A Hierarchical and Geographically Weighted Regression Model and Its Backfitting Maximum Likelihood Estimator (Short Paper)

Spatial heterogeneity is a typical and common form of spatial effect. Geographically weighted regression (GWR) and its extensions are important local modeling techniques for exploring spatial heterogeneity. However, when dealing with spatial data sampled at a micro-level but the geographical locations of them are only known at a higher level, GWR-based models encounter several problems, such as difficulty in establishing the bandwidth. Because data with this characteristic exhibit spatial hierarchical structures, such data can be suitably handled using hierarchical linear modeling (HLM). This model calibrates random effects for sample-level variables in each group to address spatial heterogeneity. However, it does not work when exploring spatial heterogeneity in some group-level variables when there is insufficient variance in each group. In this study, we therefore propose a hierarchical and geographically weighted regression (HGWR) model, together with a back-fitting maximum likelihood estimator, that can be applied to examine spatial heterogeneity in the regression relationships of data where observations nest into high-order groupings and share the same or very close coordinates within those groups. The HGWR model divides coefficients into three types: local fixed effects, global fixed effects, and random effects. Results of a simulation experiment show that HGWR distinguishes local fixed effects from others and also global effects from random effects. Spatial heterogeneity is reflected in the estimates of local fixed effects, along with the spatial hierarchical structure. Compared with GWR and HLM, HGWR produces estimates with the lowest deviations of coefficient estimates. Thus, the ability of HGWR to tackle both spatial and group-level heterogeneity simultaneously suggests its potential as a promising data modeling tool for handling the increasingly common occurrence where data, in secure settings for example, remove the specific geographic identifiers of individuals and release their locations only at a group level

Customisation and urban design: evaluating the role of informal street user modifications in the distribution of static activities and perceptions of streetscape settings

Since the mid-twentieth century, the urban planning and design practices have battled to counter their association with the creation of dead urban spaces. This deadness is conveyed in their lack of pedestrian activities – conviviality, spatial interactions – and negative perceptions of such spaces. In a variety of ways, urban design theorists have suggested that the negative impressions of planning are connected to the system’s inability to acknowledge the opinions of those subjected to it. The process of producing public spaces often result in inflexible scenarios that fail to acknowledge constantly changing end-user requirements. In several narratives, planning processes are compared to the monotony of mass-production processes – a linear process that limits participation and variety in designs by their end-users. Today, manufacturing processes offer mass-customisation as an approach towards diversifying end products, devolving design powers to customers who informally modify and optimise their products. Mass-customisation allows for end-user modifications throughout a product’s creation and post-construction. While collaborative design is embedded into many urban design processes, comparable flexibilities and successes observed in mass-customisation are not apparent. Through the empirical study of three London retail high streets, with contrasting population demographics, the impacts of informally customised streetscape features on the distribution of static pedestrian activities are scrutinised. Evidence is tested against the opinions of a selection of pedestrians distributed in streetscape regions with varying intensities of customisation. This research finds that an increased presence of customisation results in increased pedestrian activities, vitality, and positive spatial perceptions. It also finds that there is an optimal level of complexity associated with informal modifications, corresponding with past studies concerning the negative impacts of over complexity on human responses to spatial settings – a theoretical threshold. Therefore, moderate implementations of customisation are linked to the increased clustering of static activities and satisfaction across varied demographics and spatial settings

Designing an incubator of public spaces platform: Applying cybernetic principles to the co-creation of spaces

The paper is based on the experience of creating and piloting a functioning ‘Incubator’ crowdsourcing platform for designing public spaces in an estate regeneration project in South London. The paper uses a cybernetics framework to analyse and present the way the platform itself was created and how issues of effectiveness, efficiency and equity were dealt with. It explores the generic qualities of interface and reviews applications of variety reduction in established crowdsourcing CS) models. It briefly presents the legal and socio-spatial parameters (like property rights) associated with the creation of the Incubators platform as well as the generic rules applicable to human-spatial relationships, based on studies exploring human-spatial interactions. Practical constraints including costs, catchments, life-span and meaningful feedback are looked into, followed by a discussion on social and political limitations associated with this form of public participation. The paper explains how those constraints where taken into account when establishing the operational parameters of the software platform and the experiences gained from the operation of the platform. Challenges and complications, such as the exclusion of actors, are identified together with the responses encountered in practice. While the Incubators platform succeeded in attracting younger planning participation demographics, older demographics were marginalised by the platform’s graphical user interface and social networking features. These findings highlight why, in spite of what it promises, ‘crowdsourced urbanism’ is prone to similar traits with those of analogue participation. In that sense, creating a CS platform which could convey the grass-roots ideas of actors and users of urban spaces in an efficient way that could be applied to a broad range of planning systems, appears to be a challenge

