Statistical algorithms for early detection of the annual influenza peak season in Hong Kong using sentinel surveillance data

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Transmission of Japanese encephalitis virus in Hong Kong

1. Pigs are likely to be the main amplifying host for Japanese encephalitis virus. 2. The success of a swine vaccination programme depends on the timing of the loss of maternal antibody protection and seasonal dynamics of the vector population. 3. Vaccination may be ineffective in the face of strong natural infection because of the variability in timing of the loss of maternal antibody protection.4. Evidence in support of swine vaccination as a human health intervention was not found.published_or_final_versio

Methods for monitoring influenza surveillance data

Background: A variety of Serfling-type statistical algorithms requiring long series of historical data, exclusively from temperate climate zones, have been proposed for automated monitoring of influenza sentinel surveillance data. We evaluated three alternative statistical approaches where alert thresholds are based on recent data in both temperate and subtropical regions. Methods: We compared time series, regression, and cumulative sum (CUSUM) models on empirical data from Hong Kong and the US using a composite index (range = 0-1) consisting of the key outcomes of sensitivity, specificity, and time to detection (lag). The index was calculated based on alarms generated within the first 2 or 4 weeks of the peak season. Results: We found that the time series model was optimal in the Hong Kong setting, while both the time series and CUSUM models worked equally well on US data. For alarms generated within the first 2 weeks (4 weeks) of the peak season in Hong Kong, the maximum values of the index were: time series 0.77 (0.86); regression 0.75 (0.82); CUSUM 0.56 (0.75). In the US data the maximum values of the index were: time series 0.81 (0.95); regression 0.81 (0.91); CUSUM 0.90 (0.94). Conclusions: Automated influenza surveillance methods based on short-term data, including time series and CUSUM models, can generate sensitive, specific, and timely alerts, and can offer a useful alternative to Serfling-like methods that rely on long-term, historically based thresholds. © Copyright 2006 Oxford University Press.postprin

On-demand or Spot? Selling the cloud to risk-averse customers

In Amazon EC2, cloud resources are sold through a combination of an on-demand market, in which customers buy resources at a fixed price, and a spot market, in which customers bid for an uncertain supply of excess resources. Standard market environments suggest that an optimal design uses just one type of market. We show the prevalence of a dual market system can be explained by heterogeneous risk attitudes of customers. In our stylized model, we consider unit demand risk-averse bidders. We show the model admits a unique equilibrium, with higher revenue and higher welfare than using only spot markets. Furthermore, as risk aversion increases, the usage of the on-demand market increases. We conclude that risk attitudes are an important factor in cloud resource allocation and should be incorporated into models of cloud markets.Comment: Appeared at WINE 201

Expanding the role of the future zoo: Wellbeing should become the fifth aim for modern zoos

This is the final version. Available on open access from Frontiers Media via the DOI in this recordZoos and aquariums have an enormous global reach and hence an ability to craft meaningful conservation action for threatened species, implement educational strategies to encourage human engagement, development and behavior change, and conduct scientific research to enhance the husbandry, roles and impacts of the living collection. The recreational role of the zoo is also vast- people enjoy visiting the zoo and this is often a shared experience amongst family and friends. Evaluating how the zoo influences this “captive audience” and extending its reach to include a compassionate approach to animals and people can further enhance the mission, value, and relevance of their work. The modern zoo’s current aims—Conservation, Education, Research and Recreation—provide useful foundations for the activities that zoos conduct at a local and national level. However, to improve sustainability of their actions and outcomes, we feel that Wellbeing should become the fifth aim of the modern zoo for the future- both from an animal perspective (ensuring that populations are managed according to prevailing behavioral needs) and from a human perspective (enhancing access to nature, promoting planetary friendly behavior changes and ways of living, and advancing the wellbeing of the zoo’s workforce). This paper provides discussion and review of how Wellbeing is already a substantial part of what zoos work on as well as posing the idea of altering the Recreation aim of the zoo to one of Engagement, which potentially is more measurable and therefore can allow zoo researchers and managers further options for the collection of evidence on the local and global reach of their zoo’s aims. Education, Engagement, Conservation, Research and Wellbeing provide a more complete picture of the roles of the modern zoo for the animals (both in situ and ex situ), human visitors and workforce, and to society more widely

Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms

Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor

The impact of next and back buttons on time to complete and measurement reliability in computer-based surveys

To assess the impact of including next and back buttons on response burden and measurement reliability of computer-based surveys. A sample of 807 participants (mean age of 53; 64% women, 83% non-Hispanic white; 81% some college or college graduates) from the YouGov Polimetrix panel was administered 56 items assessing performance of social/role activities and 56 items measuring satisfaction with social/role activities. Participants were randomly assigned to either (1) automatic advance to the next question with no opportunity to go back (auto/no back); (2) automatic advance to the next questions with an opportunity to go back (auto/back); (3) next button to go to the next question with no opportunity to go back (next/no back); or (4) next button to go to the next question with an opportunity to go back (next/back). We found no difference in missing data, internal consistency reliability, and domain scores by group. Time to complete the survey was about 50% longer when respondents were required to use a next button to go on. Given the similarity in missing data, reliability and mean scale scores with or without use of the next button, we recommend automatic advancement to the next item with the option to go back to the previous item

Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis

We report a 14-year-old girl with juvenile dermatomyositis (JDM) complicated by severe inflammatory calcinosis successfully treated with thalidomide. She was diagnosed as JDM when she was 4 years old after a few months of increasing lethargy, muscle pain, muscle weakness, and rash. During three months, clinical manifestations and abnormal laboratory findings were effectively treated with oral prednisolone. However, calcinosis was recognized 18 months after disease onset. Generalized calcinosis rapidly progressed with high fever, multiple skin/subcutaneous inflammatory lesions, and increased level of CRP. Fifty mg/day (1.3 mg/kg day) of oral thalidomide was given for the first four weeks, and then the dose was increased to 75 mg/day. Clinical manifestations subsided, and inflammatory markers had clearly improved. Frequent high fever and local severe pain with calcinosis were suppressed. The levels of FDP-E, IgG, and tryglyceride, which were all elevated before the thalidomide treatment, were gradually returned to the normal range. Over the 18 months of observation up to the present, she has had no inflammatory calcinosis, or needed any hospitalization, although established calcium deposits still remain. Her condition became painless, less extensive and less inflammatory with the CRP level below 3.08 mg/dL. Recent examination by whole-body 18F-FDG-PET-CT over the 15 months of thalidomide treatment demonstrated fewer hot spots around the subcutaneous calcified lesions

The Societal Value of the Modern Zoo: A Commentary on How Zoos Can Positively Impact on Human Populations Locally and Globally

This is the final version. Available on open access from MDPI via the DOI in this recordModern zoos and aquariums have evolved greatly since the end of the Second World War, to become centres of conservation excellence and scientific institutions for the study of animal behaviour, ecology, husbandry management. Whilst the impact of zoos and aquariums to biodiversity conservation, population management and advancement of species care is well documented, their positive impacts on society (including the communities that they are located within) is less well known. The four established aims of the modern zoo—Conservation, Education, Recreation (Engagement) and Research—provide a strong foundation for wider review and critique of the societal value of zoos and aquariums. This article synthesises what such value may be, and how it could be measured, from a systematic review of the literature pertaining to each of these four established aims. It also recommends areas of future scientific inquiry to further study the wider impact of zoos on their local communities and on human populations and behaviour more generally. Including Wellbeing as a fifth aim of the modern zoo would also cement their wider societal value. Further scrutiny of the societal value of the modern zoo enhances the value of the zoo’s living collection and the green spaces that it manages to provide accessibility to biodiversity and nature-centric education essential to long-term, planetary friendly human behaviour change