of an intervention. Individual coverage is usually measured binomially . Population coverage is the proportion of beneficiaries who received the intervention at the specified quality level. Bottlenecks in program implementation are revealed by decreases in coverage at each sequential step as one proceeds along the PIP. This method can be extended to also identify the determinants of these bottlenecks .In summary, we identify 2 components that quantify progress along the PIP steps. One quantifies the coverage (C) and the other quantifies the magnitude of the flow (Q) within the population covered. For example, Figure 1 in García-Guerra et al.  shows a By context, we refer to the set of circumstances or characteristics in which an event, situation, or a program takes place. Differences in contexts or changes in a context foster or impede the flow of deliverables in a PIP. Context usually plays an important role at each of the junctions in a PIP. These can be identified in a model that depicts the transmission of critical elements of interventions.In this commentary, we focus particularly on the biological and social-cultural contexts, as these received primary attention in the articles in the supplement. We also briefly discuss the fifth context—political context. However, we note that contexts 3 and 4  have alsFinally, it will also be apparent to readers of the supplement articles that the collaborations among ministries, research groups, and the Prospera program were not only continuously identified and examined over the years of activity, but these collaborations and the program itself depended on a supportive political context.The following sections, which are devoted to challenge 2 and challenge 3, are structured in 2 parts. The first part examines the theoretical issues, and the second part discusses the context from the perspective of the Prospera studies in the supplement.To facilitate the discussion of the biological context, we first need to review the concepts of efficacy and effectiveness within the context of a PIP model, particularly in relation to the fortified complementary food (Nutrisano) provided by Prospera. Biological efficacy is the final step in the PIP, which occurs after the intended beneficiary has consumed the nutrient or nutrient-containing food. It is the point at which the biological deliverables  are transferred to the intracorporal flows that transmit them to the cells where they are metabolically active, as evidenced by measures of cognitive and physical health. Nutritional efficacy is a measure of the success of the intracorporal flow in achieving the nutritional changes that determine the desired health and cognitive outcomes.A fundamental feature of biological efficacy in a population evaluation is that it depends on the intended beneficiaries’ capacity to benefit from the intervention—in the case of Nutrisano, the children's “potential to benefit” from the nutrition supplement.There is a need for more of the nutrient.The nutrient in the supplement is appropriate to meet that need; in other words, it is efficacious.No biological factors impede the nutrient's absorption and use so that the interventions can produce the desired health and nutrition outcomes .Potential to benefit from a biological nutrition intervention has 3 prerequisites:P < 0.05) compared with unsupplemented controls. Lack of potential to benefit because 1 or more of the 3 prerequisites are not present, or because of poor outcome measures, explains many disappointing evaluation reports.To assess the efficacy of an intervention requires knowledge about the status of all 3 of the prerequisites in the population and using outcome measurements that reflect improved nutrition. Efficacy is investigated with a probability design  such as With respect to Prospera, it is important to note that before taking the program to scale, its efficacy was ascertained with a randomized program evaluation study. The investigators examined the impact of Prospera in a randomized selection of villages that were similar to those in which the program would be scaled up nationally. This similarity is essential for foretelling the impact of the benefit nationally; it permitted a statistical probability statement about impact.For Prospera, as for most research that is undertaken to support programs, investigators are faced with several kinds of challenging problems, including challenging ethical problems. In an RCT, potentially valuable benefits are provided to the intervention group , which neither they nor the control children would have received if there was no trial. An RCT extending the benefits to everyone would eliminate the control group and would not serve the scientific purpose for which an RCT is undertaken. Prior to establishing the benefits of the intervention, the issue is one of “fairness” . Who is However, random allocation does not address other issues of fairness relative to the control groups who should receive benefits commensurate with their efforts. Another related principle that enters the discussion is the principle of beneficence, which is based on the proposition of extending benefits to everyone if it is feasible. Some RCT evaluations provide other types of benefits, such as medical care  to help probability evidence of efficacy for initiating a supplementation program, the challenge in an ongoing program is how to organize evidence to change or stop a supplement when changes in the biological context are likely. This requires a sequence that begins with evaluating the adequacy of program effectiveness and then examining the plausibility that changes in a supplement will change program adequacy. An adequacy evaluation ascertains whether the results are adequate relative to a standard without, however, ascertaining that they are caused by the program. Adequate results could, for instance, be due to secular changes in well-being that are not related to the program. Plausibility evaluation ascertains whether the results can plausibly be due to the program  of the intervention, the quality (Q) of its implementation, and the coverage (C) of delivery of the intervention to those who can benefit. Efficacy includes the recipient's potential to benefit from the intervention. From the perspective of a biological outcome, effectiveness is calculated by multiplying E × Q × C. Effectiveness fails if either the quality or the coverage fails. This is often not well understood and, as a result, leads to lack of efficacy being blamed for poor effectiveness. This error can occur with any nutrition intervention but is especially the case when the intervention involves a supplement and the quality of delivery is neglected and not measured  or is meWas the program adequately biologically effective as judged by international norms of healthy nutrition? This judgment about adequacy is independent of the probability (<0.05) of causality.Was this adequacy plausibly accomplished by the delivery (Q × C) and efficacy (E) of the supplement? For example, is there evidence that nutritional outcomes are a result of high adherence to recommended intake and known efficacy of the intervention and not due to changes in codeterminants of the nutritional outcome?Are there other considerations, such as acceptability to child and mother  and costIn summary, the foregoing background discussion suggests the utility of the following algorithm to examine a fundamental issue of concern in many nutrition implementation research studies on supplementation—namely, whether to improve or to stop supplementation:Nutrisano, a whole milk–based fortified food, was developed by Mexican researchers based on local knowledge of nutritional status at the time and an extensive global evidence base. It was selected to be the nutritional supplement for Prospera. However, an initial evaluation in 1997  indicateTurning to the articles in the journal supplement that are concerned with the biological context, it is important to note at the outset that INSP verified all the prerequisites for the efficacy of Nutrisano's iron and macronutrients before implementing the Nutrisano program widely. Potential to benefit from a national Prospera program was ascertained at the beginning of the program. Thus, they chose the nutritional supplements based on their demonstrated efficacy in improving the nutritional health of malnourished children.However, over time, changes in dietary and anthropometric data in Mexico suggested that the potential to benefit from an energy-containing supplement might have changed since the beginning of the program 2 decades earlier. In fact, it looked as if the population was ingesting too much energy. In the case of Nutrisano, the lack of prerequisite 1, a need for more energy, would mean that Nutrisano would no longer be an efficacious intervention. Thus, substitutes that had the same micronutrient content, including iron and zinc, were considered. One of these substitutes, micronutrient powders delivered in sachets, was less than a quarter of the price of Nutrisano. Another substitute, syrup, cost more than Nutrisano.The question for the researchers was whether 2 other supplements were not only as efficacious as Nutrisano but also as effective. The conventional approach to answering this question would be to compare Nutrisano's impact with that of the 2 other supplementation candidates in an RCT, using a probability design. However, as discussed in Neufeld et al. , this woThe researchers took an innovative approach, deciding to examine each of the 3 supplements for their individual abilities to meet adequacy of performance. To do this, the researchers began by randomizing a sample of the study population into 3 comparable groups, so that any conclusion about adequacy would be similar for all of them. The findings revealed that all of the groups were adequate. These analyses do not reveal why they were adequate but showed that the adequacy conclusion could be extended to the population the samples represented.With respect to the hemoglobin values, how can one support the conclusion that they were adequate in all 3 groups? In Neufeld et al. , we see A dose-response plausibility analysis  supporteThe adequacy analysis showed some modest differences in hemoglobin values in the 3 groups. However, the dose-response analyses revealed that these differences in effectiveness were entirely due to the dose consumed. Thus, the equivalences of the 3 supplement formulations relative to iron nutrition were persuasively demonstrated without an RCT design.z score of −1.04 (P < 0.05). This is unacceptably low from a public health