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1.
Inj Prev ; 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844338

RESUMEN

OBJECTIVE: The USA has higher rates of fatal motor vehicle collisions than most high-income countries. Previous studies examining the role of the built environment were generally limited to small geographic areas or single cities. This study aims to quantify associations between built environment characteristics and traffic collisions in the USA. METHODS: Built environment characteristics were derived from Google Street View images and summarised at the census tract level. Fatal traffic collisions were obtained from the 2019-2021 Fatality Analysis Reporting System. Fatal and non-fatal traffic collisions in Washington DC were obtained from the District Department of Transportation. Adjusted Poisson regression models examined whether built environment characteristics are related to motor vehicle collisions in the USA, controlling for census tract sociodemographic characteristics. RESULTS: Census tracts in the highest tertile of sidewalks, single-lane roads, streetlights and street greenness had 70%, 50%, 30% and 26% fewer fatal vehicle collisions compared with those in the lowest tertile. Street greenness and single-lane roads were associated with 37% and 38% fewer pedestrian-involved and cyclist-involved fatal collisions. Analyses with fatal and non-fatal collisions in Washington DC found streetlights and stop signs were associated with fewer pedestrians and cyclists-involved vehicle collisions while road construction had an adverse association. CONCLUSION: This study demonstrates the utility of using data algorithms that can automatically analyse street segments to create indicators of the built environment to enhance understanding of large-scale patterns and inform interventions to decrease road traffic injuries and fatalities.

2.
Am J Epidemiol ; 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844537

RESUMEN

Human-induced climate change has led to more frequent and severe flooding throughout the globe. We examined the association between flood risk and the prevalence of coronary heart disease, high blood pressure, asthma, and poor mental health in the UnitedStates, while taking into account different levels of social vulnerability. We aggregated flood risk variables from First Street Foundation by census tract and used principal component analysis to derive a set of five interpretable flood risk factors. The dependent variables were census-tract level disease prevalences generated by the Centers for Disease Control and Prevention. Bayesian spatial conditional autoregressive models were fit on this data to quantify the relationship between flood risk and health outcomes under different stratifications of social vulnerability. We showed that three flood risk principal components had small but significant associations with each of the health outcomes, across the different stratifications of social vulnerability. Our analysis gives the first United States-wide estimates of the associated effects of flood risk on specific health outcomes. We also show that social vulnerability is an important moderator of the relationship between flood risk and health outcomes. Our approach can be extended to other ecological studies that examine the health impacts of climate hazards.

3.
J Environ Manage ; 362: 121259, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38830281

RESUMEN

Machine learning methodology has recently been considered a smart and reliable way to monitor water quality parameters in aquatic environments like reservoirs and lakes. This study employs both individual and hybrid-based techniques to boost the accuracy of dissolved oxygen (DO) and chlorophyll-a (Chl-a) predictions in the Wadi Dayqah Dam located in Oman. At first, an AAQ-RINKO device (CTD+ sensor) was used to collect water quality parameters from different locations and varying depths in the reservoir. Second, the dataset is segmented into homogeneous clusters based on DO and Chl-a parameters by leveraging an optimized K-means algorithm, facilitating precise estimations. Third, ten sophisticated variational-individual data-driven models, namely generalized regression neural network (GRNN), random forest (RF), gaussian process regression (GPR), decision tree (DT), least-squares boosting (LSB), bayesian ridge (BR), support vector regression (SVR), K-nearest neighbors (KNN), multilayer perceptron (MLP), and group method of data handling (GMDH) are employed to estimate DO and Chl-a concentrations. Fourth, to improve prediction accuracy, bayesian model averaging (BMA), entropy weighted (EW), and a new enhanced clustering-based hybrid technique called Entropy-ORNESS are employed to combine model outputs. The Entropy-ORNESS method incorporates a Genetic Algorithm (GA) to determine optimal weights and then combine them with EW weights. Finally, the inclusion of bootstrapping techniques introduces a stochastic assessment of model uncertainty, resulting in a robust estimator model. In the validation phase, the Entropy-ORNESS technique outperforms the independent models among the three fusion-based methods, yielding R2 values of 0.92 and 0.89 for DO and Chl-a clusters, respectively. The proposed hybrid-based methodology demonstrates reduced uncertainty compared to single data-driven models and two combination frameworks, with uncertainty levels of 0.24% and 1.16% for cluster 1 of DO and cluster 2 of Chl-a parameters. As a highlight point, the spatial analysis of DO and Chl-a concentrations exhibit similar pattern variations across varying depths of the dam according to the comparison of field measurements with the best hybrid technique, in which DO concentration values notably decrease during warmer seasons. These findings collectively underscore the potential of the upgraded weighted-based hybrid approach to provide more accurate estimations of DO and Chl-a concentrations in dynamic aquatic environments.


