Spatial variation and associated factors of inadequate counselling regarding pregnancy danger signs during antenatal care visits among pregnant women in Ethiopia: a Geographically Weighted Regression Model.

INTRODUCTION: Inadequate counselling of pregnant women regarding pregnancy danger signs contributes to a delay in deciding to seek care, which causes up to 77% of all maternal deaths in developing countries. However, its spatial variation and region-specific predictors have not been studied in Ethiopia. Hence, the current study aimed to model its predictors using geographically weighted regression analysis. METHODS: The 2019 Ethiopian Mini Demographic and Health Survey data were used. A total weighted sample of 2922 women from 283 clusters was included in the final analysis. The analysis was performed using ArcGIS Pro, STATA V.14.2 and SaTScan V.10.1 software. The spatial variation of inadequate counselling was examined using hotspot analysis. Ordinary least squares regression was used to identify factors for geographical variations. Geographically weighted regression was used to explore the spatial heterogeneity of selected variables to predict inadequate counselling. RESULTS: Significant hotspots of inadequate counselling regarding pregnancy danger signs were found in Gambella region, the border between Amhara and Afar regions, Somali region and parts of Oromia region. Antenatal care provided by health extension workers, late first antenatal care initiation and antenatal care follow-up at health centres were spatially varying predictors. The geographically weighted regression model explained about 66% of the variation in the model. CONCLUSION: Inadequate counselling service regarding pregnancy danger signs in Ethiopia varies across regions and there exists within country inequality in the service provision and utilisation. Prioritisation and extra efforts should be made by concerned actors for those underprivileged areas and communities (as shown in the maps), and health extension workers, as they are found in the study.

Geographically weighted machine learning for modeling spatial heterogeneity in traffic crash frequency and determinants in US.

Spatial analyses of traffic crashes have drawn much interest due to the nature of the spatial dependence and spatial heterogeneity in the crash data. This study makes the best of Geographically Weighted Random Forest (GW-RF) model to explore the local associations between crash frequency and various influencing factors in the US, including road network attributes, socio-economic characteristics, and land use factors collected from multiple data sources. Special emphasis is put on modeling the spatial heterogeneity in the effects of a factor on crash frequency in different geographical areas in a data-driven way. The GW-RF model outperforms global models (e.g. Random Forest) and conventional geographically weighted regression, demonstrating superior predictive accuracy and elucidating spatial variations. The GW-RF model reveals spatial distinctions in the effects of certain factors on crash frequency. For example, the importance of intersection density varies significantly across regions, with high significance in the southern and northeastern areas. Low-grade road density emerges as influential in specific cities. The findings highlight the significance of different factors in influencing crash frequency across zones. Road network factors, particularly intersection density, exhibit high importance universally, while socioeconomic variables demonstrate moderate effects. Interestingly, land use variables show relatively lower importance. The outcomes could help to allocate resources and implement tailored interventions to reduce the likelihood of crashes.

Spatio-Temporal analysis of exports of cultural products and their affecting factors for spatial distribution.

Cultural products constitute a significant portion of global trade, and understanding their export patterns can shed light on economic trends, trade dynamics, and market opportunities. This study conducted the spatio-temporal analysis of exports of cultural products, exploring the relationship between various influencing factors and their impact on the spatial distribution of these exports. Leveraging a diverse dataset encompassing 55 BRI countries for the period of 2005-2022, this research employs advanced spatial analysis techniques, including spatial autocorrelation and spatial regression models, to examine the spatial patterns and determinants of exports if cultural product exports. Moreover, this study delves into the multifaceted determinants affecting the spatial distribution of these exports. The findings of this study reveal significant spatio-temporal variations in the exports of cultural products. Spatial autocorrelation analysis indicates the presence of spatial clustering, suggesting that regions with high cultural product exports tend to be geographically close to each other. The spatial regression models further identify several key factors like economic development, productive capacities, cultural tourism, information development and human capital influence the spatial distribution of these exports. The findings of the study reveal that there is strong spatial relationship for exports of cultural products in BRI countries. The findings of this research contribute valuable insights for policymakers, businesses, and stakeholders regarding a deeper comprehension of the driving forces behind the spatial distribution of these cultural products, facilitating informed decision-making processes to optimize strategies for promoting and sustaining the trade of cultural products in an increasingly interconnected world.