perspective. However, it is essential to note that the length deficiency was mostly established before the mean baseline age of 8.2 mo. After this age, the subsequent growth to 24 mo was almost adequate. This is indicated by a deficit in growth from baseline of only −0.06 z score, very close to a healthy zero z score. Also, the dose-response analysis indicated that those who did not consume the supplement grew only 0.7 cm less well from baseline than did those who ingested the prescribed dose, a negligible difference from zero. Finally, the weight-for-length and BMI data did not reveal evidence of inadequate energy intake.Shifting from hemoglobin to growth, the other major nutritional outcome Nutrisano was designed to address, Neufeld et al.  found thSeveral issues follow from the study:Taken together with the findings enumerated above, along with results from other Mexican epidemiological data, the investigators’ conclusions confirm that the macronutrients in Nutrisano were no longer necessary for children older than 8 mo . On the other hand, the study also clearly highlights the inadequacy of infant attained growth. This latter finding raises other important questions. For example, is it due to the intergenerational effect of maternal childhood stunting or to inadequate infant feeding ?Adequacy evaluation showed that micronutrients were deficient between baseline (mean age 8.2 mo) and 24 mo of age.Adequacy evaluation showed that macronutrients as measured by growth were adequate between baseline (mean age 8.2 mo) and 24 mo of age.Attained growth is not adequate in the early months of life (before baseline).Plausibility evaluation by dose response showed that for both anemia and growth outcomes, effectiveness depended on consumption, not on differences in efficacy among the 3 supplements.These findings permitted the recommendation to halt the use of Nutrisano and choose a much less expensive supplement with lower distribution costs, which could also be fed more frequently, thus increasing the likelihood of consuming sufficient quantities to meet children's nutrient requirements. In other words, more ingestion with equivalent efficacy would lead to greater effectiveness.In summary, the algorithm we suggested in the background section above was fully and effectively used in the outstanding research reported in the journal supplement. It supports the following conclusions:The Prospera studies demonstrate the utility of applying a decision-making algorithm to inform decisions about whether to eliminate a widespread supplementation program or whether it is essential but needs to be modified to meet changing population needs and conditions.By “social-cultural context,” we refer to a wide range of factors that are involved in the organization and function of human activities, specifically from the perspective of implementation research in nutrition, involved in access, acquisition, and consumption of foods and nutrients. These factors moderate the effectiveness of an intervention  through In a PIP analysis, whether it is undertaken for purposes of intervention planning, formative research, or process evaluations, the social-cultural context is pertinent as the focus of research activities to identify and address the economic and social structure of both the nutrition intervention delivery system and the household delivery system. With respect to the household delivery system, the social-cultural context is a construct that encompasses a wide range of factors, including household income, types of income-earning activities, expenditures, physical living conditions, sociodemographic features (including education and family structure), the organization of household management of food acquisition and preparation, and childcare , as well as many other social characteristics that have been empirically linked to nutrition-related outcomes. Culture refers specifically to the ideational domain of determinants that includes beliefs and values, as well as perceptions and attitudes that affect and relate to the acquisition, preparation, and consumption of food.The factors that are included in the social-cultural context affect every step in the PIP of a nutritional intervention up to the point at which the nutrients or foods are swallowed by the intended beneficiary. These actions are performed by those who move the elements of the intervention  through the program to the household and within the household to the child. A PIP diagram alerts us to the fact that all of the actors, in both the program delivery component and the household delivery component, can be regarded as implementors because they have responsibilities to move the elements of the intervention to the intended beneficiaries. All implementors’ behaviors are affected by their social conditions and characteristics and by their cultures—their motivations and beliefs, including the knowledge they acquire from participating in the program. The latter applies not only to the household implementors but also to the delivery implementors. It applies to both simultaneously at the PIP transmission step from program to household .In the case of a nutrition intervention that involves a biological agent, the social-cultural context determines a child's potential to benefit as much as it is determined by the biological efficacy of the agent. This is the case not only for ensuring that the supplement reaches the child's mouth but also for ingesting it  no matteOne of the major advantages of an interactive program-research structure, such as the one between Prospera and the INSP research group, is that it permits the sustained linking of a research organization with a program delivery institution and encourages and facilitates problem-solving research to understand and correct bottlenecks and other barriers to program effectiveness. Throughout its history, the research group has been thoughtful and prescient in studying the role of the social-cultural context for the program, which is a major determinant of bottlenecks in the flow of the supplements and the flow of knowledge. As noted above, the latter component was intended to support health and nutrition of the beneficiaries, above and beyond the supplement.The examination of social-cultural factors in programs is challenging for multiple reasons. One challenge is differentiating between factors that are basically homogeneous across an entire nation and cultural-social factors that differ significantly among subgroups, specifically with respect to their implications for program modifications. Identifying and understanding diversity that matters for programs goes beyond the obvious issue of mutually unintelligible languages. Differences in language are well understood to be a factor that requires attention. However, the challenges for program design go beyond the task of finding linguistic equivalences to use in communicating with mothers and other household implementors . IdentifAn example of a nongeographic, nonethnic intragroup diversity cultural factor that affects nutrition interventions everywhere is maternal education. Geographic and ethnic cultural features undoubtedly influence the likelihood of a girl receiving more education before she becomes a mother. However, we are also referring here to the broader effects of education, in and of itself, on various nutrition parameters. Throughout the world e.g.,  and in MThe supplement articles that are particularly important with respect to the INSP research on the social-cultural context , 14, 38 Beginning with the often-problematic communication component of the “handover” of knowledge between implementors on the delivery side and implementors on the household side (mothers and other child caretakers), the research revealed an underlying problem that originates from social and cultural differences between health workers and caregivers. A primary source of poor communication was that the health workers were trained and oriented to working with patients from the perspective of curing or healing their problems. They were much less experienced or comfortable in providing information and support for “nonmedical actions” that were designed to improve nutrition. Moreover, as a consequence of the emphasis on curative care, training of health workers often did not include adequate knowledge about the technical and epidemiologically documented links between good nutrition, disease prevention, and the role of nutritional status in the efficacy of curative care. Also, in addition to the fact that health workers operate in a curative care environment that implicitly rewards attention to disease management, other social and cultural factors affect the communication between delivery implementors and household implementors. These include social class, education, and belief system differences.The INSP researchers who focused on social-cultural context factors were highly sensitive to the issues of cultural homogeneity and intracultural/intrapopulation diversity. In the series of studies, Bonvecchio et al.  identifiThe studies reviewed in Bonvecchio et al.  also revThe framework presented by Bonvecchio et al.  lays outConcluding this section, we note that at present, there are no empirically based guidelines that programs can use to determine, a priori, which factors require careful assessment in any given society. Until such time as these are available, investigators need a body of published work and experience to draw on. Thus, the articles in the supplement constitute an invaluable contribution to the implementation science literature on the roles of the social-cultural context of intervention programs for nutrition.With respect to the political context, the research reported in the supplement bolstered administrative and political commitment to the health component of Prospera. According to Levy , the eviAnother virtue of Prospera has been the transparency of the evaluations. We note, however, with respect to the larger issue of the political context of intervention programs that transparency can also be a threat. We have repeatedly witnessed situations in which imperfections revealed by evaluations are used to condemn a program, even after the imperfections have been addressed, as has happened to Prospera . BecauseBut, on balance, the social capital gains of follow-up evaluations appear to be usually worth the risk. However, this generalization is only the case when higher-level political goals remain the same as those that led to the design of the original program. In the case of Prospera, the original purpose was mitigating the ill-effects of poverty, including