Asunto(s)
Calidad del Agua , Incertidumbre , Algoritmos , Análisis Espacial , Teorema de Bayes , Análisis por Conglomerados , Monitoreo del Ambiente/métodos , Redes Neurales de la Computación , Aprendizaje Automático , Clorofila A/análisis
4.
Front Public Health ; 12: 1305458, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38827604

RESUMEN

Background: Healthcare service utilization is unequal among different subpopulations in low-income countries. For healthcare access and utilization of healthcare services with partial or full support, households are recommended to be enrolled in a community-based health insurance system (CBHIS). However, many households in low-income countries incur catastrophic health expenditure. This study aimed to assess the spatial distribution and factors associated with households' enrollment level in CBHIS in Ethiopia. Methods: A cross-sectional study design with two-stage sampling techniques was used. The 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) data were used. STATA 15 software and Microsoft Office Excel were used for data management. ArcMap 10.7 and SaTScan 9.5 software were used for geographically weighted regression analysis and mapping the results. A multilevel fixed-effect regression was used to assess the association of variables. A variable with a p < 0.05 was considered significant with a 95% confidence interval. Results: Nearly three out of 10 (28.6%) households were enrolled in a CBHIS. The spatial distribution of households' enrollment in the health insurance system was not random, and households in the Amhara and Tigray regions had good enrollment in community-based health insurance. A total of 126 significant clusters were detected, and households in the primary clusters were more likely to be enrolled in CBHIS. Primary education (AOR: 1.21, 95% CI: 1.05, 1.31), age of the head of the household >35 years (AOR: 2.47, 95% CI: 2.04, 3.02), poor wealth status (AOR: 0.31, 95% CI: 0.21, 1.31), media exposure (AOR: 1.35, 95% CI: 1.02, 2.27), and residing in Afar (AOR: 0.01, 95% CI: 0.003, 0.03), Gambela (AOR: 0.03, 95% CI: 0.01, 0.08), Harari (AOR: 0.06, 95% CI: 0.02, 0.18), and Dire Dawa (AOR: 0.02, 95% CI: 0.01, 0.06) regions were significant factors for households' enrollment in CBHIS. The secondary education status of household heads, poor wealth status, and media exposure had stationary significant positive and negative effects on the enrollment of households in CBHIS across the geographical areas of the country. Conclusion: The majority of households did not enroll in the CBHIS. Effective CBHIS frameworks and packages are required to improve the households' enrollment level. Financial support and subsidizing the premiums are also critical to enhancing households' enrollment in CBHIS.


