Advances in mapping population and demographic characteristics at small area levels

Temporally and spatially highly resolved information on population characteristics, including demographic profile (e.g. age and sex), ethnicity and socio-economic status (e.g. income, occupation, education), are essential for observational health studies at the small-area level. Time-relevant population data are critical as denominators for health statistics, analytics and epidemiology, to calculate rates or risks of disease. Demographic and socio-economic characteristics are key determinants of health and important confounders in the relationship of environmental contaminants and health. In many countries, census data have long been the source of small-area population denominators and confounder information. A strength of the traditional census model has been its careful design and high level of population coverage, allowing high-quality detailed data to be released for small areas periodically, e.g. every ten years. The timeliness of data, however, becomes a challenge when temporally and spatially highly accurate annual (or even more frequent) data at high spatial resolution 31are needed, for example, for health surveillance and epidemiological studies. Additionally, the approach to collecting demographic population information is changing in the era of openand big data and may eventually evolve to using combinations of administrative and other data, supplemented by surveys. We discuss different approaches to address these challenges including a) the U. S. American Community Survey, a rolling sample of the U.S. population census, b) the use of spatial analysis techniques to compile temporally and spatially high-resolution demographic data, and c) the use of administrative and big data sources as proxies for demographic characteristics

Effect of pre-straining and bake hardening on the microstructure and mechanical properties of CMnSi trip steels

The effects of pre-straining and bake hardening on the mechanical behaviour and microstructural changes were studied in two CMnSi TRansformation-Induced Plasticity (TRIP) steels with different microstructures after intercritical annealing. The TRIP steels before and after pre-straining and bake hardening were characterised by X-ray diffraction, optical microscopy, transmission electron microscopy, three dimensional atom probe and tensile tests. Both steels exhibited discontinuous yielding behaviour and a significant strength increase with some reduction in ductility after pre-straining and bake hardening treatment. The following main microstructural changes are responsible for the observed mechanical behaviours: a decrease in the volume fraction of retained austenite, an increase in the dislocation density and the formation of cell substructure in the polygonal ferrite, higher localized dislocation density in the polygonal ferrite regions adjacent to martensite or retained austenite, and the precipitation of fine iron carbides in bainite and martensite. The mechanism for the observed yield point phenomenon in both steels after treatment was analysed.<br /

The Mesothelioma epidemic in Western Europe: an update

The number of male deaths from pleural cancer in France, Germany and Italy increased from about 8750 in 1990-1994 to 9550 in 1995-1999, suggesting that mesothelioma deaths in males may be levelling off in most of Western Europe

Anti–Vascular Endothelial Growth Factor Drugs Compared With Panretinal Photocoagulation for the Treatment of Proliferative Diabetic Retinopathy: A Cost-Effectiveness Analysis

\ua9 2024Objectives: This study aimed to evaluate the cost-effectiveness of anti–vascular endothelial growth factor drugs (anti-VEGFs) compared with panretinal photocoagulation (PRP) for treating proliferative diabetic retinopathy (PDR) in the United Kingdom. Methods: A discrete event simulation model was developed, informed by individual participant data meta-analysis. The model captures treatment effects on best corrected visual acuity in both eyes, and the occurrence of diabetic macular edema and vitreous hemorrhage. The model also estimates the value of undertaking further research to resolve decision uncertainty. Results: Anti-VEGFs are unlikely to generate clinically meaningful benefits over PRP. The model predicted anti-VEGFs be more costly and similarly effective as PRP, generating 0.029 fewer quality-adjusted life-years at an additional cost of \ua33688, with a net health benefit of −0.214 at a \ua320 000 willingness-to-pay threshold. Scenario analysis results suggest that only under very select conditions may anti-VEGFs offer potential for cost-effective treatment of PDR. The consequences of loss to follow-up were an important driver of model outcomes. Conclusions: Anti-VEGFs are unlikely to be a cost-effective treatment for early PDR compared with PRP. Anti-VEGFs are generally associated with higher costs and similar health outcomes across various scenarios. Although anti-VEGFs were associated with lower diabetic macular edema rates, the number of cases avoided is insufficient to offset the additional treatment costs. Key uncertainties relate to the long-term comparative effectiveness of anti-VEGFs, particularly considering the real-world rates and consequences of treatment nonadherence. Further research on long-term visual acuity and rates of vision-threatening complications may be beneficial in resolving uncertainties