malnutrition. Today, higher-level policy discussions focus on elimination of poverty, not on mitigating its effects. Stepping back to consider the larger picture, it is apparent that constructing a PIP to guide planning and implementation of nutrition interventions should be undertaken with attention to the articulated goals and values that reside in the political context. For example, with respect to EsIAN, a PIP that focuses on its impact on poverty reduction would be the last step of the program implementation pathway.To our knowledge, this is the first time that a comprehensive systematic research approach has been developed and applied to support a large-scale nutrition intervention program. Bringing this research together in this supplement is a major contribution to implementation science. It provides knowledge, insight, and inspiration for the future in Mexico and for others elsewhere.The supplement is a persuasive demonstration of the value of using a PIP model to structure implementation research. It provides an underlying coherence, which is reflected in a supplement that is more than a collection of valuable individual articles.An important benefit of using a PIP approach in implementation research is that it draws investigators’ attention to the fundamental roles of context and the necessity of identifying, assessing, and addressing context factors and conditions. The articles in the supplement amply demonstrate this, particularly with respect to biological and social-cultural contexts that affected and challenged the effectiveness of Prospera. Identifying the points at which context factors adversely affected or had the potential to adversely affect the program and subjecting the PIP flow data to quantitative and qualitative analyses are models for future implementation research activities. They illustrate the importance of research to anticipate and break bottlenecks in delivery and household utilization systems.To further use the value of PIP analysis to support the development of more effective interventions, we anticipate that future program-related research in nutrition will include a greater focus on mechanisms than is currently the case. As is widely believed across the range of scientific disciplines, understanding mechanisms permits better design and implementation in the application of science to benefit humankind and, more broadly, the globe in which our species resides. We feel that, at present, mechanisms in intervention research in nutrition programs are generally inadequately examined. For example, as noted above, currently we do not understand the mechanisms through which education of the mother potentiates the effect of wealth on child nutrition. Although this relation is complex, it can be well described mathematically cf. , 37. SimHypotheses non fingo)  , which sWith respect to the biological component of the intervention, the INSP research demonstrates why a probability evaluation to decide whether the distribution of Nutrisano could be stopped was not ethically permissible or feasible. It is highly likely that this type of ethical and feasibility situation will be true for most ongoing nutrition programs throughout the world. Widely implemented vitamin A distribution programs to prevent blindness and child mortality is a salient example of this issue. Since they were initiated decades ago, they have not been scientifically and ethically amenable to examination using conventional evaluation approaches once they were implemented at a national level. However, as Neufeld et al.  demonstrConcerning the INSP research on social and cultural context factors, the journal supplement documents the vital role it played in supporting the health component of Prospera. In addition to its direct programmatic utility, the studies revealed patterns of homogeneity and diversity that are important contributions to the larger body of scientific knowledge on the interactions of social-cultural factors and nutrition. It is a resource that should be widely consulted by research scientists and program planners.The considerations and experiences reflected in this journal supplement are important for future program evaluations.The supplement is important as an extraordinarily informative case and is a major contribution to the literature on models of case histories in implementation science in nutrition.The supplement contributes conceptually to implementation research in the clarity of its conceptual organization and in the detailed examination of the many important issues the studies addressed.In our view, every student and practitioner in global and community nutrition should read and ponder the contents of this supplement. We hope it will be recognized as a landmark publication and take its place among the major contributions of scholarly work linking research and action to support programs and improve nutrition in populations.In conclusion, key points we want to highlight are as follows:


The purpose of this study was to explore structural relationships between emotional experiences, novelty seeking, tourist satisfaction, and destination loyalty in the context of active sport tourism. The study emphasizes the mediating effect tourist satisfaction has on the relationship between emotional experiences and destination loyalty. The validities and reliabilities of the measures used were examined through confirmatory factor analysis (CFA) and correlation analysis using 230 domestic and international participants who attended a marathon race as amateur athletes. Structural equation modeling analysis with maximum likelihood estimation was conducted to investigate relationships between study variables. Findings disclosed the positive impacts of (a) emotional experiences on tourist satisfaction and destination loyalty, (b) novelty seeking on tourist satisfaction, and (c) tourist satisfaction on destination loyalty, and demonstrated that (d) tourist satisfaction fully mediates the relationship between emotional experiences and destination loyalty. Based on its results, this study (a) indicates that emotional experiences play key roles in predicting tourist satisfaction and destination loyalty, (b) provides an example of the merits of the Destination Emotion Scale (DES) in a sport tourism setting, (c) implies that both emotional experiences and novelty seeking should be incorporated into tourist behavior models, and (d) contributes to tourism studies by exploring the mediating effect of tourist satisfaction on the relation between emotional experiences and destination loyalty. Thus, destination managers should manage gorgeous natural views and beautiful cityscapes, and organize various fun events, such as prize and ticket giveaway events, music performances, and charity campaigns for tourists during events. Stiff competition between destination management organizations with respect to attracting new and retaining loyal tourists in a saturated global marketplace has caused these organizations to devote time and resources to building tourist satisfaction and destination loyalty . TouristIn the context of broader tourism literature, and in order to explore antecedents of tourist satisfaction and destination loyalty, the developments of destination image  and motiSport tourism has received much attention from scholars for many years, because it has been generally recognized to provide an effective means of stably enhancing the growth of tourist destinations ,11. GibsAlthough foundations for sport tourism research have been constructed by the majority of previous studies, these foundations are limited in three important ways. First, the influence of novelty seeking on tourist satisfaction and destination loyalty remains a significant gap in sport tourism research. Novelty seeking is a key component of tourist motivation and in opposition to familiarity . A consiSecond, although studies have been conducted to understand emotional experiences and novelty seeking in the broader tourism context, few have sought to identify the mediating effects of tourist satisfaction on relations between emotional experiences and destination loyalty or between novelty seeking and destination loyalty. Rather, a considerable number of studies have focused on direct links between emotional experiences, novelty seeking, tourist satisfaction, and destination loyalty and have ignored the mediating role of tourist satisfaction on relations between such variables ,17,18. DThird, in a sport tourism context, a number of studies have concentrated on large-scale sporting events such as the Summer or Winter Olympic Games, the Fédération Internationale de Football Association (FIFA) World Cup, and World Championships . HoweverAccordingly, the main objective of this study was to explore mutual relationships between emotional experiences, novelty seeking, tourist satisfaction, and destination loyalty collectively and systematically with a view toward enhancing the competitive advantage of sporting destinations.Cheonan is located in the northeastern area of Chungcheongnam-do Province in South Korea and in 2019 had a population of 678,764 . With abCheonan has focused on becoming a sporting destination in recent years. For example, the city is home to the “Cheonan Hyundai Capital Skywalkers Volleyball Club” and has hosted many sporting events to attract tourists. Recently, with growing awareness of health, increasing focus has been placed on marathon races, that is, on active sport tourism. “The Cheonan Ryu Gwansun Peace Marathon” is named after an artist and well-known independence activist, who supported efforts to rid Korea of Japanese oppression during the colonial period . This maEmotions have been discussed by psychology and marketing research scholars for a considerable time because the concept is seen as the most critical driver of consumer behavior . HoweverTwo major theoretical approaches to emotional experiences are evident in psychology literature, that is, dimensional  and categorical (emotion specificity) approaches. Dimensional approaches include a handful of dimensions such as positive, negative, pleasure, and arousal, whereas categorical approaches view emotions as a set of idiosyncratic affective states  . In the Moreover, Hosany and Gilbert  pointed In the active sport tourism setting, tourists can feel joy when they meet personal goals, improve mental and physical health, build self-confidence, relieve stress, learn new skills, and have unique experiences . For insSome tourists may desire a low level of novelty on a holiday, but the majority prefer a high level as they typically seek novel or