Asunto(s)
Seguros de Salud Comunitarios , Composición Familiar , Humanos , Etiopía , Estudios Transversales , Femenino , Masculino , Adulto , Seguros de Salud Comunitarios/estadística & datos numéricos , Análisis Espacial , Persona de Mediana Edad , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Factores Socioeconómicos , Aceptación de la Atención de Salud/estadística & datos numéricos
5.
Artículo en Inglés | MEDLINE | ID: mdl-38851399

RESUMEN

BACKGROUND: The extent to which asthma-related ED visit incidence rates vary from neighborhood to neighborhood and predictors of neighborhood-level asthma ED visit burden are not well understood. OBJECTIVE: To describe the census tract-level spatial distribution of asthma-related emergency department visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates. METHODS: Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across Travis County, TX census tracts and to assess the contribution of census tract characteristics to their distribution. RESULTS: There were distinct patterns in ED visit incidence rates at the census tract scale, which were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. However, racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. The census tract predictors of ED visit incidence rates differed by racial and ethnic group. CONCLUSIONS: Variability in asthma ED visit incidence rates are apparent at smaller spatial scales. The majority of the variability in census tract-level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood characteristics.

6.
J Safety Res ; 89: 251-261, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38858048

RESUMEN

INTRODUCTION: There is regional diversity inside countries regarding road safety indices (RSIs), and countries rarely have been compared based on these indicators. Thus, regional RSIs of England, the United States, Egypt, and Turkey were evaluated. Regional data were collected from the statistical center of each country. The adopted regional RSIs include road fatalities, health risk (HR) or fatalities per population, and traffic risk (TR) or fatalities per number of vehicles. The associations between variables were examined using correlation and regression analysis. The spatial distributions of subdivisions were evaluated using Moran's I, the local Moran index. RESULTS: Considerable differences between the countries were observed, including differences in the spatial distribution of regions and associations between RSIs. Significant relationships were detected between road fatality, population, and the number of motor vehicles. Higher exposure rates mean higher fatalities in regions. A robust linear relationship between the HR and TR indices was identified in developed countries. There is a nonlinear and significant association between motorization rates and TR indices of regions, and fatality risk decreases as the motorization rate increases. There is a considerable gap between developed and developing countries regarding regional RSIs, and the transferability of road safety models from one country to another is challenging. Huge hotspots regarding RSIs were observed in Turkey and the United States. The locations of hot spots in terms of the risk indices were identical in the developed countries.


Asunto(s)
Accidentes de Tránsito , Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Humanos , Turquía/epidemiología , Estados Unidos/epidemiología , Egipto/epidemiología , Inglaterra/epidemiología , Seguridad/estadística & datos numéricos , Medición de Riesgo
7.
Circ Res ; 134(12): 1681-1702, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38843288

RESUMEN

Throughout our lifetime, each beat of the heart requires the coordinated action of multiple cardiac cell types. Understanding cardiac cell biology, its intricate microenvironments, and the mechanisms that govern their function in health and disease are crucial to designing novel therapeutical and behavioral interventions. Recent advances in single-cell and spatial omics technologies have significantly propelled this understanding, offering novel insights into the cellular diversity and function and the complex interactions of cardiac tissue. This review provides a comprehensive overview of the cellular landscape of the heart, bridging the gap between suspension-based and emerging in situ approaches, focusing on the experimental and computational challenges, comparative analyses of mouse and human cardiac systems, and the rising contextualization of cardiac cells within their niches. As we explore the heart at this unprecedented resolution, integrating insights from both mouse and human studies will pave the way for novel diagnostic tools and therapeutic interventions, ultimately improving outcomes for patients with cardiovascular diseases.


Asunto(s)
Análisis de la Célula Individual , Humanos , Animales , Análisis de la Célula Individual/métodos , Miocardio/metabolismo , Miocardio/patología , Miocitos Cardíacos/metabolismo , Genómica/métodos , Ratones
8.
JMIR Form Res ; 8: e54207, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38857493