Mastering geographically weighted regression: key considerations for building a robust model.

Geographically weighted regression (GWR) takes a prominent role in spatial regression analysis, providing a nuanced perspective on the intricate interplay of variables within geographical landscapes (Brunsdon et al., 1998). However, it is essential to have a strong rationale for employing GWR, either as an addition to, or a complementary analysis alongside, non-spatial (global) regression models (Kiani, Mamiya et al., 2023). Moreover, the proper selection of bandwidth, weighting function or kernel types, and variable choices constitute the most critical configurations in GWR analysis (Wheeler, 2021). [...].

Spatial regression models to assess variations of composite index for anthropometric failure across the administrative zones in Ethiopia.

BACKGROUND: There are a number of previous studies that investigated undernutrition and its determinants in Ethiopia. However, the national average in the level of undernutrition conceals large variation across administrative zones of Ethiopia. Hence, this study aimed to determine the geographic distribution of composite index for anthropometric failure (CIAF) and identify the influencing factors it' might be more appropriate. METHODS: We used the zonal-level undernutrition data for the under-five children in Ethiopia from the Ethiopian Demographic and Health Survey (EDHS) dataset. Different spatial models were applied to explore the spatial distribution of the CIAF and the covariates. RESULTS: The Univariate Moran's I statistics for CIAF showed spatial heterogeneity of undernutrition in Ethiopian administrative zones. The spatial autocorrelation model (SAC) was the best fit based on the AIC criteria. Results from the SAC model suggested that the CIAF was positively associated with mothers' illiteracy rate (0.61, pvalue 0.001), lower body mass index (0.92, pvalue = 0.023), and maximum temperature (0.2, pvalue = 0.0231) respectively. However, the CIAF was negatively associated with children without any comorbidity (-0.82, pvalue = 0.023), from families with accessibility of improved drinking water (-0.26, pvalue = 0.012), and minimum temperature (-0.16). CONCLUSION: The CIAF across the administrative zones of Ethiopia is spatially clustered. Improving women's education, improving drinking water, and improving child breast feeding can reduce the prevalence of undernutrition (CIAF) across Ethiopian administrative zones. Moreover, targeted intervention in the geographical hotspots of CIAF can reduce the burden of CIAF across the administrative zones.

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China.

BACKGROUND: The disease burden of tuberculosis (TB) was heavy in Hainan Province, China, and the information on transmission patterns was limited with few studies. This atudy aims to further explore the epidemiological characteristics and influencing factors of TB in Hainan Province, and thereby contribute valuable scientific evidences for TB elimination in Hainan Province. METHODS: The TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System, along with socio-economic data. The spatial-temporal and population distributions were analyzed, and spatial autocorrelation analysis was conducted to explore TB notification rate clustering. In addition, the epidemiological characteristics of the cases among in-country migrants were described, and the delay pattern in seeking medical care was investigated. Finally, a geographically and temporally weighted regression (GTWR) model was adopted to analyze the relationship between TB notification rate and socio-economic indicators. The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR. RESULTS: From 2013 to 2022, 64,042 cases of TB were notified in Hainan Province. The estimated annual percentage change of TB notification rate in Hainan Province from 2013 to 2020 was - 6.88% [95% confidence interval (CI): - 5.30%, - 3.69%], with higher rates in central and southern regions. The majority of patients were males (76.33%) and farmers (67.80%). Cases among in-country migrants primarily originated from Sichuan (369 cases), Heilongjiang (267 cases), Hunan (236 cases), Guangdong (174 cases), and Guangxi (139 cases), accounting for 53%. The majority (98.83%) of TB cases were notified through passive case finding approaches, with delay in seeking care. The GTWR analysis showed that gross domestic product per capita, the number of medical institutions and health personnel per 10,000 people were main factors affecting the high TB notification rates in some regions in Hainan Province. Different regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region. CONCLUSIONS: The notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions. Particular attention should be paid to the prevalence of TB among males, farmers, and out-of-province migrant populations. The notification rate was also influenced by economic development and medical conditions, indicating the need of more TB specialized hospitals, active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.