unique experiences ,37. For Previous studies have consistently reported emotions are critical for the building of satisfaction and loyalty . Lee et Hypothesis 1 (H1).Emotional experiences positively influence tourist satisfaction.Hypothesis 2 (H2).Emotional experiences positively influence destination loyalty.Supportive evidence exists for positive relations between novelty seeking, satisfaction, and loyalty. Toyama and Yamada  investigHypothesis 3 (H3).Novelty seeking positively influences tourist satisfaction.Hypothesis 4 (H4).Novelty seeking positively influences destination loyalty.Hypothesis 5 (H5).Tourist satisfaction positively influences destination loyalty.A vast amount of literature is devoted to the positive relationship between tourist satisfaction and destination loyalty. Eid  investigWhen exploring relations between emotions and loyalty or behavioral intentions, previous studies have considered satisfaction a key construct . Martin Hypothesis 6 (H6).Tourist satisfaction mediates the relations between emotional experiences and destination loyalty.Hypothesis 7 (H7).Tourist satisfaction mediates the relationship between novelty seeking and destination loyalty.Based on past studies, the present study offers the following conceptual model .Data for the present study were collected from domestic and international participants that attended the 2019 Cheonan Ryu Gwansun Peace Marathon in Cheonan. Cheonan was chosen as the site for this study primarily for two reasons. First, the event is reportedly one of the most famous small-scale sporting events in South Korea. Second, Cheonan has a high level of repeat visitation among tourists. Thanks to its rich cultural heritage, the city has become one of the most famous tourist destinations in Korea. To obtain a sample, the authors and two trained research assistants administered a face-to-face questionnaire-based survey near the ticket office on 19 May 2019, using a convenient sampling procedure. We approached 270 respondents and asked them to participate in the survey without reward; participants were not actively solicited to participate and locals were totally excluded in the survey. Consequently, 250 questionnaires were collected, but 20 were subsequently eliminated because some important questions were not answered. The remaining 230 satisfactorily completed questionnaires were analyzed. The sample contained 165 (71.7%) males and 65 (28.3%) females, and 140 (60.9%) domestic tourists and 90 (39.1%) international tourists. Of the respondents, 78 (33.9%) were aged between 40 and 49 years, 81 (35.2%) were university educated, 144 (62.6%) were married, and 47 (20.4%) earned between $40,000 and $59,999 per annum.The survey questionnaire consisted of five main sections: (a) emotional experiences, (b) novelty seeking, (c) tourist satisfaction, (d) destination loyalty, and (e) respondent demographic information. Emotional experiences’ items were adapted from Hosany and Gilbert’s Destination Emotion Scale (DES) . The DESOnce a preliminary questionnaire to measure each construct was established, a panel of six experts (sport tourism and management professors) reviewed the scales for content validity. Items were evaluated based on whether the format and constructs were (a) appropriate, (b) adequate/representative, and (c) accurate/clear. Based on the feedback provided by the panel of experts, the preliminary questionnaire was modified, revised, and improved mainly in the areas of adequacy, test format, factor relevance, and wording clarity.2/df = 2.600, IFI = 0.931, TLI = 0.914, and CFI = 0.930). All model fit indices were within recommended thresholds [p < 0.001) [A confirmatory factor analysis (CFA) model with a total of 98 degrees of freedom was used to assess the goodness of fit of the measurement model by using the latest version of AMOS software . The CFA model showed that the measurement model reasonably fitted data (xresholds . Constru< 0.001)  Table 1< 0.001) . Hence, < 0.001 .For discriminant validity, we verified that the AVE of the latent variable was greater than the square of the correlation coefficient between latent variables. Since it was difficult to verify all variables, the pair with the highest correlation coefficient was selected and verified. The highest correlation coefficient was 0.466   and the Reliability estimates  for emotional experiences, novelty seeking, tourist satisfaction, and destination loyalty were all above the recommended threshold of 0.7 (range from 0.849 to 0.922), which indicated measures were reliable  Table 1Table 1.2/df = 1.797, p < 0.001). Absolute fit index  and incremental fit index  were satisfactory [The five hypothesized relationships were analyzed by structural equation modeling (SEM). Overall, the SEM achieved acceptable fit (xsfactory .p < 0.001) and destination loyalty , which offers supportive evidence for hypotheses 1 and 2. The path coefficient from novelty seeking to tourist satisfaction was positive and statistically significant , supporting hypothesis 3. Non-significant paths emerged for novelty seeking → destination loyalty, which rejected hypothesis 4. However, hypothesis 5 was supported, as tourist satisfaction significantly and positively influenced destination loyalty .Estimates of structural coefficients (paths) provided the basis for testing the proposed hypotheses. As shown in To identify effects mediating tourist satisfaction, we utilized the bootstrap test, which is a data-based resampling statistical method . As regaFrom a theoretical point of view, the current study offers several contributions to research in marketing, tourism, and sport marketing. First, this study answers the recent call of Prayag et al.  to exploSecond, from a methodological perspective, our results provide an example of the merits of the Destination Emotion Scale (DES) developed by Hosany and Gilbert  in a spoThird, the current study responds to a recent call to use integrative models . AccordiFourth, this study contributes to tourism studies by identifying the mediating effect of tourist satisfaction on the relation between emotional experiences and destination loyalty. Prior studies failed to address the mediating effect of tourist satisfaction; for example, Kim and Lennon  investigFifth, this study stresses the importance of hosting small-scale sporting events for developing or sustaining sporting destinations. While a number of studies have been dedicated to large-scale sporting events, only a handful of studies highlight the merits of small-scale sporting events. According to Kim , despiteContrary to our prediction, novelty seeking was not found to affect destination loyalty, and as such, the mediating effect of tourist satisfaction on the relation between novelty seeking and destination loyalty was not supported. One explanation for this discrepancy is that whereas non-sport tourists generally have long-term relationships with destinations, sport tourists that attend small-scale sporting events as participants have short-term relationships , and fewThe major results of this study disclose that strengthening emotional experiences and novelty seeking cannot be isolated from strategies designed to generate tourist satisfaction or destination loyalty and provide practical hints to sport tourism managers or marketers. To generate love as a component of emotional experiences, active sport tourists should be exposed to gorgeous natural views and beautiful cityscapes. As we have discussed in the literature review section, marathon participants usually run a distance of 5, 10, or 21 km and have an hour or less to appreciate spectacular architecture, picturesque villages, or unique natural environments, which can elicit a feeling of love toward a city. The study by Kulczyk-Dynowska and Bal-Domańska  noted thThe objectives of this study were to determine the nature of relationships between emotional experiences, novelty seeking, tourist satisfaction, and destination loyalty with an emphasis on the mediating effects of tourist satisfaction in the tourism environment using an integrated model. The proposed model allowed the identification of relations between (1) emotional experiences and tourist satisfaction, (2) emotional experiences and destination loyalty, (3) novelty seeking and tourist satisfaction, and (4) tourist satisfaction and destination loyalty, and showed that tourist satisfaction had a full mediating effect on the relationship between emotional experiences and destination loyalty. The current study offers several contributions to research in tourism and sport marketing. For instance, this study answers the recent call of Prayag et al.  to exploAlthough the current study broadens our knowledge of emotions and novelty seeking concepts in tourism, it is subject to several limitations. First, it would have been interesting to include tourist involvement in evaluations of emotions, satisfaction, and loyalty. Degree of involvement in a marathon event or any other active sport tourism event is likely to influence emotions and play a major role in driving satisfaction and loyalty. Second, we considered satisfaction to be a mediator of the relation between emotional experiences and destination loyalty, and between novelty seeking and destination loyalty. However, we suggest future studies explore whether other mediators such as destination image and perceived value affect relationships between the factors. Third, these findings are limited to one sporting event, and data were collected at a specific place and time of year. Consequently, our findings cannot be generalized to active sport tourists. Future research could study active sport tourists at different sporting events and locations to increase the generalizability of the results. Fourth, because marathon races in which active sport tourists participate provide only short-term relationships with destinations, we did not measure the positive surprise component of emotional experiences. We suggest this dimension be included in future studies on sport tourism events, such as the Olympics, World Cup, and World Championships, that provide long-term relationships with destinations. Fifth, in this study, the likely impact on tourists’ experiences of volunteers’ behavior was not taken into consideration. Generally, sporting events have some level of contact between tourists/visitors and volunteers. Consequently, this situation offers opportunities for interaction, and thus might considerably influence tourists’ emotional experiences. Future research could examine the role of volunteers’ performance in predicting tourists’ emotional experiences.