RESUMEN

BACKGROUND: The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural low- and middle-income settings. OBJECTIVE: Nested in a 3-month ecological momentary assessment intervention pilot trial, this study aims to leverage mobile health app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes. METHODS: Pilot trial participants were recruited from the Rakai Community Cohort Study-an ongoing population-based cohort study in rural south-central Uganda. Participants used a smartphone app that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non-long-term partner) via the app that were both location and time stamped. In this substudy, we characterized participant mobility using 3 measures: average distance (kilometers) traveled per week, number of unique locations visited (deduplicated points within 25 m of one another), and the percentage of GPS points recorded away from home. The latter measure was calculated using home buffer regions of 100 m, 400 m, and 800 m. We also evaluated the number of unique locations visited for each specific health behavior, and whether those locations were within or outside the home buffer regions. Sociodemographic information, mobility measures, and locations of health behaviors were summarized across the sample using descriptive statistics. RESULTS: Of the 46 participants with complete GPS data, 24 (52%) participants were men, 30 (65%) participants were younger than 35 years, and 33 (72%) participants were in the top 2 socioeconomic status quartiles. On median, participants traveled 303 (IQR 152-585) km per week. Over the study period, participants on median recorded 1292 (IQR 963-2137) GPS points-76% (IQR 58%-86%) of which were outside their 400-m home buffer regions. Of the participants reporting drinking alcohol, cigarette smoking, and engaging in condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400-m home neighborhood and across a median of 3.0 (IQR 1.5-5.5), 3.0 (IQR 1.0-3.0), and 3.5 (IQR 1.0-7.0) unique locations, respectively. CONCLUSIONS: Among residents in rural Uganda, an ecological momentary assessment app successfully captured high mobility and health-related behaviors across multiple locations. Our findings suggest that future mobile health interventions in similar settings can benefit from integrating spatial data collection using the GPS technology in mobile phones. Leveraging such individual-level GPS data can inform place-based strategies within these interventions for promoting healthy behavior change.

9.
Geohealth ; 8(5): e2023GH000927, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38711844

RESUMEN

The environmental justice literature demonstrates consistently that low-income and minority communities are disproportionately exposed to environmental hazards. In this case study, we examined cumulative multipollutant, multidomain, and multimatrix environmental exposures in Milwaukee County, Wisconsin for the year 2015. We identified spatial hot spots in Milwaukee County both individually (using local Moran's I) and through clusters (using K-means clustering) across a profile of environmental pollutants that span regulatory domains and matrices of exposure, as well as socioeconomic indicators. The cluster with the highest exposures within the urban area was largely characterized by low socioeconomic status and an overrepresentation of the Non-Hispanic Black population relative to the county as a whole. In this cluster, average pollutant concentrations were equivalent to the 78th percentile in county-level blood lead levels, 67th percentile in county-level NO2, 79th percentile in county-level CO, and 78th percentile in county-level air toxics. Simultaneously, this cluster had an average equivalent to the 62nd percentile in county-level unemployment, 70th percentile in county-level population rate lacking a high school diploma, 73rd percentile in county-level poverty rate, and 28th percentile in county-level median household income. The spatial patterns of pollutant exposure and SES indicators suggested that these disparities were not random but were instead structured by socioeconomic and racial factors. Our case study, which combines environmental pollutant exposures, sociodemographic data, and clustering analysis, provides a roadmap to identify and target overburdened communities for interventions that reduce environmental exposures and consequently improve public health.