Certified causes of death in patients with mesothelioma in South East England

Background: Mesothelioma is a highly fatal cancer that is caused by exposure to asbestos fibres. In many populations, the occurrence of mesothelioma is monitored with the use of mortality data from death certification. We examine certified causes of death of patients who have been diagnosed with mesothelioma, and assess the validity of death certification data as a proxy for mesothelioma incidence.Methods: We extracted mesothelioma registrations in the South East of England area between 2000 and 2004 from the Thames Cancer Registry database. We retained for analysis 2200 patients who had died at the time of analysis, after having excluded seven dead cases where the causes of death were not known to the cancer registry. The 2200 deaths were classified hierarchically to identify (1) mesothelioma deaths, (2) deaths certified as lung cancer deaths or (3) deaths from unspecified cancer, and (4) deaths from other causes.Results: 87% of the patients had mesothelioma mentioned on the death certificate. 6% had no mention of mesothelioma but included lung cancer as a cause of death. Another 6% had no mention of mesothelioma or lung cancer, but included an unspecified cancer as a cause of death. Lastly, 2% had other causes of death specified on the death certificate.Conclusion: This analysis suggests that official mortality data may underestimate the true occurrence of mesothelioma by around 10%

Stable isotope analysis reveals different trophic niche spaces for wild and hatchery origin juvenile Chinook salmon in the Nisqually Delta

Hatchery programs have been used as a conservation tool to bolster declining Chinook salmon (Oncorhynchus tshawytscha) populations throughout much of the Salish Sea. In many watersheds, hatchery fish are released concurrently with the natural-origin population, thus raising the potential for density dependent effects via depleted prey resources, territorial behavior, and movement into sub-optimal habitats. Competition during the critical period for early marine growth and survival might have detrimental effects for wild Chinook salmon populations, highlighting the potential importance of a productive delta habitat mosaic. We used an integrated diet approach with stomach content and stable isotope analyses to evaluate differential patterns of habitat use and prey consumption in a fall run population of juvenile Chinook salmon from the Nisqually River Delta in Puget Sound. We examined size class and origin-level differences throughout the out-migration gradient, from freshwater riverine to nearshore habitat. Natural- and hatchery-origin smolts exhibited distinct habitat use patterns, whereby hatchery-origin individuals were captured less frequently in forested and transitional habitats, and more frequently in the nearshore. Consequently, hatchery-origin juveniles were less likely to consume terrestrial insect drift that was almost twice as energy rich as nearshore crustacean prey. Stable isotope signatures from muscle and liver tissues corroborated this finding, showing that while natural-origin Chinook salmon derived 24–31% of their diets from terrestrially sourced prey, terrestrial insects only made up 2–8% of hatchery-origin diets. This may have explained why natural-origin fish were in better condition and had stomach contents that were 15% more energy-rich on average than hatchery-origin fish. We did not observe strong evidence for trophic overlap in natural- and hatchery-origin juvenile Chinook salmon, but our results suggest that hatchery fish are less likely to take advantage of the terrestrial-aquatic interface, and could suffer behaviorally-mediated consequences to early marine growth and survival

On the accumulation of planetesimals near disc gaps created by protoplanets

We have performed three-dimensional two-fluid (gas-dust) hydrodynamical models of circumstellar discs with embedded protoplanets (3 - 333 M\oplu) and small solid bodies (radii 10cm to 10m). We find that high mass planets (\gtrsim Saturn mass) open sufficiently deep gaps in the gas disc such that the density maximum at the outer edge of the gap can very efficiently trap metre-sized solid bodies. This allows the accumulation of solids at the outer edge of the gap as solids from large radii spiral inwards to the trapping region. This process of accumulation occurs fastest for those bodies that spiral inwards most rapidly, typically metre-sized boulders, whilst smaller and larger objects will not migrate sufficiently rapidly in the discs lifetime to benefit from the process. Around a Jupiter mass planet we find that bound clumps of solid material, as large as several Earth masses, may form, potentially collapsing under self-gravity to form planets or planetesimals. These results are in agreement with Lyra et al. (2009), supporting their finding that the formation of a second generation of planetesimals or of terrestrial mass planets may be triggered by the presence of a high mass planet.Comment: 14 pages, 10 figures. Accepted for publication in MNRA