The effects of serotonin on the immune response are less well understood. Mast cells are known to produce serotonin, while T cells, dendritic cells, monocytes, macrophages and microglia express 5-HT7 receptor. Here, we review the known roles of 5-HT7 receptors in the immune system, as well as their potential therapeutic implication in inflammatory and immune-mediated disorders.In mammalians, serotonin (5-HT) has critical roles in the central nervous system (CNS), including mood stability, pain tolerance, or sleep patterns. However, the vast majority of serotonin is produced by intestinal enterochromaffin cells of the gastrointestinal tract and circulating blood platelets, also acting outside of the CNS. Serotonin effects are mediated through its interaction with 5-HT receptors (5-HTRs), a superfamily with a repertoire of at least fourteen well-characterized members. 5-HT We also reviewed the reference lists of the articles identified during the search. The authors independently reviewed the selected articles.We performed a comprehensive search of English language literature to identify all original research, and review articles regarding 5-HT7 receptors , specially AC1 and AC8 -ases  -1β and IL-8, while reducing the secretion of IL-12 and tumor necrosis factor (TNF)-α 19 , exhibit an inflammatory and anti-apoptotic polarization, including upregulation of TNF-α and IL-6, as well as upregulation of the transcription factors B-cell lymphoma 2 (Bcl-2), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB); and inhibition of caspase-3. Moreover, treating monocytes with serotonin resulted in increased expression of the costimulatory molecules cluster of differentiation (CD) 40, CD80, and CD86, but not of MHC class II molecules -stimulated M2 macrophages, increasing the production of TNF-α and IL-12, while also interfering with polarization  decrease inflammatory priming, in part by reducing the production of IL-12, TNF-α, and type 1 interferons, as well as enhancing the production of transforming growth factor β 1 (TGF-β1). Moreover, 5-HT7 receptor signaling promotes pro-fibrotic gene signature in a 5-HT7 and PKA-dependent manner  cells, suggesting that myeloid expression of 5-HT7 receptors may also –under specific insults- attenuate the inflammatory response . In these cells, the administration of serotonin, as well as 5-carboxamidotryptamine (5-CT) induces an inflammatory priming and IL-6 production, indicating that these receptors may play a role in CNS inflammation and repair  reverted this effect, an observation with potential implications for extra-hepatic tumor seeding to the liver  and TNF-α in a dose-dependent manner -induced sepsis, lung expression of 5-HT7 receptor agonist (AS19) in a rat model of CLP-induced sepsis results in increased survival, decreased tissue injury, a reduction in circulating inflammatory cytokines , an increase in antioxidant mediators (superoxide dismutase and glutathione), and a reduction in lung NF-κB  is a well validated model of severe poli-microbial sepsis that results in acute and chronic inflammation  and oxidative stress burden. In the chronic fibrogenic phase, 5-HT7 receptor antagonism reduces collagen deposition, and mRNA expression of TGF-β1 and procollagen type Ӏ  and aspartate transaminase (AST) levels; increased the level of superoxide dismutase; and decreased the levels of TNF-α, IL-6 and TGF-β1. By the same token, 5-HT7 receptor antagonism increases cytokines levels. In their histopathological analysis, the carbon tetrachloride group showed severe vacuolar degeneration, necrosis, irregular walls of the vena centralis and lytic areas. In contrast, the administration of the 5-HT7 receptor agonist LP-44 partially rescued animals from liver damage. This suggests that 5-HT7 receptors may be a potential therapeutic target for chronic liver inflammation  inhibited the neurotoxic effect of β-amyloid in hippocampus . In models of severe sepsis, 5-HT7 receptor agonists have resulted in a net anti-inflammatory effect. In contrast, bleomycin-induced lung injury is the only experimental model where 5-HT7 receptors seems to be pro-inflammatory. In experimental murine inflammatory bowel disease, the effect of 5-HT7 receptors has shown contradictory results.Regarding an organ-specific effect, in CNS, soft tissue, and liver inflammatory injury, the net effect of 5-HT7 receptors and inflammation is still limited, significant advances have emerged in the past two decades. Nonetheless, current evidence suggests that pharmacological interventions targeting 5-HT7 receptors may be potentially useful for treating inflammatory conditions.While our understanding of the connection between 5-HT


This study examines program planning strategies among older adults participating in programs promoting aging-in-community (AIC) programs. Older adults from three programs were recruited (n=290): a university-based lifelong learning program , a county neighborhood lunch program , and a village program (n=96). Mean age was 72.4 (SD=8.68) years and 78% female. Findings showed NLP participants were more likely to obtain health information from TV (p=.030), friends and neighbors (p=.016), family members (p<.001), or mailed advertisement (p<.001); while less likely to obtain health information online (p<.001). Village members preferred afternoon while NLP participants preferred morning programs (p=.025). Most desired frequency was weekly (45%) and delivered in small group modes (68%). NLP participants were more likely to report self as risk takers (29% vs. 17%) or old tradition (23% vs. 3-8%) towards new technology adoption (p<.001). Results have implications on tailored program planning for older adults in different AIC programs.


