Geographically weighted spatial interaction (GWSI)

One of the key concerns in spatial analysis and modelling is to study and analyse similarities or dissimilarities between places over geographical space. However, ”global“ spatial models may fail to identify spatial variations of relationships (spatial heterogeneity) by assuming spatial stationarity of relationships. In many real-life situations spatial variation in relationships possibly exists and the assumption of global stationarity might be highly unrealistic leading to ignorance of a large amount of spatial information. In contrast, local spatial models emphasise differences or dissimilarity over space and focus on identifying spatial variations in relationships. These models allow the parameters of models to vary locally and can provide more useful information on the processes generating the data in different parts of the study area. In this study, a framework for localising spatial interaction models, based on geographically weighted (GW) techniques, has been developed. This framework can help in detecting, visualising and analysing spatial heterogeneity in spatial interaction systems. In order to apply the GW concept to spatial interaction models, we investigate several approaches differing mainly in the way calibration points (flows) are defined and spatial separation (distance) between flows is calculated. As a result, a series of localised geographically weighted spatial interaction (GWSI) models are developed. Using custom-built algorithms and computer code, we apply the GWSI models to a journey-to-work dataset in Switzerland for validation and comparison with the related global models. The results of the model calibrations are visualised using a series of conventional and flow maps along with some matrix visualisations. The comparison of the results indicates that in most cases local GWSI models exhibit an improvement over the global models both in providing more useful local information and also in model performance and goodness-of-fit

Flow autocorrelation: a dyadic approach

The paper proposes and investigates a new index of flow autocorrelation, based upon a generalization of Moran’s I, and made of two ingredients. The first one consists of a family of spatial weights matrix, the exchange matrix, possessing a freely adjustable parameter interpretable as the age of the network, and controlling for the distance decay range. The second one is a matrix of chi-square dissimilarities between outgoing or incoming flows. Flows have to be adjusted, that is their diagonal part must first be calibrated from their off-diagonal part, thanks to a new iterative procedure procedure aimed at making flows as independent as possible. Commuter flows in Western Switzerland as well as migration flows in Western US illustrate the statistical testing of flow autocorrelation, as well as the computation, mapping and interpretation of local indicators of flow autocorrelation. We prove the present dyadic formalism to be equivalent to the “origin-based” tetradic formalism found in alternative studies of flow autocorrelation

The Role of a Multi-Step Core Stability Exercise Program in the Treatment of Nurses with Chronic Low Back Pain: A Single-Blinded Randomized Controlled Trial

Study Design Single-blinded randomized controlled trial. Purpose To evaluate the effects of a multi-step core stability exercise program in nurses with chronic low back pain (CLBP). Overview of Literature CLBP is a common disorder among nurses. Considering that patient-handling activities predispose nurses to CLBP, core stability exercises suggested for managing CLBP in the general population may also be helpful in nurses. However, sufficient evidence is not available on whether a multi-step core stability exercise program affects pain, disability, quality of life, and the diameter of lateral abdominal muscles in nurses with CLBP. Methods In this single-blinded randomized controlled trial, 36 female nurses with CLBP were recruited. The sample was divided into two groups of 18 patients (intervention and control). Nurses in the intervention group performed core stability exercises for 8 weeks, based on a progressive pattern over time. Roland–Morris Disability Questionnaire (RDQ), quality of life (36-item Short Form Health Survey [SF-36]), ultrasound assessment of the diameter of lateral abdominal muscles, and Visual Analog Scale (VAS) score for pain were evaluated in the participants before and after the trial. Sixteen nurses (eight from each group) dropped out of the study, and analysis of covariance was used to compare outcomes for the remaining nurses in the intervention (10 nurses) and control (10 nurses) groups. Results The results after the trial showed significant improvements in RDQ, SF-36, and VAS score in the intervention group compared with that in the control group (p <0.005). Furthermore, the ultrasound data showed a significant increase in the left and right muscle diameter of all three abdominal muscles during the abdominal drawing-in maneuver in the intervention group compared with that in the control group (p <0.05). Conclusions This study showed that a multi-step core stability exercise program is a helpful treatment option for improving quality of life and reducing disability and pain in female nurses with CLBP

