Modelling typhoid risk in Dhaka Metropolitan Area of Bangladesh: the role of socio-economic and environmental factors

BackgroundDeveloping countries in South Asia, such as Bangladesh, bear a disproportionate burden of diarrhoeal diseases such as Cholera, Typhoid and Paratyphoid. These seem to be aggravated by a number of social and environmental factors such as lack of access to safe drinking water, overcrowdedness and poor hygiene brought about by poverty. Some socioeconomic data can be obtained from census data whilst others are more difficult to elucidate. This study considers a range of both census data and spatial data from other sources, including remote sensing, as potential predictors of typhoid risk. Typhoid data are aggregated from hospital admission records for the period from 2005 to 2009. The spatial and statistical structures of the data are analysed and Principal Axis Factoring is used to reduce the degree of co-linearity in the data. The resulting factors are combined into a Quality of Life index, which in turn is used in a regression model of typhoid occurrence and risk.ResultsThe three Principal Factors used together explain 87% of the variance in the initial candidate predictors, which eminently qualifies them for use as a set of uncorrelated explanatory variables in a linear regression model. Initial regression result using Ordinary Least Squares (OLS) were disappointing, this was explainable by analysis of the spatial autocorrelation inherent in the Principal factors. The use of Geographically Weighted Regression caused a considerable increase in the predictive power of regressions based on these factors. The best prediction, determined by analysis of the Akaike Information Criterion (AIC) was found when the three factors were combined into a quality of life index, using a method previously published by others, and had a coefficient of determination of 73%.ConclusionsThe typhoid occurrence/risk prediction equation was used to develop the first risk map showing areas of Dhaka Metropolitan Area whose inhabitants are at greater or lesser risk of typhoid infection. This, coupled with seasonal information on typhoid incidence also reported in this paper, has the potential to advise public health professionals on developing prevention strategies such as targeted vaccination

Incremental Evaluation of Rules and its Relationship to Parallelism

Rule interpreters usually start with an initial database and perform the inference procedure in cycles, ending with a final database. In a real time environment it is possible to receive updates to the initial database after the inference procedure has started or even after it has ended. We present an algorithm for incremental maintenance of the deductive database in the presence of such updates. Interestingly, the same algorithm is useful for parallel and distributed rule processing in the following sense. \\'hen the processors evaluating a program operate asynchronously. then they may have different views of the database. The incremental maintenance procedure we present can be used to synchronize these views

Selective effects of 5-HT2C receptor modulation on performance of a novel valence-probe visual discrimination task and probabilistic reversal learning in mice.

RATIONALE: Dysregulation of the serotonin (5-HT) system is a pathophysiological component in major depressive disorder (MDD), a condition closely associated with abnormal emotional responsivity to positive and negative feedback. However, the precise mechanism through which 5-HT tone biases feedback responsivity remains unclear. 5-HT2C receptors (5-HT2CRs) are closely linked with aspects of depressive symptomatology, including abnormalities in reinforcement processes and response to stress. Thus, we aimed to determine the impact of 5-HT2CR function on response to feedback in biased reinforcement learning. METHODS: We used two touchscreen assays designed to assess the impact of positive and negative feedback on probabilistic reinforcement in mice, including a novel valence-probe visual discrimination (VPVD) and a probabilistic reversal learning procedure (PRL). Systemic administration of a 5-HT2CR agonist and antagonist resulted in selective changes in the balance of feedback sensitivity bias on these tasks. RESULTS: Specifically, on VPVD, SB 242084, the 5-HT2CR antagonist, impaired acquisition of a discrimination dependent on appropriate integration of positive and negative feedback. On PRL, SB 242084 at 1 mg/kg resulted in changes in behaviour consistent with reduced sensitivity to positive feedback. In contrast, WAY 163909, the 5-HT2CR agonist, resulted in changes associated with increased sensitivity to positive feedback and decreased sensitivity to negative feedback. CONCLUSIONS: These results suggest that 5-HT2CRs tightly regulate feedback sensitivity bias in mice with consequent effects on learning and cognitive flexibility and specify a framework for the influence of 5-HT2CRs on sensitivity to reinforcement

Plasma modeling for a nonsymmetric capacitive discharge driven by a nonsinusoidal radio frequency current

An analytical solution for the sheath dynamics of an asymmetrically driven capacitively coupled plasma is obtained under the assumptions of time-independent, collisionless ion motion, inertialess electrons, and uniform current density. Modeling is performed considering that the plasma is driven by a nonsinusoidal radio frequency (rf) current which can be resolved into a finite number of harmonic components. Together with different sheath parameters the equation for the bulk plasma impedance is also obtained to calculate the overall plasma impedance and the overall rf voltage. Assuming equal plate areas the solution for a symmetric discharge is also obtainable from this model. We have found that the even harmonic components of rf voltage and impedance are always present, even in a symmetric discharge. Experimental results are shown to be in qualitative agreement with the theoretical model. The values of normalized rf voltage and impedance harmonics assume lower values as the asymmetry of the plasma chamber decreases

Understanding the information-based transformation of strategy and society

The world economy is undergoing dramatic changes, largely driven by the new availability of fine-grained information. Innovative ways of using datalarge and small-have also prompted a rethinking of the boundaries for the combination and use of knowledge. The strategic design of information flows in the economy has the upside of higher economic rents and competitive advantage, as well as the downsides of wealth inequality and abuse of power. This has brought a wide range of regulatory challenges. To understand the nature of these sweeping changes, it is important to examine the new ways information is used, and how information flows can be leveraged to create competitive advantage and dampen competition. The analysis in this article examines four economic entities that produce and consume value, as well as three determinants for the modes of their operations. The economic entities include consumers, producers, markets, and society, whose interactions are determined by viability, networks, and agency. In this framework, we paint a picture of the transformation of information-based strategy in the future and suggest promising research opportunities

The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis

Introduction: The Antifibrinolytic Trialists Collaboration aims to increase knowledge about the effectiveness and safety of antifibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials. This article presents the statistical analysis plan for an IPD meta-analysis of the effects of antifibrinolytics for acute intracranial haemorrhage. Methods: The protocol for the IPD meta-analysis has been registered with PROSPERO (CRD42016052155). We will conduct an individual patient data meta-analysis of randomised controlled trials with 1000 patients or more assessing the effects of antifibrinolytics in acute intracranial haemorrhage. We will assess the effect on two co-primary outcomes: 1) death in hospital at end of trial follow-up, and 2) death in hospital or dependency at end of trial follow-up. The co-primary outcomes will be limited to patients treated within three hours of injury or stroke onset. We will report treatment effects using odds ratios and 95% confidence intervals. We use logistic regression models to examine how the effect of antifibrinolytics vary by time to treatment, severity of intracranial bleeding, and age. We will also examine the effect of antifibrinolytics on secondary outcomes including death, dependency, vascular occlusive events, seizures, and neurological outcomes. Secondary outcomes will be assessed in all patients irrespective of time of treatment. All analyses will be conducted on an intention-to-treat basis. Conclusions: This IPD meta-analysis will examine important clinical questions about the effects of antifibrinolytic treatment in patients with intracranial haemorrhage that cannot be answered using aggregate data. With IPD we can examine how effects vary by time to treatment, bleeding severity, and age, to gain better understanding of the balance of benefit and harms on which to base recommendations for practice