Pointers are difficult learning targets for novice learners of C programming. For such difficult targets, introducing a system visualizing program behaviors is generally expected to support learners to understand the targets. However, visualization in existing systems often conceals the concrete value of variables such as pointers; the way in which each visualized object is located on the memory is not made explicit. In order to address this issue, we focused on a program visualization system called TEDViT. It visualizes simultaneously and synchronously the memory image that is the field that presents the concrete value of variables and the target domain world that is the field that presents logically the data structures processed by the program. We consider that observing and comparing program code, memory image, and target domain world with TEDViT could work for understanding pointers. TEDViT visualizes the status of the target domain world according to the visualization policy defined by the teacher in order to allow teachers to set their instruction content based on the growing variety of learner background knowledge. We also consider that this feature could support teachers’ instructions and class managements appropriately, and improving teachers’ performance by TEDViT’s support would bring improvement of learners’ understanding. We conducted classroom practice for understanding pointers in connection with a memory model, thus introducing TEDViT to a real class. Analysis of answered scores in a questionnaire conducted after the practice suggests that our practice using TEDViT provided useful supports for participants to understand pointers. It also suggests our practice had a certain effect to reduce uneven levels of understanding among participants. Based on these results, we describe that classroom practices in our framework could support learners to understand pointers and support teachers to manage the class. As information technology has pervaded our society in recent years, improving the productivity of program codes has been expected increasingly. Many institutes of higher education have organized programming classes for various students. Teachers are required to teach learners with various levels of background knowledge in limited time and hence to achieve efficient and effective programming education.Novice learners often see particular programming concepts merely as pieces of code rather than as active components of a dynamic process that occurs at runtime.Novice learners often cannot grasp so-called notional machine which is an abstraction of the computer in the role of executor of programs.The runtime world of the notional machine and the domain world of target processed by program code are hidden and are not clearly visible in program code.Novice learners often fail to trace programs step by step because of insufficient understandings of statement sequencing and insufficient ability to keep track of program state.Thus far, several program visualization systems have been developed to support novice learners in understanding program codes  is a collaborative consortium with industries and the university to which some of the authors belong; HEPT is also training system engineers. HEPT offers a training course for software design and development engineering, including lectures on programming in C. Our classroom practice was incorporated into four sessions of these lectures and conducted at 13 May 2015. The practice participants were 15 software engineers responsible for software development, but without much experience in C programming, as listed in Tables The goal of the sessions is to understand how to design and implement a function that can take arbitrary data types using function and generic pointers. In order to achieve this goal, the learners need to understand “relationships among types, variables, and pointers,” “pointers in function arguments,” “pointers as return values,” “pointer operations,” and “relationships between pointers and arrays” in connection with a memory model. Pointer is a mechanism specific to a few programming languages such as C/C++. It is difficult for engineers who usually use other language such as Java, VB, and Perl to understand these learning targets, even if they had sufficient experience in software development. The sessions into which our practice was incorporated were held to support those engineers to understand pointers. Pointer operators and memory modelVariables and pointers Calls by value Calls by pointer Return values with pointersFunctions and pointers Relationship between array names and pointers Relationship between arithmetic operations on pointers and array index operations Memory model of multidimensional arrays Handling an array to reverse the orderArrays and pointers Operations on generic pointers Sample library of integer stacksGeneric pointersThe practiced sessions and the learning sections in each session are the following:Aiming to the goal achievement, we introduced TEDViT into the session classes and incorporated learning activities to observe statuses of the target domain world associating with statuses of the memory image into the session learnings. We expected that these activities could contribute to cultivating better understanding of pointers. In the practice, four sessions were conducted in above order by 90 min each. Each learning section consisted of receiving the classroom lecture, observing the program behavior with TEDViT, practicing with a coding exercise, and receiving an explanation of the solutions for the exercise. We planned to allow the participants to use TEDViT mainly for observing program behavior so that they could observe and compare the memory image of variables and the target domain world by operating individually the learning environment visualized by TEDViT. We also observed that the teacher of the session classes used TEDViT to explain the point of an exercise solution with connections between the status of the target domain world and the memory image of variables.The teacher prepared the target program codes observed by the participants with TEDViT in the practice and the configuration files for the visualization of the target domain world. The number of prepared teaching materials  was ten. The visualizations defined by the teacher in accordance with the teacher’s own intent included arrow objects for representing the relationships between pointers and pointed variables, and coloring to highlight the objects on which the teacher intended the participants to focus. Figure It was difficult to conduct a certain test for the evaluation of the learning effect with TEDViT because the participants in the practice were not students, but engineers already employed. For the same reason, participants’ achievement codes in coding exercises were not assessed. Hence, our evaluation of the classroom practice is based on an analysis of the answers of two questionnaires conducted after the practice. One of them (Q1) was about learning with TEDViT, intended to evaluate how much the participants were satisfied with learning supports of pointers by TEDViT. The other (Q2) was about the learning content in the session, which is the same as the questionnaires conducted every past year, intended to evaluate the effect of the practiced sessions with TEDViT comparing corresponding past sessions without it.Q1-1. Asks how much TEDViT contributed to understanding C programming using five-point scale.Q1-2. Asks how much TEDViT contributed to ascertaining wanted matters using five-point scale.Q1-3. Asks how much TEDViT was needed for learning using five-point scale.Q1-4. Asks whether the teaching materials are regarded as useful from among the prepared ten materials .Q1-5. Asks for comments on the advantages and disadvantages of learning with TEDViT.Q1-6. Asks for comments on the insufficient or inconvenient functions of TEDViT.The questionnaire Q1 contains six items.Table Q2-1. Asks how much the participant was interested in learning the session content using 5-point scale.Q2-2. Asks how well the participant understood the session learning content using 5-point scale.Q2-3. Asks how fast the participant perceived was the teacher’s progress in the session using 5-point scale .Q2-4. Asks how difficult the session learning content was using 5-point scale .Q2-5. Asks how difficult the exercises were in the session using 5-point scale (similar to Q2-4).The questionnaire Q2 has five items, all of which are same as those conducted over several years at the HEPT training course:Table Our practice described in the previous section was conducted not in virtual classroom for experiment, but in the actual open lecture. Hence, we need to take into account that the knowledge obtained from the practice might have some limitations, though it would be more practical. The limitations of our practice are that we could not procure an enough number of participants to measure the learning effects and could not conduct a certain test for the evaluation of the effects. In this section, we discuss that the learning supports provided by TEDViT were accepted positively by the participants and that TEDViT could support teacher’s class management by reducing unevenness among learners in understanding.Learning items with complicated behavior, such as “handling an array to reverse the order” and “sample library of integer stacks”Learning items where a learner is required to grasp the relationship between the target domain world and memory model, such as “pointer operators and memory model,” “calls by pointer,” and “operations on generic pointers”According to the results in Table We consider that the participants who felt to be supported by the visualized target domain world to understand the program code with complicated behavior would prefer materials in the former categories. This suggests that the visualization defined by the teacher successfully supports participants to understand program behavior. On the other hand, the positive answers to the latter categories suggest that not a few participants felt to be supported to grasp the relationship between the memory image and the target domain world by observing and comparing the corresponding fields visualized by TEDViT. This suggests that synchronous and