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1.
Malar J ; 23(1): 102, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594716

RESUMO

BACKGROUND: Ghana is among the top 10 highest malaria burden countries, with about 20,000 children dying annually, 25% of which were under five years. This study aimed to produce interactive web-based disease spatial maps and identify the high-burden malaria districts in Ghana. METHODS: The study used 2016-2021 data extracted from the routine health service nationally representative and comprehensive District Health Information Management System II (DHIMS2) implemented by the Ghana Health Service. Bayesian geospatial modelling and interactive web-based spatial disease mapping methods were employed to quantify spatial variations and clustering in malaria risk across 260 districts. For each district, the study simultaneously mapped the observed malaria counts, district name, standardized incidence rate, and predicted relative risk and their associated standard errors using interactive web-based visualization methods. RESULTS: A total of 32,659,240 malaria cases were reported among children < 5 years from 2016 to 2021. For every 10% increase in the number of children, malaria risk increased by 0.039 (log-mean 0.95, 95% credible interval = - 13.82-15.73) and for every 10% increase in the number of males, malaria risk decreased by 0.075, albeit not statistically significant (log-mean - 1.82, 95% credible interval = - 16.59-12.95). The study found substantial spatial and temporal differences in malaria risk across the 260 districts. The predicted national relative risk was 1.25 (95% credible interval = 1.23, 1.27). The malaria risk is relatively the same over the entire year. However, a slightly higher relative risk was recorded in 2019 while in 2021, residing in Keta, Abuakwa South, Jomoro, Ahafo Ano South East, Tain, Nanumba North, and Tatale Sanguli districts was associated with the highest malaria risk ranging from a relative risk of 3.00 to 4.83. The district-level spatial patterns of malaria risks changed over time. CONCLUSION: This study identified high malaria risk districts in Ghana where urgent and targeted control efforts are required. Noticeable changes were also observed in malaria risk for certain districts over some periods in the study. The findings provide an effective, actionable tool to arm policymakers and programme managers in their efforts to reduce malaria risk and its associated morbidity and mortality in line with the Sustainable Development Goals (SDG) 3.2 for limited public health resource settings, where universal intervention across all districts is practically impossible.


Assuntos
Malária , Masculino , Criança , Humanos , Gana/epidemiologia , Teorema de Bayes , Malária/epidemiologia , Serviços de Saúde , Risco
2.
Demography ; 61(3): 711-735, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38767569

RESUMO

Despite the persistence of relationships between historical racist violence and contemporary Black-White inequality, research indicates, in broad strokes, that the slavery-inequality relationship in the United States has changed over time. Identifying the timing of such change across states can offer insights into the underlying processes that generate Black-White inequality. In this study, we use integrated nested Laplace approximation models to simultaneously account for spatial and temporal features of panel data for Southern counties during the period spanning 1900 to 2018, in combination with data on the concentration of enslaved people from the 1860 census. Results provide the first evidence on the timing of changes in the slavery-economic inequality relationship and how changes differ across states. We find a region-wide decline in the magnitude of the slavery-inequality relationship by 1930, with declines traversing the South in a northeasterly-to-southwesterly pattern over the study period. Different paces in declines in the relationship across states suggest the expansion of institutionalized racism first in places with the longest-standing overt systems of slavery. Results provide guidance for further identifying intervening mechanisms-most centrally, the maturity of racial hierarchies and the associated diffusion of racial oppression across institutions, and how they affect the legacy of slavery in the United States.


Assuntos
Negro ou Afro-Americano , Escravização , Racismo , Fatores Socioeconômicos , Humanos , Escravização/história , Estados Unidos , Racismo/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , História do Século XX , Análise Espaço-Temporal , População Branca/estatística & dados numéricos , História do Século XXI , História do Século XIX , Pessoas Escravizadas/estatística & dados numéricos , Pessoas Escravizadas/história
3.
BMC Womens Health ; 24(1): 120, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360619