Urban green and blue infrastructure: unveiling the spatiotemporal impact on carbon emissions in China's Yangtze River Delta.

Blue-green infrastructure (BGI) plays a crucial role in regulating urban carbon cycles. Nonetheless, the spatiotemporal effect of BGI on carbon emissions has not received extensive attention. This study used the Yangtze River Delta (YRD) region as the study area and quantified the landscape patterns of BGI. Using a spatiotemporal geographically weighted regression model, we analyzed the impact of evolving spatiotemporal characteristics of BGI on carbon emissions. Additionally, we constructed a spatiotemporal weight matrix using the Moran index ratio to examine the spillover effects of BGI among different regions. Our results show that the aggregation effect of carbon emissions in the YRD region is gradually increasing while BGI has a dynamic impact on carbon emissions. In terms of spatial and temporal spillovers, under the influence of economic connections between regions, patch fragmentation and distance exert a persistent positive influence on carbon emissions, while shape complexity has a negative impact, with area and layout characteristics showing no significant effects. However, area and patch distance have a persistent positive influence on carbon emissions in adjacent areas, while shape complexity exhibits a negative impact. Therefore, optimizing urban BGI through a regional synergistic governance system is important to promote low-carbon urban development.

Spatiotemporal dynamics and influencing factors of human brucellosis in Mainland China from 2005-2021.

BACKGROUND: Brucellosis poses a significant public health concern. This study explores the spatial and temporal dynamic evolution of human brucellosis in China and analyses the spatial heterogeneity of the influencing factors related to the incidence of human brucellosis at the provincial level. METHODS: The Join-point model, centre of gravity migration model and spatial autocorrelation analysis were employed to evaluate potential changes in the spatial and temporal distribution of human brucellosis in mainland China from 2005 to 2021. Ordinary Least Squares (OLS), Geographically Weighted Regression (GWR), and Multi-scale Geographically Weighted Regression (MGWR) models were constructed to analyze the spatial and temporal correlation between the incidence rate of human brucellosis and meteorological and social factors. RESULTS: From 2005 to 2021, human brucellosis in China showed a consistent upward trend. The incidence rate rose more rapidly in South, Central, and Southwest China, leading to a shift in the center of gravity from the North to the Southwest, as illustrated in the migration trajectory diagram. Strong spatial aggregation was observed. The MGWR model outperformed others. Spatio-temporal plots indicated that lower mean annual temperatures and increased beef, mutton, and milk production significantly correlated with higher brucellosis incidence. Cities like Guangxi and Guangdong were more affected by low temperatures, while Xinjiang and Tibet were influenced more by beef and milk production. Inner Mongolia and Heilongjiang were more affected by mutton production. Importantly, an increase in regional GDP and health expenditure exerted a notable protective effect against human brucellosis incidence. CONCLUSIONS: Human brucellosis remains a pervasive challenge. Meteorological and social factors significantly influence its incidence in a spatiotemporally specific manner. Tailored prevention strategies should be region-specific, providing valuable insights for effective brucellosis control measures.

Determinants of disparities of diabetes-related hospitalization rates in Florida: a retrospective ecological study using a multiscale geographically weighted regression approach.