10.
BMC Pregnancy Childbirth ; 24(1): 350, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38720255

RESUMEN

BACKGROUND: Access to maternity care in the U.S. remains inequitable, impacting over two million women in maternity care "deserts." Living in these areas, exacerbated by hospital closures and workforce shortages, heightens the risks of pregnancy-related complications, particularly in rural regions. This study investigates travel distances and time to obstetric hospitals, emphasizing disparities faced by those in maternity care deserts and rural areas, while also exploring variances across races and ethnicities. METHODS: The research adopted a retrospective secondary data analysis, utilizing the American Hospital Association and Centers for Medicaid and Medicare Provider of Services Files to classify obstetric hospitals. The study population included census tract estimates of birthing individuals sourced from the U.S. Census Bureau's 2017-2021 American Community Survey. Using ArcGIS Pro Network Analyst, drive time and distance calculations to the nearest obstetric hospital were conducted. Furthermore, Hot Spot Analysis was employed to identify areas displaying significant spatial clusters of high and low travel distances. RESULTS: The mean travel distance and time to the nearest obstetric facility was 8.3 miles and 14.1 minutes. The mean travel distance for maternity care deserts and rural counties was 28.1 and 17.3 miles, respectively. While birthing people living in rural maternity care deserts had the highest average travel distance overall (33.4 miles), those living in urban maternity care deserts also experienced inequities in travel distance (25.0 miles). States with hotspots indicating significantly higher travel distances included: Montana, North Dakota, South Dakota, and Nebraska. Census tracts where the predominant race is American Indian/Alaska Native (AIAN) had the highest travel distance and time compared to those of all other predominant races/ethnicities. CONCLUSIONS: Our study revealed significant disparities in obstetric hospital access, especially affecting birthing individuals in maternity care deserts, rural counties, and communities predominantly composed of AIAN individuals, resulting in extended travel distances and times. To rectify these inequities, sustained investment in the obstetric workforce and implementation of innovative programs are imperative, specifically targeting improved access in maternity care deserts as a priority area within healthcare policy and practice.


Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Maternidades , Servicios de Salud Materna , Humanos , Estados Unidos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Femenino , Embarazo , Estudios Retrospectivos , Disparidades en Atención de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Servicios de Salud Materna/estadística & datos numéricos , Maternidades/estadística & datos numéricos , Viaje/estadística & datos numéricos , Población Rural/estadística & datos numéricos
11.
Int J Gen Med ; 17: 2129-2142, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38766596

RESUMEN

Purpose: This study aimed to analyze myopia distribution in Hubei and the impact of regional Sunshine Duration on myopia in children and adolescents. Patients and Methods: The Cross-sectional study included students (kindergarten to grade 12) through multistage cluster stratified sampling in 17 cities (103 areas) of Hubei, China, who underwent ophthalmic examinations from September 2021 to November 2021. The association of sunshine duration with the prevalence and distribution of myopia was analyzed. Using Moran's index to quantify the distribution relationship, a spatial analysis was constructed. Results: A total of 435,996 students (53.33% male; mean age, 12.16±3.74 years) were included in the study. A negative association was identified between myopia prevalence and sunshine duration in the region, especially in population of primary students (r=-0.316, p<0.001). Each 1-unit increment in the sunshine duration was associated with a decreased risk of myopia prevalence (OR=0.996; 95% CI, 0.995-0.998; P <0.001). Regression showed a linear relationship between sunshine duration and myopia rates of primary school students [Prevalence%= (-0.1331*sunshine duration+47.73)%, p = 0.02]. Sunshine duration influenced the distribution of myopia rates among primary (Moran's I=-0.206, p<0.001) and junior high school (Moran's I=-0.183, p=0.002). Local spatial analysis showed that areas with low sunshine duration had high myopia prevalence concentration. Conclusion: This study revealed sunshine duration associations with myopia prevalence at the regional and population levels. The results may emphasize the significance of promptly implementing myopia control in regions with poor sunshine. The effect of sunshine on myopia is pronounced in the early years of education, especially in primary students.

12.
Artículo en Inglés | MEDLINE | ID: mdl-38708714

RESUMEN

BACKGROUND: To analyse the temporal trends and spatiotemporal distribution of leprosy relapse in Brazil from 2001 to 2021. METHODS: An ecological study with a temporal trend approach and space-time analysis of leprosy relapse in Brazil was carried out with data from the Notifiable Diseases Information System. RESULTS: A total of 31 334 patients who experienced leprosy relapse were identified. The number of recurrent cases tended to increase throughout the study period, and this increase was significant among females and in almost all age groups, except for those <15, 50-59 and ≥70 y. Several clusters of high- and low-risk patients were identified across all regions with a heterogeneous distribution. CONCLUSIONS: The burden of relapse showed an increasing trend in some groups and was distributed in all regions.

