A comparison of spatio-temporal disease mapping approaches including an application to ischaemic heart disease in New South Wales, Australia

© 2017 by the authors; licensee MDPI, Basel, Switzerland. The field of spatio-temporal modelling has witnessed a recent surge as a result of developments in computational power and increased data collection. These developments allow analysts to model the evolution of health outcomes in both space and time simultaneously. This paper models the trends in ischaemic heart disease (IHD) in New South Wales, Australia over an eight-year period between 2006 and 2013. A number of spatio-temporal models are considered, and we propose a novel method for determining the goodness-of-fit for these models by outlining a spatio-temporal extension of the Moran’s I statistic. We identify an overall decrease in the rates of IHD, but note that the extent of this health improvement varies across the state. In particular, we identified a number of remote areas in the north and west of the state where the risk stayed constant or even increased slightly

Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes

This article is made available through the Brunel Open Access Publishing Fund and is distributed by the Creative Commons CC-BY 3.0 license, under which all are free to reuse or distribute the article under the condition that this original publication must be cited.Repeated injury of the airway epithelium caused by hyperpnoea of poorly conditioned air has been proposed as a key factor in the pathogenesis of exercise-induced bronchoconstriction (EIB) in athletes. In animals, the short-acting β2-agonist terbutaline has been shown to reduce dry airflow-induced bronchoconstriction and the associated shedding of airway epithelial cells. Our aim was to test the efficacy of inhaled terbutaline in attenuating hyperpnoea-induced bronchoconstriction and airway epithelial injury in athletes. Twenty-seven athletes with EIB participated in a randomized, double-blind, placebo-controlled, crossover study. Athletes completed an 8-min eucapnic voluntary hyperpnoea (EVH) test with dry air on two separate days 15 min after inhaling 0.5 mg terbutaline or a matching placebo. Forced expiratory volume in 1 s (FEV1) and urinary concentration of the club cell (Clara cell) protein 16 (CC16, a marker of airway epithelial perturbation) were measured before and up to 60 min after EVH. The maximum fall in FEV1 of 17 ± 8% (SD) on placebo was reduced to 8 ± 5% following terbutaline (P < 0.001). Terbutaline gave bronchoprotection (i.e., post-EVH FEV1 fall <10%) to 22 (81%) athletes. EVH caused an increase in urinary excretion of CC16 in both conditions (P < 0.001), and terbutaline significantly reduced this rise (pre- to postchallenge CC16 increase 416 ± 495 pg/μmol creatinine after placebo vs. 315 ± 523 pg/μmol creatinine after terbutaline, P = 0.016). These results suggest that the inhalation of a single therapeutic dose of terbutaline offers significant protection against hyperpnoea-induced bronchoconstriction and attenuates acute airway epithelial perturbation in athletes.World Anti Doping Agenc

Methods for estimating the case fatality ratio for a novel, emerging infectious disease.

During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital

Identifying as in, out, or sexually inexperienced: Perception of sex-related personal disclosures

The current research explored perceptions of disclosing the information of "I am gay", "I am heterosexual", and "I am a virgin" to a variety of audiences. Participants were 842 undergraduate students who evaluated the valence of each disclosure, listed the associated feelings, and rated the comfort of disclosing such information to various audiences (e.g., a family member, online community). Participants rated the statement consistent with their own sexual orientation as being significantly more positive. No significant difference was found between gay and heterosexual participants’ ratings about disclosing virginity, and disclosure of virginity status was ranked as the most uncomfortable of the three disclosures. Both heterosexual and gay respondents indicated it would be more comfortable to disclose a heterosexual orientation than a gay one, despite gay participants rating a gay orientation as more positive. The audience ranked most to least comfortable to disclose varied with sexual orientation and disclosure content. Perceived closeness of audience was correlated with comfort of disclosure for known (family, partner, friend, colleague) audiences, but not professional (counsellor) or unknown (stranger, online) audiences. These findings are discussed with reference to the literature on “coming out”, addressing important differences in the perceptions of in-group and out-group disclosure of sexual orientation, and sex-related personal information