BACKGROUND: Early diagnosis, control of blood glucose levels and cardiovascular risk factors, and regular screening are essential to prevent or delay complications of diabetes. However, most adults with diabetes do not meet recommended targets, and some populations have disproportionately high rates of potentially preventable diabetes-related hospitalizations. Understanding the factors that contribute to geographic disparities can guide resource allocation and help ensure that future interventions are designed to meet the specific needs of these communities. Therefore, the objectives of this study were (1) to identify determinants of diabetes-related hospitalization rates at the ZIP code tabulation area (ZCTA) level in Florida, and (2) assess if the strengths of these relationships vary by geographic location and at different spatial scales. METHODS: Diabetes-related hospitalization (DRH) rates were computed at the ZCTA level using data from 2016 to 2019. A global ordinary least squares regression model was fit to identify socioeconomic, demographic, healthcare-related, and built environment characteristics associated with log-transformed DRH rates. A multiscale geographically weighted regression (MGWR) model was then fit to investigate and describe spatial heterogeneity of regression coefficients. RESULTS: Populations of ZCTAs with high rates of diabetes-related hospitalizations tended to have higher proportions of older adults (p < 0.0001) and non-Hispanic Black residents (p = 0.003). In addition, DRH rates were associated with higher levels of unemployment (p = 0.001), uninsurance (p < 0.0001), and lack of access to a vehicle (p = 0.002). Population density and median household income had significant (p < 0.0001) negative associations with DRH rates. Non-stationary variables exhibited spatial heterogeneity at local (percent non-Hispanic Black, educational attainment), regional (age composition, unemployment, health insurance coverage), and statewide scales (population density, income, vehicle access). CONCLUSIONS: The findings of this study underscore the importance of socioeconomic resources and rurality in shaping population health. Understanding the spatial context of the observed relationships provides valuable insights to guide needs-based, locally-focused health planning to reduce disparities in the burden of potentially avoidable hospitalizations.

Spatial associations between chronic kidney disease and socio-economic factors in Thailand.

Chronic kidney disease (CKD) is a persistent, progressive condition characterized by gradual decline of kidney functions leading to a range of health issues. This research used recent data from the Ministry of Public Health in Thailand and applied spatial regression and local indicators of spatial association (LISA) to examine the spatial associations with night-time light, Internet access and the local number of health personnel per population. Univariate Moran's I scatter plot for CKD in Thailand's provinces revealed a significant positive spatial autocorrelation with a value of 0.393. High-High (HH) CKD clusters were found to be predominantly located in the North, with Low-Low (LL) ones in the South. The LISA analysis identified one HH and one LL with regard to Internet access, 15 HH and five LL clusters related to night-time light and eight HH and five LL clusters associated with the number of health personnel in the area. Spatial regression unveiled significant and meaningful connections between various factors and CKD in Thailand. Night-time light displayed a positive association with CKD in both the spatial error model (SEM) and the spatial lag model (SLM), with coefficients of 3.356 and 2.999, respectively. Conversely, Internet access exhibited corresponding negative CKD associations with a SEM coefficient of - 0.035 and a SLM one of -0.039. Similarly, the health staff/population ratio also demonstrated negative associations with SEM and SLM, with coefficients of -0.033 and -0.068, respectively. SEM emerged as the most suitable spatial regression model with 54.8% according to R2. Also, the Akaike information criterion (AIC) test indicated a better performance for this model, resulting in 697.148 and 698.198 for SEM and SLM, respectively. These findings emphasize the complex interconnection between factors contributing to the prevalence of CKD in Thailand and suggest that socioeconomic and health service factors are significant contributing factors. Addressing this issue will necessitate concentrated efforts to enhance access to health services, especially in urban areas experiencing rapid economic growth.

Explaining the role of land use changes on land surface temperature in an arid and semi-arid metropolitan area with multi-scale spatial regression analysis.