13.
bioRxiv ; 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38712207

RESUMEN

The tumor microenvironment is widely recognized for its central role in driving cancer progression and influencing prognostic outcomes. Despite extensive research efforts dedicated to characterizing this complex and heterogeneous environment, considerable challenges persist. In this study, we introduce a data-driven approach for identifying patterns of cell organizations in the tumor microenvironment that are associated with patient prognoses. Our methodology relies on the construction of a bi-level graph model: (i) a cellular graph, which models the intricate tumor microenvironment, and (ii) a population graph that captures inter-patient similarities, given their respective cellular graphs, by means of a soft Weisfeiler-Lehman subtree kernel. This systematic integration of information across different scales enables us to identify patient subgroups exhibiting unique prognoses while unveiling tumor microenvironment patterns that characterize them. We demonstrate our approach in a cohort of breast cancer patients, where the identified tumor microenvironment patterns result in a risk stratification system that provides complementary, new information with respect to alternative standards. Our results, which are validated in a completely independent cohort, allow for new insights into the prognostic implications of the breast tumor microenvironment, and this methodology could be applied to other cancer types more generally.

14.
Brief Bioinform ; 25(3)2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38701421

RESUMEN

Cancer is a complex cellular ecosystem where malignant cells coexist and interact with immune, stromal and other cells within the tumor microenvironment (TME). Recent technological advancements in spatially resolved multiplexed imaging at single-cell resolution have led to the generation of large-scale and high-dimensional datasets from biological specimens. This underscores the necessity for automated methodologies that can effectively characterize molecular, cellular and spatial properties of TMEs for various malignancies. This study introduces SpatialCells, an open-source software package designed for region-based exploratory analysis and comprehensive characterization of TMEs using multiplexed single-cell data. The source code and tutorials are available at https://semenovlab.github.io/SpatialCells. SpatialCells efficiently streamlines the automated extraction of features from multiplexed single-cell data and can process samples containing millions of cells. Thus, SpatialCells facilitates subsequent association analyses and machine learning predictions, making it an essential tool in advancing our understanding of tumor growth, invasion and metastasis.


Asunto(s)
Análisis de la Célula Individual , Programas Informáticos , Microambiente Tumoral , Análisis de la Célula Individual/métodos , Humanos , Neoplasias/patología , Aprendizaje Automático , Biología Computacional/métodos
15.
Trop Med Int Health ; 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38757387

RESUMEN

OBJECTIVES: Although the link between poverty and tuberculosis (TB) is widely recognised, limited studies have investigated the association between neighbourhood factors and TB incidence. Since the factors influencing different episodes of TB might be different, this study focused on the first episode of TB disease (first-episode TB). METHODS: All first episodes in previously linked and geocoded TB notification data from 2007 to 2015 in Cape Town, South Africa, were aggregated at the neighbourhood level and merged with the 2011 census data. We conducted an ecological study to assess the association between neighbourhood incidence of first-episode TB and neighbourhood factors (total TB burden [all episodes] in the previous year, socioeconomic index, mean household size, mean age, and percentage males) using a negative binomial regression. We also examined the presence of hotspots in neighbourhood TB incidence with the Global Moran's I statistic and assessed spatial dependency in the association between neighbourhood factors and TB incidence using a spatial lag model. RESULTS: The study included 684 neighbourhoods with a median first-episode TB incidence rate of 114 (IQR: 0-345) per 100,000 people. We found lower neighbourhood socioeconomic index (SEI), higher neighbourhood total TB burden, lower neighbourhood mean household size, and lower neighbourhood mean age were associated with increased neighbourhood first-episode TB incidence. Our findings revealed a hotspot of first-episode TB incidence in Cape Town and evidence of spatial dependency in the association between neighbourhood factors and TB incidence. CONCLUSION: Neighbourhood TB burden and SEI were associated with first-episode TB incidence, and there was spatial dependency in this association. Our findings can inform targeted interventions to reduce TB in high-risk neighbourhoods, thereby reducing health disparities and promoting health equity.