From pandemic to endemic: Spatial-temporal patterns of influenza-like illness incidence in a Swiss canton, 1918-1924

In pandemics, past and present, there is no textbook definition of when a pandemic is over, and how and when exactly a respiratory virus transitions from pandemic to endemic spread. In this paper we have compared the 1918/19 influenza pandemic and the subsequent spread of seasonal flu until 1924. We analysed 14,125 reports of newly stated 32,198 influenza-like illnesses from the Swiss canton of Bern. We analysed the temporal and spatial spread at the level of municipalities, regions, and the canton. We calculated incidence rates per 1000 inhabitants of newly registered cases per calendar week. Further, we illustrated the incidences of each municipality for each wave (first wave in summer 1918, second wave in fall/winter 1918/19, the strong later wave in early 1920, as well as the two seasonal waves in 1922 and 1924) on a choropleth map. We performed a spatial hotspot analysis to identify spatial clusters in each wave, using the Gi* statistic. Furthermore, we applied a robust negative binomial regression to estimate the association between selected explanatory variables and incidence on the ecological level. We show that the pandemic transitioned to endemic spread in several waves (including another strong wave in February 1920) with lower incidence and rather local spread until 1924 at least. At the municipality and regional levels, there were different patterns of spread both between pandemic and seasonal waves. In the first pandemic wave in summer 1918 the probability of higher incidence was increased in municipalities with a higher proportion of manufacturing factories (OR 2.60, 95%CI 1.42-4.96), as well as in municipalities that had access to a railway station (OR 1.50, 95%CI 1.16-1.96). In contrast, the strong fall/winter wave 1918 was very widespread throughout the canton. In general, municipalities at higher altitude showed lower incidence. Our study adds to the sparse literature on incidence in the 1918/19 pandemic and subsequent years. Before Covid-19, the last pandemic that occurred in several waves and then became endemic was the 1918-19 pandemic. Such scenarios from the past can inform pandemic planning and preparedness in current and future outbreaks

Reinfections and Cross-Protection in the 1918/19 Influenza Pandemic: Revisiting a Survey Among Male and Female Factory Workers

Objectives: The COVID-19 pandemic highlights questions regarding reinfections and immunity resulting from vaccination and/or previous illness. Studies addressing related questions for historical pandemics are limited.Methods: We revisit an unnoticed archival source on the 1918/19 influenza pandemic. We analysed individual responses to a medical survey completed by an entire factory workforce in Western Switzerland in 1919.Results: Among the total of n = 820 factory workers, 50.2% reported influenza-related illness during the pandemic, the majority of whom reported severe illness. Among male workers 47.4% reported an illness vs. 58.5% of female workers, although this might be explained by varied age distribution for each sex (median age was 31 years old for men, vs. 22 years old for females). Among those who reported illness, 15.3% reported reinfections. Reinfection rates increased across the three pandemic waves. The majority of subsequent infections were reported to be as severe as the first infection, if not more. Illness during the first wave, in the summer of 1918, was associated with a 35.9% (95%CI, 15.7–51.1) protective effect against reinfections during later waves.Conclusion: Our study draws attention to a forgotten constant between multi-wave pandemics triggered by respiratory viruses: Reinfection and cross-protection have been and continue to be a key topic for health authorities and physicians in pandemics, becoming increasingly important as the number of waves increases

Assessment of the Relationship between Fear and Self-efficacy of Childbirth during Labor in Primipara Women

Fear of childbirth is an important and prevalent problem during pregnancy and delivery. Self-efficacy of childbirth is one of the factors playing an important role in the fear of delivery. This study aimed to determine the relationship between the fear and self-efficacy of childbirth during labor in primipara women. This descriptive and analytical study was conducted on 100 primipara women in Ommolbanin Hospital, Mashhad, Iran, during 2017. Data were analyzed in SPSS software using descriptive statistics and Pearson’s correlation coefficient. According to the results, the mean scores of fear and self-efficacy of delivery were reported to be 48.9±14.2 and 220.5±54.9, respectively. In addition, there was a reverse association between the scores of fear of childbirth and self-efficacy of delivery using Pearson’s results (r=-0.44,

Mimicry and well known genetic friends: molecular diagnosis in an Iranian cohort of suspected Bartter syndrome and proposition of an algorithm for clinical differential diagnosis.