HIV Testing and Conspiracy Beliefs Regarding the Origins of HIV among African Americans

Abstract Conspiracy beliefs regarding the origins of HIV are common among African Americans, and have been associated with engaging in HIV risk behaviors but also with earlier diagnosis among HIV patients. The objective of the present study was to test the association of HIV serostatus testing with conspiracy beliefs. A total of 1430 African Americans from low-income neighborhoods with high rates of drug use were surveyed in 1997-1999 in face-to-face interviews. Two 4-point items assessed if participants agreed that AIDS was started by an experiment that went wrong and AIDS was created to kill blacks and poor folks. A binary variable indicated if the respondent agreed with the statements, on average. 22.5% of the sample endorsed conspiracy beliefs, 4.0% of whom reported not having had an HIV test, compared to 7.7% of those who did not endorse conspiracy beliefs. In multivariable logistic regression modeling, never having had an HIV test was significantly associated with conspiracy beliefs (adjusted odds ratio [AOR]=0.43, 95% confidence interval [CI]=1.3-4.3), having a high school education (AOR=0.55, CI=0.35-0.84), having depression (AOR=1.61, CI=1.02-2.52), female gender (AOR=0.54, CI=0.34-0.86), younger age, and a history of injection drug use (AOR=0.36, CI=0.23-0.56), but not sex risk behaviors (multiple partners, irregular condom use). The finding that individuals who have conspiracy beliefs are more likely to have been tested for HIV may partially explain why HIV-positive individuals who endorse conspiracy beliefs are more likely to obtain an earlier diagnosis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78123/1/apc.2009.0061.pd

Gender Differences in Diabetes Attitudes and Adherence

This study focused on three questions: Is there a difference in men's and women's diabetes attitudes? Do health professionals give different recommendations to men and women? Is there a difference between men and women in care adherence? A total of 1201 patients with diabetes were surveyed; 65% of these patients were women. Differences in diabetes attitudes (three of seven attiticdes) were most evident between men and women with insulin-dependent diabetes mellitus (IDDM). No differences were found in the attitudes of men and women with non-insulin-dependent diabetes mellitus (NIDDM) using insulin, and only one attitude was different for patients with NIDDM not using insulin. Few differences were observed in the recommendations given by health professionals to men and women. Gender differences in adherence to the components of self-care also were minimal. These findings may indicate that there are many similarities in the reactions of men and women who have been diagnosed with diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69143/2/10.1177_014572179502100605.pd

Influence of southern hemispheric biomass burning on midtropospheric distributions of nonmethane hydrocarbons and selected halocarbons over the remote South Pacific

Aircraft measurements of nonmethane hydrocarbons (NMHCs) and halocarbons were made over the remote South Pacific Ocean during late August-early October 1996 for NASA's Global Tropospheric Experiment (GTE) Pacific Exploratory Mission-Tropics A (PEM-Tropics A). This paper discusses the large-scale spatial distributions of selected trace gases encountered during PEM-Tropics A. The PEM-Tropics A observations are compared to measurements made over the southwestern pacific in early November 1995 as part of Aerosol Characterization Experiment (ACE 1). Continental pollution in the form of layers containing elevated levels of O3 was observed during a majority of PEM-Tropics flights, as well as during several ACE 1 flights. The chemical composition of these air masses indicates that they were not fresh and were derived from nonurban combustion sources. The substantial impact of biomass burning on the vertical structure of the South Pacific troposphere is discussed. Copyright 1999 by the American Geophysical Union

Quantitative proteomic analysis by iTRAQ® for the identification of candidate biomarkers in ovarian cancer serum