Innovating to improve primary care in less developed countries:Towards a global model

One of the biggest problems in global health is the lack of well trained and supported health workers in less developed settings. In many rural areas there are no physicians, and it is important to find ways to support and empower nurses and other health workers. The Knowledge Translation Unit of the University of Cape Town Lung Institute has spent 14 years developing a series of innovative packages to support and empower nurses and other health workers. PACK (Practical Approach to Care Kit) Adult comprises policybased and evidence-informed guidelines; onsite, team and case-based training; non-physician prescribing; and a cascade system of scaling up. A series of randomised trials has shown the effectiveness of the packages, and methods are now being developed to respond cost-effectively and sustainably to global demand for implementing PACK Adult. Global health would probably benefit from less time and money spent developing new innovations and more spent on finding ways to spread those we already have

A systematic comparison of all mutations in hereditary sensory neuropathy type I (HSAN I) reveals that the G387A mutation is not disease associated

Hereditary sensory neuropathy type 1 (HSAN I) is an autosomal dominant inherited neurodegenerative disorder of the peripheral nervous system associated with mutations in the SPTLC1 subunit of the serine palmitoyltransferase (SPT). Four missense mutations (C133W, C133Y, V144D and G387A) in SPTLC1 were reported to cause HSAN I. SPT catalyses the condensation of Serine and Palmitoyl-CoA, which is the first and rate-limiting step in the de novo synthesis of ceramides. Earlier studies showed that C133W and C133Y mutants have a reduced activity, whereas the impact of the V144D and G387A mutations on the human enzyme was not tested yet. In this paper, we show that none of the HSAN I mutations interferes with SPT complex formation. We demonstrate that also V144D has a reduced SPT activity, however to a lower extent than C133W and C133Y. In contrast, the G387A mutation showed no influence on SPT activity. Furthermore, the growth phenotype of LY-B cells—a SPTLC1 deficient CHO cell line—could be reversed by expressing either the wild-type SPTLC1 or the G387A mutant, but not the C133W mutant. This indicates that the G387A mutation is most likely not directly associated with HSAN I. These findings were genetically confirmed by the identification of a nuclear HSAN family which showed segregation of the G387A variant as a non-synonymous SN

Changes in quantitative sensory testing and patient perspectives following spinal cord stimulation for persistent spinal pain syndrome:an observational study with long-term follow-up

BACKGROUND: Spinal cord stimulation (SCS) can impact sensory, pain and tolerance thresholds in various ways, which can be accessed via quantitative sensory testing (QST). The objectives of this study were to (1) assess the subjective sensory responses using QST in patients following SCS therapy for PSPS and (2) to get a clinical impression of the results of SCS during an interview of these patients with PSPS and SCS during long term follow-up. METHODS: Forty patients with PSPS who received SCS treatment underwent QST via electrical and mechanical pressure stimuli. QST was performed at four different moments (1. pre-implantation SCS, 2. two weeks postoperatively, 3. three months after permanent SCS implantation and 4. six months after permanent SCS implantation. Patients' perspectives on pain, use of drugs and quality of life were assessed via semi-structured interviews during a follow-up between five and eleven years. RESULTS: We found statistical differences in the changes of sensory, pain and tolerance thresholds. A decrease in pain complaints and analgesics use were reported by the patients during follow-up. The quality of life in patients increased from three to eight (NRS 0 (worst QoL imaginable) -10 (best QoL imaginable) after receiving SCS. CONCLUSIONS: The increased thresholds on areas without pain or being covered by the SCS induced paresthesias may indicate that there are central changes contributing to these deviations in thresholds. The overall QoL in patients improved greatly after receiving SCS

Strategies to improve effectiveness of physical activity coaching systems:Development of personas for providing tailored feedback

Mobile physical activity interventions can be improved by incorporating behavioural change theories. Relations between self-efficacy, stage of change, and physical activity are investigated, enabling development of feedback strategies that can be used to improve their effectiveness. A total of 325 healthy control participants and 82 patients wore an activity monitor. Participants completed a self-efficacy or stage of change questionnaire. Results show that higher self-efficacy is related to higher activity levels. Patients are less active than healthy controls and show a larger drop in physical activity over the day. Patients in the maintenance stage of change are more active than patients in lower stages of change, but show an equally large drop in level of physical activity. Findings suggest that coaching should at least be tailored to level of self-efficacy, stage of change, and physical activity pattern. Tailored coaching strategies are developed, which suggest that increasing self-efficacy of users is most important. Guidelines are provided