16.
J Environ Manage ; 359: 121054, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38728982

RESUMEN

Semi-arid regions present unique challenges for maintaining aquatic biological integrity due to their complex evolutionary mechanisms. Uncovering the spatial patterns of aquatic biological integrity in these areas is a challenging research task, especially under the compound environmental stress. Our goal is to address this issue with a scientifically rigorous approach. This study aims to explore the spatial analysis and diagnosis method of aquatic biological based on the combination of machine learning and statistical analysis, so as to reveal the spatial differentiation patterns and causes of changes of aquatic biological integrity in semi-arid regions. To this end, we have introduced an innovative approach that combines XGBoost-SHAP and Fuzzy C-means clustering (FCM), we successfully identified and diagnosed the spatial variations of aquatic biological integrity in the Wei River Basin (WRB). The study reveals significant spatial variations in species number, diversity, and aquatic biological integrity of phytoplankton, serving as a testament to the multifaceted responses of biological communities under the intricate tapestry of environmental gradients. Delving into the depths of the XGBoost-SHAP algorithm, we discerned that Annual average Temperature (AT) stands as the pivotal driver steering the spatial divergence of the Phytoplankton Integrity Index (P-IBI), casting a positive influence on P-IBI when AT is below 11.8 °C. The intricate interactions between hydrological variables (VF and RW) and AT, as well as between water quality parameters (WT, NO3-N, TP, COD) and AT, collectively sculpt the spatial distribution of P-IBI. The fusion of XGBoost-SHAP with FCM unveils pronounced north-south gradient disparities in aquatic biological integrity across the watershed, segmenting the region into four distinct zones. This establishes scientific boundary conditions for the conservation strategies and management practices of aquatic ecosystems in the region, and its flexibility is applicable to the analysis of spatial heterogeneity in other complex environmental contexts.


Asunto(s)
Aprendizaje Automático , Fitoplancton , Ríos , Monitoreo del Ambiente/métodos , Algoritmos
17.
Actas Dermosifiliogr ; 2024 May 29.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38821354

RESUMEN

INTRODUCTION: The incidence of melanoma is growing in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data on to its first year in service. METHODS: REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that includes demographics, staging, individual, and health care-related baseline data, while storing the patients' health records and surgical treatment received. RESULTS: A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas ≤ 1 mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of the cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS: The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.

18.
Acta Trop ; 256: 107229, 2024 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-38768698

RESUMEN

Laos is a hyperendemic country of all 4 dengue serotypes. Various factors contribute to the spread of the disease including viral itself, vectors, and environment. This study aims to analyze dengue data and its incidence in nine districts of Vientiane Capital, Laos spanning from 2019 to 2021 by data collected from Mittaphab Hospital. The Maximum Entropy algorithm (MaxEnt) was applied to assess spatial distribution and identify high-probability locations for dengue occurrence by analyzing crucial environmental and climatic conditions. Dengue cases were more prominent in female (54.88 %) and highest case number was found in worker group (29.02 %) followed by student (28.47 %) and officer (16.92 %). In this study, the age group 21-30 years old had the highest infection rate (42.23 %), followed by 10-20 years old (24.21 %). Most of dengue cases was primary infection (91.61 %). Dengue serotype 2 predominated in 2019 and 2020 and substitute by serotype 1 in 2021. Across the nine districts of Vientiane Capital, the highest incidence of dengue was found in Xaythany district population in 2019, shifting to Chanthabouly district in 2020 and 2021. The MaxEnt revealed potentially most suitable areas for dengue were widely distributed central south part of Vientiane, Laos. Additionally, the best predictive variable for dengue occurrence was normalized difference vegetation index. Understanding of case characteristics and spatial distribution features of dengue will be helpful in effective surveillance and disease control in the future.