<p>Abstract</p> <p>Background</p> <p>Ovarian cancer is the most lethal gynecologic malignancy, with the majority of cases diagnosed at an advanced stage when treatments are less successful. Novel serum protein markers are needed to detect ovarian cancer in its earliest stage; when detected early, survival rates are over 90%. The identification of new serum biomarkers is hindered by the presence of a small number of highly abundant proteins that comprise approximately 95% of serum total protein. In this study, we used pooled serum depleted of the most highly abundant proteins to reduce the dynamic range of proteins, and thereby enhance the identification of serum biomarkers using the quantitative proteomic method iTRAQ^®.</p> <p>Results</p> <p>Medium and low abundance proteins from 6 serum pools of 10 patients each from women with serous ovarian carcinoma, and 6 non-cancer control pools were labeled with isobaric tags using iTRAQ^®to determine the relative abundance of serum proteins identified by MS. A total of 220 unique proteins were identified and fourteen proteins were elevated in ovarian cancer compared to control serum pools, including several novel candidate ovarian cancer biomarkers: extracellular matrix protein-1, leucine-rich alpha-2 glycoprotein-1, lipopolysaccharide binding protein-1, and proteoglycan-4. Western immunoblotting validated the relative increases in serum protein levels for several of the proteins identified.</p> <p>Conclusions</p> <p>This study provides the first analysis of immunodepleted serum in combination with iTRAQ^®to measure relative protein expression in ovarian cancer patients for the pursuit of serum biomarkers. Several candidate biomarkers were identified which warrant further development.</p

Livestock trade network: potential for disease transmission and implications for risk-based surveillance on the island of Mayotte

The island of Mayotte is a department of France, an outermost region of the European Union located in the Indian Ocean between Madagascar and the coast of Eastern Africa. Due to its close connection to the African mainland and neighbouring islands, the island is under constant threat of introduction of infectious diseases of both human and animal origin. Here, using social network analysis and mathematical modelling, we assessed potential implications of livestock movements between communes in Mayotte for risk-based surveillance. Our analyses showed that communes in the central region of Mayotte acted as a hub in the livestock movement network. The majority of livestock movements occurred between communes in the central region and from communes in the central region to those in the outer region. Also, communes in the central region were more likely to be infected earlier than those in the outer region when the spread of an exotic infectious disease was simulated on the livestock movement network. The findings of this study, therefore, suggest that communes in the central region would play a major role in the spread of infectious diseases via livestock movements, which needs to be considered in the design of risk-based surveillance systems in Mayotte

Comparison of tumour-based (Petersen Index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancer

After resection, it is important to identify colon cancer patients, who are at a high risk of recurrence and who may benefit from adjuvant treatment. The Petersen Index (PI), a prognostic model based on pathological criteria is validated in Dukes' B and C disease. Similarly, the modified Glasgow Prognostic Score (mGPS) based on biochemical criteria has also been validated. This study compares both the scores in patients undergoing curative resection of colon cancer. A total of 244 patients underwent elective resection between 1997 and 2005. The PI was constructed from pathological reports; the mGPS was measured pre-operatively. The median follow-up was 67 months (minimum 36 months) during which 109 patients died; 68 of them from cancer. On multivariate analysis of age, Dukes' stage, PI and mGPS, age (hazard ratio, HR, 1.74, P=0.001), Dukes' stage (HR, 3.63, P&#60;0.001), PI (HR, 2.05, P=0.010) and mGPS (HR, 2.34, P&#60;0.001) were associated independently with cancer-specific survival. Three-year cancer-specific survival rates for Dukes' B patients with the low-risk PI were 98, 92 and 82% for the mGPS of 0, 1 and 2, respectively (P&#60;0.05). The high-risk PI population is small, in particular for Dukes' B disease (9%). The mGPS further stratifies those patients classified as low risk by the PI. Combining both the scoring systems could identify patients who have undergone curative surgery but are at high-risk of cancer-related death, therefore guiding management and trial stratification