‘Free In, Free Out’: Exploring Dutch Firewall Protections for Irregular Migrant Victims of Crime

Real and perceived risks of deportation may compromise the effective right of irregular migrants to report to the police if they have been a victim of crime. Some localities have therefore introduced so-called ‘firewall protection’, providing a clear separation between the provision of public services and immigration enforcement. This article explores one such policy in the Netherlands: ‘free in, free out’. While the policy began as a local pilot project, in 2015 it was introduced at the national-level alongside implementation of EU Victim’s Rights Directive, and currently represents the only national-level example of ‘firewall protection’ for victims of crime in Europe. This article is based on a socio-legal study that included interviews with informants from governmental and non-governmental organisations. It documents the legal and social reasons for instituting the policy, while critically assessing the challenges in implementation. Finally, it discusses the lessons and opportunities for expanding firewall protection more broadly in a European context

Transforming Manure and Cedar Mulch from “Waste” to “Worth”

In nearly every production environment, there are opportunities to capture profits if waste streams can be further processed or enhanced to create “value added” products. Animal feeding operations in Nebraska generate significant amounts of manure that are considered as a “waste” product. Additionally, Eastern red cedar (Juniperus virginiana) encroachment into grazing land has become an economic and ecological threat, reducing forage production, fragmenting wildlife habitats, and increasing the risk and severity of wild fires. Value- added uses for cedar woodchips are being sought by the Nebraska Forest Service and other agencies to promote tree management by landowners. Using manure and cedar mulch individually or in combination as soil amendments on agricultural crop land was proposed by farmers in the Middle Niobrara Natural Resource District to assess their impacts on soil health and crop productivity. On- farm research studies were initiated during 2019 at four locations across the state of Nebraska and two more sites were added in 2020. The goal is to document and demonstrate the effects of land applied manure and cedar mulch on agronomic, economic and soil health variables in corn fields under different agro-climatic conditions. Results from the 2019 cropping season indicate that pre- plant applications of beef manure can make significant contributions of nitrogen (N), phosphorus (P) and potassium (K) and K in crop fields without compromising yield, constituting a reliable resource to replace inorganic fertilizers. Depending on initial soil quality, manure also increased soil organic matter (SOM) concentration, pH, and electrical conductivity (EC). Surface applications of cedar mulch did not promote soil acidification or N immobilization, although it induced soil nitrate reduction in top soil layers when incorporated after crop harvest at one research site

COVID-19 among adults living with HIV:correlates of mortality among public sector healthcare users in Western Cape, South Africa

Abstract Introduction While a large proportion of people with HIV (PWH) have experienced SARS‐CoV‐2 infections, there is uncertainty about the role of HIV disease severity on COVID‐19 outcomes, especially in lower‐income settings. We studied the association of mortality with characteristics of HIV severity and management, and vaccination, among adult PWH. Methods We analysed observational cohort data on all PWH aged ≥15 years experiencing a diagnosed SARS‐CoV‐2 infection (until March 2022), who accessed public sector healthcare in the Western Cape province of South Africa. Logistic regression was used to study the association of mortality with evidence of antiretroviral therapy (ART) collection, time since first HIV evidence, CD4 cell count, viral load (among those with evidence of ART collection) and COVID‐19 vaccination, adjusting for demographic characteristics, comorbidities, admission pressure, location and time period. Results Mortality occurred in 5.7% (95% CI: 5.3,6.0) of 17,831 first‐diagnosed infections. Higher mortality was associated with lower recent CD4, no evidence of ART collection, high or unknown recent viral load and recent first HIV evidence, differentially by age. Vaccination was protective. The burden of comorbidities was high, and tuberculosis (especially more recent episodes of tuberculosis), chronic kidney disease, diabetes and hypertension were associated with higher mortality, more strongly in younger adults. Conclusions Mortality was strongly associated with suboptimal HIV control, and the prevalence of these risk factors increased in later COVID‐19 waves. It remains a public health priority to ensure PWH are on suppressive ART and vaccinated, and manage any disruptions in care that occurred during the pandemic. The diagnosis and management of comorbidities, including for tuberculosis, should be optimized