Urban Heat Islands (UHIs), Land Surface Temperature (LST), and Land Use Land Cover (LULC) changes are critical environmental concerns that require continuous monitoring and assessment, especially in cities within arid and semi-arid (ASA) climates. Despite the abundance of research in tropical, Mediterranean, and cold climates, there is a significant knowledge gap for cities in the Middle East with ASA climates. This study aimed to examine the effects of LULC change, population, and wind speed on LST in the Mashhad Metropolis, a city with an ASA climate, over a 30-year period. The research underscores the importance of environmental monitoring and assessment in understanding and mitigating the impacts of urbanization and climate change. Our research combines spatial regression models, multi-scale and fine-scale analyses, seasonal and city outskirts considerations, and long-term change assessments. We used Landsat satellite imagery, a crucial tool for environmental monitoring, to identify LULC changes and their impact on LST at three scales. The relationships were analyzed using Ordinary Least Squares (OLS) and Spatial Error Model (SEM) regressions, demonstrating the value of these techniques in environmental assessment. Our findings highlight the role of environmental factors in shaping LST. A decrease in vegetation and instability of water bodies significantly increased LST over the study period. Bare lands and rocky terrains had the most substantial effect on LST. At the same time, built-up areas resulted in Urban Cooling Islands (UCIs) due to their lower temperatures compared to surrounding bare lands. The Normalized Difference Vegetation Index (NDVI) and Dry Bare-Soil Index (DBSI) were the most effective indices impacting LST in ASA regions, and the 30×30 m2 micro-scale provides more precise results in regression models, underscoring their importance in environmental monitoring. Our study provided a comprehensive understanding of the relationship between LULC changes and LST in an ASA environment, contributing significantly to the literature on environmental change in arid regions and the methodologies for monitoring such changes. Future research should aim to validate and expand additional LST-affecting factors and test our approach and findings in other ASA regions, considering the unique characteristics of these areas and the importance of tailored environmental monitoring and assessment approaches.

Is environment destiny? Spatial analysis of the relationship between geographic factors and obesity in Türkiye.

This study aims to evaluate the relationship of geographical factors, including precipitation, slope, air pollution and elevation with adult obesity prevalence in Türkiye (TR) using a cross-regional study design. Ordinary least squares (OLS) and geographically weighted regression (GWR) were performed to evaluate the spatial variation in the relationship between all geographic factors and obesity prevalence. In the model, a positive relationship was found between obesity prevalence and slope, whereas a negative significant relationship was determined between obesity prevalence and elevation (p < 0.05). These results, revealing spatially varying associations, were very useful in refining the interpretations of the statistical results on adult obesity. This research suggests that geographical factors should be considered as one of the components of the obesogenic environment. In addition, it is recommended that national and international strategies to overcome obesity should be restructured by taking into account the geographical characteristics of the region.

Spatial-temporal heterogeneity in the influence of landscape patterns on trade-offs/synergies among ecosystem services: a case study of the Loess Plateau of northern Shaanxi.

Exploring the role of landscape patterns in the trade-offs/synergies among ecosystem services (ESs) is helpful for understanding ES generation and transmission processes and is of great significance for multiple ES management. However, few studies have addressed the potential spatial-temporal heterogeneity in the influence of landscape patterns on trade-offs/synergies among ESs. This study assessed the landscape patterns and five typical ESs (water retention (WR), food supply (FS), habitat quality (HQ), soil retention (SR), and landscape aesthetics (LA)) on the Loess Plateau of northern Shaanxi and used the revised trade-off/synergy degree indicator to measure trade-offs/synergies among ESs. The multiscale geographically weighted regression (MGWR) model was constructed to determine the spatial-temporal heterogeneity in the influence of landscape patterns on the trade-offs/synergies. The results showed that (1) from 2000 to 2010, the increase in cultivated land and the decrease in forestland and grassland increased landscape diversity and decreased landscape heterogeneity and fragmentation. During 2010-2020, the change range decreased, the spatial distribution was homogeneous, and the landscape diversity and fragmentation in the northwestern area increased significantly. (2) The supply of the five ESs continued to increase from 2000 to 2020. During 2000-2010, FS-SR, FS-LA and SR-LA were dominated by synergies. From 2010 to 2020, the proportion of trade-off units in all relationships increased, and HQ-FS, HQ-SR and HQ-LA were dominated by trade-offs. (3) Landscape patterns had complex impacts on trade-offs/synergies, and the same landscape variable could have the opposite impact on specific trade-offs/synergies in different periods and areas. The results of this study will inform managers in developing regional sustainable ecosystem management strategies and advocating for more research to address ecological issues from a spatial-temporal perspective.