BACKGROUND: Bartter Syndrome is a rare, genetically heterogeneous, mainly autosomal recessively inherited condition characterized by hypochloremic hypokalemic metabolic alkalosis. Mutations in several genes encoding for ion channels localizing to the renal tubules including SLC12A1, KCNJ1, BSND, CLCNKA, CLCNKB, MAGED2 and CASR have been identified as underlying molecular cause. No genetically defined cases have been described in the Iranian population to date. Like for other rare genetic disorders, implementation of Next Generation Sequencing (NGS) technologies has greatly facilitated genetic diagnostics and counseling over the last years. In this study, we describe the clinical, biochemical and genetic characteristics of patients from 15 Iranian families with a clinical diagnosis of Bartter Syndrome. RESULTS: Age range of patients included in this study was 3 months to 6 years and all patients showed hypokalemic metabolic alkalosis. 3 patients additionally displayed hypercalciuria, with evidence of nephrocalcinosis in one case. Screening by Whole Exome Sequencing (WES) and long range PCR revealed that 12/17 patients (70%) had a deletion of the entire CLCNKB gene that was previously identified as the most common cause of Bartter Syndrome in other populations. 4/17 individuals (approximately 25% of cases) were found to suffer in fact from pseudo-Bartter syndrome resulting from congenital chloride diarrhea due to a novel homozygous mutation in the SLC26A3 gene, Pendred syndrome due to a known homozygous mutation in SLC26A4, Cystic Fibrosis (CF) due to a novel mutation in CFTR and apparent mineralocorticoid excess syndrome due to a novel homozygous loss of function mutation in HSD11B2 gene. 1 case (5%) remained unsolved. CONCLUSIONS: Our findings demonstrate deletion of CLCNKB is the most common cause of Bartter syndrome in Iranian patients and we show that age of onset of clinical symptoms as well as clinical features amongst those patients are variable. Further, using WES we were able to prove that nearly 1/4 patients in fact suffered from Pseudo-Bartter Syndrome, reversing the initial clinical diagnosis with important impact on the subsequent treatment and clinical follow up pathway. Finally, we propose an algorithm for clinical differential diagnosis of Bartter Syndrome

Comparison of fuzzy and crisp analytic hierarchy process (AHP) methods for spatial multicriteria decision analysis in GIS

There are a number of decision making problems in which Geographical Information System (GIS) has employed to organize and facilitate the procedure of analyzing the problem. These GIS-based decision problems which typically include a number of different criteria and alternatives are generally analyzed by Multicriteria Decision Analysis (MCDA).Different locations within a geographical area represent the alternatives by which the overall goal of the project is achieved. The quality of achieving the goal is evaluated by a set of criteria which should be considered in the work. Analytic Hierarchy Process (AHP) which is a powerful method of MCDA generally can organize spatial problems and decides which alternatives are most suitable for the defined problems. However due to some intrinsic uncertainty in the method, a number of authors suggest fuzzifying the method while others are against fuzzification of the AHP. The debate over fuzzifying AHP is going on and attempt for finding that was mostly in theory, and little, if any; practical comparison between the AHP and fuzzified AHP has done. This work presents a practical comparison of AHP and fuzzy AHP in a GIS-based problem, case study, for locating a dam in Costa Rica, considering different criteria. In order to perform the AHP and fuzzy AHP in the GIS-based problem and calculating weights of the criteria by the methods, some computer codes have written and developed in MATLAB. The comparisons between the AHP and fuzzy AHP methods are done on result weights and on the result final maps. The comparison between the weights is repeated on different levels of uncertainty in fuzzy AHP then all the results are compared with the result of AHP method. Also this study for checking the effect of fuzzification on results is suggested Chi-Square test as a suitable tool. Comparisons between the resulting weights of the AHP and fuzzy AHP methods show some differences between the methods. Furthermore, the Chi-Square test shows that the higher level of uncertainty in the fuzzy AHP, the greater the difference in results between the AHP and fuzzy AHP methods