simultaneous visualization of program code, memory image, and target domain world contributes to supporting learners to understand the relationship.According to the results in Table F test to evaluate the variance uniformity of answer distributions on each items of Q2 for two groups: one is the answer in 2015 and the other is the answer in 2013 and 2014. Table F test. Table t test conducted for the same two groups as F test. Assuming significance level of 0.05, statistically significant differences were not found through the both test. However, there were no participants of sessions in 2015 who answered “not understandable at all” or “slightly not understandable” in Q2-2, in contrast to the sessions in 2013 and 2014, where some participants did provide these answers. Moreover, we conducted an interview with the teacher of practiced classes and received a comment that unevenness among participants in progress in their exercises could be reduced by TEDViT, and hence, he felt easy to teach the practiced classes. These suggest that individual learning support successfully reached every participant by using TEDViT.We conducted an As mentioned in the “Learning based on observations and comparisons of target program code, memory image, and target domain world would contribute to understanding of pointers.TEDViT could contribute to reducing unevenness among learners in progress in their exercises and could support teacher’s class management.Based on these discussions, we can summarize knowledge obtained through the classroom practice as follows:The limitation of our practice is that we could not procure an enough number of participants for the practice, because our practice was incorporated into the sessions of an open lecture for engineers already employed. However, we believe that continuous practice will suppress this matter. We plan to continue the classroom practices of programming education introducing TEDViT. Other limitations include that our evaluation of learning effect with TEDViT was based only on the answer scores in questionnaires. It was difficult to conduct a certain overall test for the evaluation of the learning effect with TEDViT because the participants in the practice were not students, but engineers already employed. We plan to develop some way of direct evaluation realizing lower externalization cost of participant’s learning achievement and to examine some indirect evaluation such as recording and analyzing participant’s operation logs of TEDViT.In this paper, we described a classroom practice for understanding pointers and a program visualization system introduced into the practice. Pointer is one of most difficult learning targets for novice learners to understand as well as recursion. Introducing program visualization systems to programming classes is expected to support novice learners to overcome these difficulties. Program visualization systems visualize the data structures processed by the target programs in certain ways and support learners in understanding the programs and algorithms by making their behavior visible. However, concrete values of pointer variables are often concealed in such visualizations, and hence, the way in which each visualized object is located on the memory is not made explicit. Therefore, novice learners often fail to grasp the relationship between program behavior and program code and reach a learning impasse.To address this issue, we focused on TEDViT, a system providing an environment to observe and compare program code, memory image, and target domain world. TEDViT visualizes three visualization fields simultaneously and synchronously and provides a learning environment where learners can observe and compare the three, that is, the target program code, the memory image representing the concrete values of the variables, and the target domain world representing logically the data structures processed by the target program. Moreover, in order to allow teachers to set their instruction content based on the growing variety of learner background knowledge, TEDViT visualizes the status of the target domain world according to the visualization policy defined by the teacher. Using TEDViT, teachers can provide flexible visualizations that are consistent with the teacher’s class instructions to the learners, and learners can be less confused with the visualizations.We conducted a classroom practice introducing TEDViT for understanding pointers in connection with a memory model. The participants in this practice were not university students, but software engineers responsible for software development. They learned program behavior by observing and comparing the memory image and target domain world visualized in the learning environment of TEDViT. In the questionnaire conducted after our practice, we obtained generally satisfactory answers for TEDViT. The analysis of answered scores suggested that TEDViT could contribute to reducing unevenness among participants in levels of understanding and that individual learning support successfully reached every participant by using TEDViT. In the questionnaire, some participants commented that the observations of the memory image in learning pointers were especially valuable. The comments by the teacher of our practice were also positive in that unevenness among participants in progress in their exercises could be reduced by TEDViT, and hence, he felt easy to teach the practiced classes.These results suggest that synchronous and simultaneous visualization of program code, memory image, and target domain world contributes to understanding of pointers. Although we need to consider that a statistically insufficient number of the participants of our practice may influence the reliability of evaluation results, continuous practice would suppress this matter. We can conclude that the framework of our classroom practice could be conducted successfully by introducing TEDViT. In future work, we plan to conduct more educational practices and evaluate the effectiveness of using TEDViT with higher reliability.


After an earthquake, the important task of emergency rescue work is to minimize casualties, but due to the suddenness of earthquake disasters, it is difficult to obtain enough disaster information immediately, especially personnel distribution and movement information. The traditional methods of obtaining disaster data are through reports from the disaster area or field investigations by the emergency rescue team; this work lags, and its efficiency is low. This paper analyzes the feasibility of using mobile phone location signal data in earthquake emergency rescue work in several respects, such as quantity, location, change rate, and epicentral distance. The results show that mobile phone location signal data can quickly obtain the situation of personnel distribution and quantity after an earthquake, and we find the change rate, distance, etc., can determine the approximate range of the earthquake impact field. Through the data distribution in different time periods, the movement of personnel after the earthquake can be obtained. Based on several situations, we can determine the basic situation of the disaster-stricken areas in times after the earthquake, especially the personnel relevant to the situation, and these data can provide a scientific basis for emergency rescue decision making. In recent years, mobile phones have become a pervasive technology with users carrying them at almost all times. From this perspective, the ubiquity of such platforms has transformed mobile phones into one of the main sensors of human behavior. With the advent of the era of big data, mobile phones have become increasingly popular; the result is that people's dependence on mobile phones has become increasingly high. Many users carry mobile phones at any time all day long. The GPS information from the mobile phone itself and the location information obtained in the process of using the mobile phone can reflect the real-time location information of the user. From this point of view, mobile phone location signal data can be seen as indicators of human activity. This ‘geographical footprint’ is similar to that collected when a cell phone call or text message is sent. Thus, social activity with GPS coordinates can be aggregated to and summarized by various spatial/political units for different analytical purposes–4. MobilDisaster management demands an immediate decision-making process, and this work requires us to conduct comprehensive analysis based on timely and accurate information data obtained after an earthquake. The primary task of earthquake emergency rescue work is to reduce casualties. Therefore, it is particularly important to accurately understand the distribution of personnel and the movement of the population after the earthquake. The existing approaches to assess population movements in the immediate aftermath of disasters, such as transport surveys and manual registration of individuals at emergency relief hubs, are often less useful: while important for record-keeping purposes, both methods are slow and may exclude those groups who are unreachable–8.China is one of the countries with the most intense seismic activity in the world and the most severe earthquake disasters. EarthquMany researchers have studied the application of mobile phones in postdisaster emergency rescue work. For example, mobile phone traces have been used to trace population movement behaviors or the response to large-scale emergencies in a postearthquake scenario  12] [13 [1312] . On the The core of earthquake emergency rescue work is to minimize the number of casualties. Therefore, it is crucial to obtain timely data about the affected people after the earthquake, and the traditional method to obtain the situation of the affected people is based on manual registration of individuals. However, the efficiency of this work is very low. According to mobile phone location signal data, we find that due to its characteristics of real-time availability and easy access, it provides a possibility for quickly obtaining disaster data after an earthquake. In this paper, we use mobile phone location signal data in earthquakes to study the possibility of use in emergency rescue work. For example, the distribution of earthquake hazard