Spatial variation and predictors of missing birth preparedness and complication readiness (BPCR) messages in Ethiopia.

BACKGROUND: The Birth Preparedness and Complication Readiness (BPCR) message is one of the prenatal care packages targeted at reducing maternal and neonatal mortality by avoiding unnecessary delays during labor and delivery. There is limited evidence in Ethiopia that has looked at the spatial variation of missing BPCR messages and potential predictors. Hence, this study aimed to identify spatial predictors missing BPCR messages at the national level. METHODS: The study was based on analysis of 2016 Ethiopia Demographic Health Survey data, using a weighted sample of 4771 women. Arc-GIS version 10.7 and SaTScan version 9.6 statistical software were used for the spatial analysis. To explore spatial variation and locate spatial clusters of missing BPCR messages, the Global Moran's I statistic and Bernoulli-based spatial scan (SaTScan) analysis were carried out, respectively. Hotspot (Getis-OrdGi*) analysis was conducted to identify Hotspots and Cold spotsof missing BPCR messages. Finally, spatial regression were carried out via ordinary least squares and geographically weighted regression to identify predictors of hotspots for missing BPCR messages. RESULTS: The overall prevalence of missing BPCR messages in Ethiopia was found to be 44.0% (95%CI: 42.6, 45.4%), with significant spatial variation across regions (Moran's I = 0.218, p-value<0.001) and seven most likely significant SaTScan clusters. The vast majority of Somali, central Afar, and Gambella regions were identified as statistically significant hotspots. Living in the poorest wealth quintile, having only one ANC visit, lack of access to listening to the radio, facing difficulty in accessing money, not having a mobile phone, and being not covered by health insurance were identified as significant spatial predictors of missing BPCR messages. CONCLUSION: The level of missing BPCR messages during pregnancy was found to be high in Ethiopia, with significant local variation. As a result, policymakers at the national level and local planners should develop strategies and initiatives that enhance women's economic capacities, health-seeking behavior, and media exposure. Furthermore, the regional authorities should focus on strategies that promote universal health coverage through enrolling citizens in health insurance schemes.

Analysis of spatial variation of street landscape greening and influencing factors: an example from Fuzhou city, China.

Urban street greening is an important part of urban green infrastructure, and Green View Index (GVI) is widely used to assess urban street quality and ecosystem service value as an important indicator to quantify the perception of green street landscape from a pedestrian perspective. However, the distribution of street greenery is imbalanced. Therefore, to explore the differences in street greening levels within urban cities, we crawled streetscape data using the Internet to assess the spatial distribution patterns of urban street GVI using deep learning and spatial autocorrelation, and combined 11 surrounding environmental features with multi-source geographic data to further analyze the key factors influencing the spatial variation of block GVI using ordinary least squares, geographically weighted regression (GWR) models, and multi-scale geographically weighted regression (MGWR) models. The results show that the mean value of GVI in Fuzhou city is low (23.08%), with large differences among neighborhoods and a significant spatial autocorrelation. Among the regression models, MGWR has the best fit with an R2 of 0.702, where the variables of NDVI, house price, accessibility of water bodies and parks, and the proportion of built-up land have a greater impact on GVI, and the factors do not have the same spatial effect size. The results can provide a scientific basis for promoting green visual equity in different blocks.

Spatial distribution and influencing factors analysis of national key rural tourism villages in the Yangtze River Delta region based on geographically weighted regression.