Come back Marshall, all is forgiven? : Complexity, evolution, mathematics and Marshallian exceptionalism

Marshall was the great synthesiser of neoclassical economics. Yet with his qualified assumption of self-interest, his emphasis on variation in economic evolution and his cautious attitude to the use of mathematics, Marshall differs fundamentally from other leading neoclassical contemporaries. Metaphors inspire more specific analogies and ontological assumptions, and Marshall used the guiding metaphor of Spencerian evolution. But unfortunately, the further development of a Marshallian evolutionary approach was undermined in part by theoretical problems within Spencer's theory. Yet some things can be salvaged from the Marshallian evolutionary vision. They may even be placed in a more viable Darwinian framework.Peer reviewedFinal Accepted Versio

Analysis of oral cancer epidemiology in the US reveals state-specific trends: implications for oral cancer prevention

Background: Downward trends have been observed in oral cancer incidence and mortality in the US over the past 30 years; however, these declines are not uniform within this population. Several studies have now demonstrated an increase in the incidence and mortality from oral cancers among certain demographic groups, which may have resulted from increased risks or risk behaviors. This study examines the underlying data that comprise these trends, to identify specific populations that may be at greater risk for morbidity and mortality from oral cancers. Methods: Oral cancer incidence and mortality data analyzed for this study were generated using the National Cancer Institute\u27s Surveillance, Epidemiology and End Results (SEER) program. Results: While oral cancer incidence and mortality rates have been declining over the past thirty years, these declines have reversed in the past five years among some demographic groups, including black females and white males. Sorting of these data by state revealed that eight states exhibited increasing rates of oral cancer deaths, Nevada, North Carolina, Iowa, Ohio, Maine, Idaho, North Dakota, and Wyoming, in stark contrast to the national downward trend. Furthermore, a detailed analysis of data from these states revealed increasing rates of oral cancer among older white males, also contrary to the overall trends observed at the national level. Conclusion: These results signify that, despite the declining long-term trends in oral cancer incidence and mortality nationally, localized geographic areas exist where the incidence and mortality from oral cancers have been increasing. These areas represent sites where public health education and prevention efforts may be focused to target these specific populations in an effort to improve health outcomes and reduce disparities within these populations

Expression and DNA methylation of TNF, IFNG and FOXP3 in colorectal cancer and their prognostic significance.

BACKGROUND: Colorectal cancer (CRC) progression is associated with suppression of host cell-mediated immunity and local immune escape mechanisms. Our aim was to assess the immune function in terms of expression of TNF, IFNG and FOXP3 in CRC. METHODS: Sixty patients with CRC and 15 matched controls were recruited. TaqMan quantitative PCR and methylation-specific PCR was performed for expression and DNA methylation analysis of TNF, IFNG and FOXP3. Survival analysis was performed over a median follow-up of 48 months. RESULTS: TNF was suppressed in tumour and IFNG was suppressed in peripheral blood mononuclear cells (PBMCs) of patients with CRC. Tumours showed enhanced expression of FOXP3 and was significantly higher when tumour size was >38 mm (median tumour size; P=0.006, Mann-Whitney U-test). Peripheral blood mononuclear cell IFNG was suppressed in recurrent CRC (P=0.01). Methylated TNFpromoter (P=0.003) and TNFexon1 (P=0.001) were associated with significant suppression of TNF in tumours. Methylated FOXP3cpg was associated with significant suppression of FOXP3 in both PBMC (P=0.018) and tumours (P=0.010). Reduced PBMC FOXP3 expression was associated with significantly worse overall survival (HR=8.319, P=0.019). CONCLUSIONS: We have detected changes in the expression of immunomodulatory genes that could act as biomarkers for prognosis and future immunotherapeutic strategies