zones, the response of personnel, the movement of personnel, etc., could be traced. When we need to make emergency rescue decisions after an earthquake, these data can provide supporting information and a scientific basis.http://news.ceic.ac.cn/CC20170808211947.html), and the casualties of the earthquake amounted to 25 (http://finance.china.com.cn/hz/sh/2345/20170813/7818.shtml).According to the China Seismological Network Center, a Ms7.0 earthquake occurred in Jiuzhaigou County, Sichuan Province, on August 8, 2017, at 21:19:46, and the epicenter was located at 33.14°N, 103.79°E. The earthquake occurred at the eastern end of the eastern Kunlun fault zone of the Bayankala block on the Qinghai-Tibet Plateau, which intersects with the Huya fault and the Minjiang fault. The earthquake was moderate-strong and occurred due to the slippage of the Bayankala block on the Qinghai-Tibet Plateau. The focal depth of the earthquake was approximately 20 km . The data acquisition format is Geohash, and the precision is 6 bits. The obtained mobile phone location signal data mainly include the time and number of mobile phone signal acquisition within a certain latitude and longitude range, do not include any personal privacy information about the mobile phone user, and do not violate relevant legal norms.In this article, the mobile phone location data adopted are real-time location data provided by Getui Company , for a total of 10 hours of data. In contrast, we also collect data for the same period on the days before the earthquake. We carry out experiments and analysis from three aspects: the distribution of signal data, the change rate in signal data, and the distance between signals and the epicenter. Considering the change in the number of phone signals before and after the earthquake in the study area, the calculation of the change rate is the basis for the correlation analysis.Second, the obtained number of mobile phone signals is grid-processed; the data in the grid are integrated and statistically analyzed. Through analyzing the trend in the number of mobile phone signals in different periods, we obtain the change trends at different times  within the study area. We distinguish the rate of change and perform separate analyses based on overlapping regions and nonoverlapping regions. The data determined from the same research area are selected from 10 minutes before the earthquake to 10 minutes after the earthquake, and the seismic intensity map of the study area is superimposed and analyzed. Therefore, we can obtain the relationship between the distribution of mobile phone signals, the trend of change, and the actual intensity. For overlap data, if the amount of mobile phone signal data before an earthquake is the same as the amount of signal data at the time of an earthquake, then the personnel in the location have not changed or moved. The other situation is nonoverlap data; the data or location before and after the earthquake are different . We analyze these two kinds of data separately to obtain the change or the movement of personnel in earthquake regions. In this paper, we select the data change rates for 21:09 (10 minutes before the earthquake), 21:19 (earthquake time), and 21:29 (10 minutes after the earthquake) to analyze.Third, we take the epicentral location as the center, and we research the relationship between the change rate in mobile phone location signal data and the epicenter location before and after the earthquake, and the range that we set is within 100 km from the epicenter.We performed a detailed analysis of the results from three aspects. As shown in As shown in To obtain accurate changes in the number of signals, we conducted a comparative analysis on an hourly basis. We selected data from one hour before the earthquake, one hour after the earthquake, and the time of the earthquake. As As shown in The overall number of mobile phone locations in the study area is shown in As shown in In 2, and the value ranges between 0 and 1. If R2 is closer to 1, the goodness of fit is higher, whereas if R2 is closer to 0, the goodness of fit is lower. In this paper, the R2 is 0.8455, which indicates that fit analysis is good.The goodness of fit is represented by RWe obtained the rates of change for two phases in the same location of the study area: phase a is the change rate in data from before the earthquake to the time of the earthquake, and phase b is from the time of the earthquake to the time after the earthquake.2 is small, and the correlations are poor. From this, we can also find that the movement and change of people after the earthquake have irregular. For the change rate of data in phase a, nearly one-third of the number of signal change rates is 0, indicating that within this 10 minutes, the number of signals in these locations did not increase or decrease, which means that the people in this area did not move. Phase a is mainly distributed in the range from 0 to 2; that is, the change in the number of signals in the same area shows an increasing trend. The reason for this pattern may be that the main group of overlapping areas is mainly concentrated in the counties of Jiuzhaigou and Songpan. Because the time is 21:00 in the evening, most of the local residents have entered rest time, but after the earthquake, they use the phone to contact others or release information, which may be the main reason for the increase in the number of signals. In contrast, the change rate of data in phase b is mainly concentrated in the range from -2 to 0; that is, the change in the number of signals in the same area shows a decreasing trend. One of the main reasons for the decrease in the change rate may be that after the earthquake, residents in the earthquake zone move to other regions or the base stations are damaged.In the 10 minutes before the earthquake, the change rate of mobile phone signals in the study area was mainly concentrated between -1 and 1, favoring the direction of 1, which indicates that the number of signals showed an increasing trend in the 10 minutes before the earthquake. Additionally, at the time of the earthquake, we find from the distance distribution of signal data that the personnel in the study area showed an increasing trend. Second, in the 10 minutes after the earthquake, the change rate of cell phone signals in the study area was mainly concentrated between -1 and 1, favoring the direction of -1, indicating that the number of signals showed a decreasing trend in the 10 minutes after the earthquake. This result means after the earthquake, personnel in the study area showed a decreasing trend.In In Compared with the data in the overlap areas, there is a certain proportion of nonoverlap areas in the mobile phone signal in the study area. The time period is divided into three phases: 10 minutes before the earthquake , the earWe compare the distribution of the data at the time of the earthquake with the data before the earthquake and find a relatively stable movement trend, with certain similarities in concentrated distribution and coincidence with the roads in the county area. The data volume after the earthquake is similar to the data volume before the earthquake, the change is relatively stable, and a large amount of data is concentrated in the county area.However, from Taking the epicenter as the center, we selected buffer zones at distances of 15 km, 20 km, 40 km, and 80 km from the epicenter, and we analyzed the change rate in signal data in different buffer zones. The change in signal data is related to the change in time and the increase in distance.From In In this paper, we present preliminary results to characterize the social response to an earthquake. We used the Jiuzhaigou earthquake as an example; we obtained mobile phone location signal data 2 hours before the earthquake and 8 hours after the earthquake in Jiuzhaigou and determined the behavior patterns of the people after the earthquake based on the distribution of and changes in the mobile phone location signal data. In contrast, we also collected data for the same period on the day before the earthquake. The distribution of personnel and the regular pattern of activities provide data support and a theoretical basis for earthquake emergency decision making. Our results show that the total amount of signal data in the study area can be divided into several stages:In the first stage, the pre-earthquake period, the total amount of data is relatively large. Moreover, the change in the total amount of signals is generally more stable, and the amount of data change is small. The number of signals per minute was concentrated in the range of 200–400. The number of mobile phone signals currently obtained is only the number of signals that can be collected. It cannot represent the actual number of people in the local area. The actual population may be higher than the number of mobile phone position signals we have obtained. However, the obtained mobile phone location signal data can reflect the actual real-time personnel response.http://www.scca.gov.cn/2/2/2017-08-09/2834.html).In the second phase, within 1 minute after the earthquake, the data volume fluctuates markedly and rapidly decreases. The total signal reduction ratio is approximately 26.7%. The main reason is that after the earthquake, the evacuation of people in the earthquake area to outside of the earthquake area caused rapid signal data in the earthquake area. A second possible reason is that due to the decommissioning of the communication base stations, the amount of signal collection is small. According to the Sichuan Communications Administration's announcement, the base stations in the study area were damaged. From Sichuan Telecom, Jiuzhaigou has 78 base stations, and 31 base stations were affected; from Sichuan Unicom, Jiuzhaigou has 97 base stations, and 65 base stations were affected, and local transmission from Songjing to Hongyangou was interrupted. From Sichuan Mobile, Jiuzhaigou has 360 base stations, 138 base stations were damaged, and the cable from Gonggangling to the Convention and Exhibition Center was interrupted. From Sichuan Iron Tower, Jiuzhaigou has 410 base stations, 21 base stations were affected, and the overall rate of decommissioning was approximately 27% Click here for additional data file.