National key rural tourism villages (NKRTVs) can lead to the high-quality development of rural tourism, and their spatial distribution is influenced by a variety of factors. However, existing studies have neglected the fact that influencing factors can have different directions and effects in different geographic spaces. This study investigates 156 NKRTVs in the Yangtze River Delta region of China as the research object and employs ArcGIS spatial analysis technology to examine their spatial distribution characteristics. Additionally, two new indicators of land and culture are introduced to enhance the index system of influencing factors. A geographically weighted regression model is utilized to identify the spatial heterogeneity of various factors that affect the spatial distribution of NKRTVs. The results of this study indicate the following: (1) The spatial distribution of NKRTVs in the Yangtze River Delta region is characterized by "small clustering and large dispersion." The spatial distribution exhibits strong spatial correlation, with Shanghai serving as the primary spatial clustering core and Huangshan city forming a secondary spatial clustering subcore. The distribution of NKRTVs is relatively scattered in other areas, with obvious differences in the spatial distribution of cold and hot spots. (2) The results of the geographically weighted regression model show that with the change in spatial location, the influence effect of each influencing factor on the spatial distribution of NKRTVs has obvious spatial differences. Based on the spatial heterogeneity of the influencing factors, this study proposes targeted suggestions for the development of rural tourism in different regions.

Geospatial analysis of the hospitalisation rate of patients with rheumatoid arthritis in Hunan: a cross-sectional Chinese study.

OBJECTIVE: Little is known about spatial variability of hospitalisation rate (HR) of patients with rheumatoid arthritis (RA) worldwide, especially in China. METHODS: A cross-sectional study was conducted among patients with RA admitted to hospitals in Hunan Province. Global Moran's I and local indicators of spatial association were used to explore the geospatial pattern of the HR of patients with RA. Generalised estimating equation analysis and geographically weighted regression were used to identify the potential influencing factors of the HR of patients with RA. RESULTS: There were a total of 11 599 admissions, and the average HR was 1.57 per 10 000 population in Hunan. We detected different cluster patterns of the HR among patients with RA by local indicators of spatial association. Age, ethnicity, average temperature, average temperature range, average rainfall, regions, gross domestic product per capita, and doctors and hospitals per 10 000 people were risk factors for the HR. However, only average temperature, gross domestic product per capita and hospitals per 10 000 people showed different regression coefficients on the HR in different counties. The increase in hospitals increased the probability of HR from east to west in Hunan with a positive coefficient, while temperature decreases increased the risk of HR from south to north negatively. Similarly, the growth of gross domestic product per capita decreased the probability of HR from southwest to northeast. CONCLUSION: A non-random spatial distribution of the HR of patients with RA was demonstrated in Hunan, and average temperature, gross domestic product per capita and hospitals per 10 000 people showed different regression coefficients on the HR in different counties. Our study indicated that spatial and geostatistics may be useful approaches for further study among patients with RA.

Spatial heterogeneity in relationship between district patterns of HIV incidence and covariates in Zimbabwe: a multi-scale geographically weighted regression analysis.

A study was conducted to investigate the district-level patterns of incidence of the human immunodeficiency virus (HIV) in Zimbabwe in the period 2005-2015 and explore variations in the relationship between covariates and HIV incidence across different districts. Demographic health survey data were analysed using hotspot analysis, spatial autocorrelation, and multi-scale geographically weighted regression (MGWR) techniques. The analysis revealed hotspots of the HIV epidemic in the southern and western regions of Zimbabwe in contrast to the eastern and northern regions. Specific districts in Matabeleland South and Matabeleland North provinces showed clusters of HIV incidence in 2005-2006, 2010-2011 and 2015. Variables studied were multiple sex partners and sexually transmitted infections (STI) condom use and being married. Recommendations include implementing targeted HIV prevention programmes in identified hotspots, prioritising interventions addressing the factors mentioned above as well as enhancing access to HIV testing and treatment services in high-risk areas, strengthening surveillance systems, and conducting further research to tailor interventions based on contextual factors. The study also emphasizes the need for regular monitoring and evaluation at the district level to inform effective responses to the HIV epidemic over time. By addressing the unique challenges and risk factors in different districts, significant progress can be made in reducing HIV transmission and improving health outcomes in Zimbabwe. These findings should be valuable for policymakers in resource allocation and designing evidence-based interventions.

