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

War came to the Iowa community

On April 6, 1917, the United States of America declared war. Throughout the country communities marshalled forces to meet the situation. Today the United States is engaged in another war, which is creating problems of social and economic war planning on dimensions greater than those of the war in 1917-18. As the defense effort expands each community will face a notable increase in organized group activities, in new integrating organizations, heightened enthusiasm expressed in rallies and campaigns, new regulations of private lives. Everyone today recognizes that war involves readjustments in our society. Economic and political adjustments are obviously serious. Equally drastic are the necessary modifications in family life, in churches, in recreation, in education, in the innumerable activities which in peacetime follow so normal a routine that we accept them as a matter of course. These problems are no less vital to the welfare of our people than the effects of war upon land values and prices of farm products. The preservation of a democratic way of life depends upon the actions and attitude of all members of the nation in their local communities. The successful adjustment of individuals to these changes, and the organization of our energies for effective prosecution of the war require an understanding of the problems which will be involved

Individual level covariate adjusted conditional autoregressive (indiCAR) model for disease mapping

© 2016 The Author(s). Background: Mapping disease rates over a region provides a visual illustration of underlying geographical variation of the disease and can be useful to generate new hypotheses on the disease aetiology. However, methods to fit the popular and widely used conditional autoregressive (CAR) models for disease mapping are not feasible in many applications due to memory constraints, particularly when the sample size is large. We propose a new algorithm to fit a CAR model that can accommodate both individual and group level covariates while adjusting for spatial correlation in the disease rates, termed indiCAR. Our method scales well and works in very large datasets where other methods fail. Results: We evaluate the performance of the indiCAR method through simulation studies. Our simulation results indicate that the indiCAR provides reliable estimates of all the regression and random effect parameters. We also apply indiCAR to the analysis of data on neutropenia admissions in New South Wales (NSW), Australia. Our analyses reveal that lower rates of neutropenia admissions are significantly associated with individual level predictors including higher age, male gender, residence in an outer regional area and a group level predictor of social disadvantage, the socio-economic index for areas. A large value for the spatial dependence parameter is estimated after adjusting for individual and area level covariates. This suggests the presence of important variation in the management of cancer patients across NSW. Conclusions: Incorporating individual covariate data in disease mapping studies improves the estimation of fixed and random effect parameters by utilizing information from multiple sources. Health registries routinely collect individual and area level information and thus could benefit by using indiCAR for mapping disease rates. Moreover, the natural applicability of indiCAR in a distributed computing framework enhances its application in the Big Data domain with a large number of individual/group level covariates. CI NSW Study Reference Number: 2012/07/410. Dated: July 2012

Was it Good for You? Gender Differences in Motives and Emotional Outcomes Following Casual Sex

Casual sex, also referred to as a hookup, has been associated with a range of negative emotional outcomes for women, including regret, anxiety, depression and social stigma. However, it has been argued that it is the nature of the sexual motivation, not gender that influences the emotional outcome. This study was designed to ascertain what motivates people to have casual sex, what emotional outcomes follow casual sex and whether there are gender differences among these variables. Seven hundred and one participants (47% men and 52.8% women) completed a 44-item online survey. Gender differences were found for both sexual motivations and emotional outcomes of casual sex, with women generally having more negative emotional outcomes than men. Additionally, a principal components analysis uncovered four reliable principal motivations underlying engagement in casual sex, and three principal emotional outcomes of casual sex. Predictors of negative emotional outcomes included being motivated to regulate negative emotions and to achieve positive emotions. No predictors (apart from being a man) were found for a positive emotional outcome. While the stigma surrounding female sexual agency is diminishing, results generally support the presence of a sexual double-standard which encourages male promiscuity but dissuades female sexual autonomy

Quantum Cosmological Relational Model of Shape and Scale in 1-d

Relational particle models are useful toy models for quantum cosmology and the problem of time in quantum general relativity. This paper shows how to extend existing work on concrete examples of relational particle models in 1-d to include a notion of scale. This is useful as regards forming a tight analogy with quantum cosmology and the emergent semiclassical time and hidden time approaches to the problem of time. This paper shows furthermore that the correspondence between relational particle models and classical and quantum cosmology can be strengthened using judicious choices of the mechanical potential. This gives relational particle mechanics models with analogues of spatial curvature, cosmological constant, dust and radiation terms. A number of these models are then tractable at the quantum level. These models can be used to study important issues 1) in canonical quantum gravity: the problem of time, the semiclassical approach to it and timeless approaches to it (such as the naive Schrodinger interpretation and records theory). 2) In quantum cosmology, such as in the investigation of uniform states, robustness, and the qualitative understanding of the origin of structure formation.Comment: References and some more motivation adde

Minimal breast milk transfer of rituximab, a monoclonal antibody used in neurological conditions.

ObjectiveTo determine the transfer of rituximab, an anti-CD20 monoclonal antibody widely used for neurologic conditions, into mature breast milk.MethodsBreast milk samples were collected from 9 women with MS who received rituximab 500 or 1,000 mg intravenous once or twice while breastfeeding from November 2017 to April 2019. Serial breast milk samples were collected before infusion and at 8 hours, 24 hours, 7 days, and 18-21 days after rituximab infusion in 4 patients. Five additional patients provided 1-2 samples at various times after rituximab infusion.ResultsThe median average rituximab concentration in mature breast milk was low at 0.063 μg/mL (range 0.046-0.097) in the 4 patients with serial breast milk collection, with an estimated median absolute infant dose of 0.0094 mg/kg/d and a relative infant dose (RID) of 0.08% (range 0.06%-0.10%). Most patients had a maximum concentration at 1-7 days after infusion. The maximum concentration occurred in a woman with a single breast milk sample and was 0.29 μg/mL at 11 days postinfusion, which corresponds with an estimated RID of 0.33%. Rituximab concentration in milk was virtually undetectable by 90 days postinfusion.ConclusionsWe determined minimal transfer of rituximab into mature breast milk. The RID for rituximab was less than 0.4% and well below theoretically acceptable levels of less than 10%. Low oral bioavailability would probably also limit the absorption of rituximab by the newborn. In women with serious autoimmune neurologic conditions, monoclonal antibody therapy may afford an acceptable benefit to risk ratio, supporting both maternal treatment and breastfeeding

Emergent Semiclassical Time in Quantum Gravity. I. Mechanical Models

Strategies intended to resolve the problem of time in quantum gravity by means of emergent or hidden timefunctions are considered in the arena of relational particle toy models. In situations with `heavy' and `light' degrees of freedom, two notions of emergent semiclassical WKB time emerge; these are furthermore equivalent to two notions of emergent classical `Leibniz--Mach--Barbour' time. I futhermore study the semiclassical approach, in a geometric phase formalism, extended to include linear constraints, and with particular care to make explicit those approximations and assumptions used. I propose a new iterative scheme for this in the cosmologically-motivated case with one heavy degree of freedom. I find that the usual semiclassical quantum cosmology emergence of time comes hand in hand with the emergence of other qualitatively significant terms, including back-reactions on the heavy subsystem and second time derivatives. I illustrate my analysis by taking it further for relational particle models with linearly-coupled harmonic oscillator potentials. As these examples are exactly soluble by means outside the semiclassical approach, they are additionally useful for testing the justifiability of some of the approximations and assumptions habitually made in the semiclassical approach to quantum cosmology. Finally, I contrast the emergent semiclassical timefunction with its hidden dilational Euler time counterpart.Comment: References Update