19.
Heliyon ; 10(10): e31083, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38803965

RESUMEN

Previous studies ignored the geospatial dynamics spillover effects of energy consumption on CO2 emissions while assessing such impacts in developed and developing countries. Moreover, most studies wrongfully assess spillover effects in its aggregated format rather than decomposing by its components. This is important as not all energy sources share the same characteristics. We fill these gaps in the literature by investigating the spillover effects of various forms of energy, including fossil fuels, renewable energy, and nuclear power, on CO2 emissions in 135 developed and developing countries from 2000 to 2019. We used the Dynamic Spatial Durbin Model (DSDM) to better understand the results. A series of indicative tests confirmed using the DSDM model and including spatial interaction of CO2 emissions in the analysis. Our findings show evidence of indirect spillover effects of the various energy sources on CO2 emissions. Further considering the spillover effects of the energy sources of neighbouring countries, the paper finds that the driving increase in CO2 emissions mainly came from the energy consumption of the country itself and neighbouring countries' energy consumption. Nevertheless, the results indicate that the direct effects of energy consumption often exceed its indirect effects. The results also confirm that total and fossil energy consumption harms the environment, whereas adopting renewable and nuclear energy sources reduces CO2 emissions. Lastly, we find nuclear energy is the most environmentally sustainable energy source. The study concludes that the Dynamic Spatial Durbin Model is paramount in estimating the environmental impact of energy consumption in our sample. The practical policy implications drawn from this study could be used to promote increased collaboration to hasten the energy transition process and address global warming and climate change.

20.
Parasit Vectors ; 17(1): 240, 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38802953

RESUMEN

BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, is still a public health problem in Latin America and in the Southern Cone countries, where Triatoma infestans is the main vector. We evaluated the relationships among the density of green vegetation around rural houses, sociodemographic characteristics, and domestic (re)infestation with T. infestans while accounting for their spatial dependence in the municipality of Pampa del Indio between 2007 and 2016. METHODS: The study comprised sociodemographic and ecological variables from 734 rural houses with no missing data. Green vegetation density surrounding houses was estimated by the normalized difference vegetation index (NDVI). We used a hierarchical Bayesian logistic regression composed of fixed effects and spatial random effects to estimate domestic infestation risk and quantile regressions to evaluate the association between surrounding NDVI and selected sociodemographic variables. RESULTS: Qom ethnicity and the number of poultry were negatively associated with surrounding NDVI, whereas overcrowding was positively associated with surrounding NDVI. Hierarchical Bayesian models identified that domestic infestation was positively associated with surrounding NDVI, suitable walls for triatomines, and overcrowding over both intervention periods. Preintervention domestic infestation also was positively associated with Qom ethnicity. Models with spatial random effects performed better than models without spatial effects. The former identified geographic areas with a domestic infestation risk not accounted for by fixed-effect variables. CONCLUSIONS: Domestic infestation with T. infestans was associated with the density of green vegetation surrounding rural houses and social vulnerability over a decade of sustained vector control interventions. High density of green vegetation surrounding rural houses was associated with households with more vulnerable social conditions. Evaluation of domestic infestation risk should simultaneously consider social, landscape and spatial effects to control for their mutual dependency. Hierarchical Bayesian models provided a proficient methodology to identify areas for targeted triatomine and disease surveillance and control.


Asunto(s)
Enfermedad de Chagas , Insectos Vectores , Triatoma , Triatoma/fisiología , Triatoma/parasitología , Animales , Enfermedad de Chagas/transmisión , Enfermedad de Chagas/epidemiología , Humanos , Argentina/epidemiología , Insectos Vectores/fisiología , Teorema de Bayes , Población Rural , Trypanosoma cruzi , Vivienda , Factores Socioeconómicos , Factores de Riesgo
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