Intra-urban differences underlying leprosy spatial distribution in central Brazil: geospatial techniques as potential tools for surveillance.

This ecological study identified an aggregation of urban neighbourhoods spatial patterns in the cumulative new case detection rate (NCDR) of leprosy in the municipality of Rondonópolis, central Brazil, as well as intra-urban socioeconomic differences underlying this distribution. Scan statistics of all leprosy cases reported in the area from 2011 to 2017 were used to investigate spatial and spatiotemporal clusters of the disease at the neighbourhood level. The associations between the log of the smoothed NCDR and demographic, socioeconomic, and structural characteristics were explored by comparing multivariate models based on ordinary least squares (OLS) regression, spatial lag, spatial error, and geographically weighted regression (GWR). Leprosy cases were observed in 84.1% of the neighbourhoods of Rondonópolis, where 848 new cases of leprosy were reported corresponding to a cumulative NCDR of 57.9 cases/100,000 inhabitants. Spatial and spatiotemporal high-risk clusters were identified in western and northern neighbourhoods, whereas central and southern areas comprised low-risk areas. The GWR model was selected as the most appropriate modelling strategy (adjusted R²: 0.305; AIC: 242.85). By mapping the GWR coefficients, we identified that low literacy rate and low mean monthly nominal income per household were associated with a high NCDR of leprosy, especially in the neighbourhoods located within high-risk areas. In conclusion, leprosy presented a heterogeneous and peripheral spatial distribution at the neighbourhood level, which seems to have been shaped by intra-urban differences related to deprivation and poor living conditions. This information should be considered by decision-makers while implementing surveillance measures aimed at leprosy control.

Spatial characterization of forest ecosystem services and human-induced complexities in Himalayan biodiversity hotspot area.

The forest ecosystem of Indian Himalayan Region offers various ecosystem services (ESs) that are crucial for the sustenance of human beings. However, the rapid expansion of human activities (HA) poses a significant threat to the provision of the forest ecosystem services (FES). For simple and definitive assessments of FES and HA, the use of indicators has become an indispensable approach. In the present study, we performed: (i) indicator-based mapping of FES and HA, and (ii) evaluated the impact of HA on FES with the aid of geospatial techniques. Village-level analysis was conducted for FES and HA in the Aglar watershed of Uttarakhand, India for 2015. Four dominant forest types in the watershed-Quercus mixed, Pinus roxburghii, Cedrus deodara, and mixed forest were considered. For spatial characterization of FES, indicators such as forest carbon stock, net primary productivity, total water retention, and sediment yield were assessed, whereas human activity index (HAI) was evaluated using indicators of HAs, namely population density, road density, farmland, and habitation ratio. The integration of normalized values of FES indicators generated multiple ecosystem services indicator (MESI), and HAI was contructed using analytical hierarchical process based assignment of weights to HA indicators. Spatial analysis techniques such as ordinary least-square regression (OLS) and geographically weighted regression (GWR) models were used to derive the spatial relationship between them. The adjusted R2 and AIC were utilized to evaluate the effectiveness of the model. The GWR model had a better fit with an adjusted R2 of 0.68 and a lower AIC of 42.940, compared to the OLS model with an adjusted R2 of 0.21 and an AIC of 60.52. The statistics showed that GWR performed better than OLS and ably captured the heteroscedasticity of the phenomena. An inverse relation was observed between MESI and HAI. The findings of the study highlight the close link between the supply of FES and the impact of human-induced disturbances over the provision of FES, which has the potential to increase over time. The study provides a scientific basis for structuring policy dialogues to coordinate the long-term regional sustainability of FES provisioned from the Himalayan regions.