RESUMO

BACKGROUND: Despite the significant weight of difficulty, Ethiopia's survival rate and mortality predictors have not yet been identified. Finding out what influences outpatient breast cancer patients' survival time was the major goal of this study. METHODS: A retrospective study was conducted on outpatients with breast cancer. In order to accomplish the goal, 382 outpatients with breast cancer were included in the study using information obtained from the medical records of patients registered at the University of Gondar referral hospital in Gondar, Ethiopia, between May 15, 2016, and May 15, 2020. In order to compare survival functions, Kaplan-Meier plots and the log-rank test were used. The Cox-PH model and Bayesian parametric survival models were then used to examine the survival time of breast cancer outpatients. The use of integrated layered Laplace approximation techniques has been made. RESULTS: The study included 382 outpatients with breast cancer in total, and 148 (38.7%) patients died. 42 months was the estimated median patient survival time. The Bayesian Weibull accelerated failure time model was determined to be suitable using model selection criteria. Stage, grade 2, 3, and 4, co-morbid, histological type, FIGO stage, chemotherapy, metastatic number 1, 2, and >=3, and tumour size all have a sizable impact on the survival time of outpatients with breast cancer, according to the results of this model. The breast cancer outpatient survival time was correctly predicted by the Bayesian Weibull accelerated failure time model. CONCLUSIONS: Compared to high- and middle-income countries, the overall survival rate was lower. Notable variables influencing the length of survival following a breast cancer diagnosis were weight loss, invasive medullar histology, comorbid disease, a large tumour size, an increase in metastases, an increase in the International Federation of Gynaecologists and Obstetricians stage, an increase in grade, lymphatic vascular space invasion, positive regional nodes, and late stages of cancer. The authors advise that it is preferable to increase the number of early screening programmes and treatment centres for breast cancer and to work with the public media to raise knowledge of the disease's prevention, screening, and treatment choices.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/patologia , Teorema de Bayes , Estudos Retrospectivos , Etiópia/epidemiologia , Modelos de Riscos Proporcionais
4.
J Environ Manage ; 363: 121294, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38880600

RESUMO

The substantial threat of concurrent air pollutants to public health is increasingly severe under climate change. To identify the common drivers and extent of spatiotemporal similarity of PM2.5 and ozone (O3), this paper proposed a log Gaussian-Gumbel Bayesian hierarchical model allowing for sharing a stochastic partial differential equation and autoregressive model of order one (SPDE-AR(1)) spatiotemporal interaction structure. The proposed model, implemented by the approach of integrated nested Laplace approximation (INLA), outperforms in terms of estimation accuracy and prediction capacity for its increased parsimony and reduced uncertainty, especially for the shared O3 sub-model. Besides the consistently significant influence of temperature (positive), extreme drought (positive), fire burnt area (positive), gross domestic product (GDP) per capita (positive), and wind speed (negative) on both PM2.5 and O3, surface pressure and precipitation demonstrate positive associations with PM2.5 and O3, respectively. While population density relates to neither. In addition, our results demonstrate similar spatiotemporal interactions between PM2.5 and O3, indicating that the spatial and temporal variations of these pollutants show relatively considerable consistency in California. Finally, with the aid of the excursion function, we see that the areas around the intersection of San Luis Obispo and Santa Barbara counties are likely to exceed the unhealthy O3 level for USG simultaneously with other areas throughout the year. Our findings provide new insights for regional and seasonal strategies in the co-control of PM2.5 and O3. Our methodology is expected to be utilized when interest lies in multiple interrelated processes in the fields of environment and epidemiology.


Assuntos
Poluentes Atmosféricos , Monitoramento Ambiental , Ozônio , Material Particulado , Ozônio/análise , California , Material Particulado/análise , Poluentes Atmosféricos/análise , Teorema de Bayes , Análise Espaço-Temporal , Mudança Climática , Poluição do Ar
5.
J Environ Manage ; 349: 119518, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37944321

RESUMO

This forecasting approach may be useful for water managers and associated public health managers to predict near-term future high-risk cyanobacterial harmful algal blooms (cyanoHAB) occurrence. Freshwater cyanoHABs may grow to excessive concentrations and cause human, animal, and environmental health concerns in lakes and reservoirs. Knowledge of the timing and location of cyanoHAB events is important for water quality management of recreational and drinking water systems. No quantitative tool exists to forecast cyanoHABs across broad geographic scales and at regular intervals. Publicly available satellite monitoring has proven effective in detecting cyanobacteria biomass near-real time within the United States. Weekly cyanobacteria abundance was quantified from the Ocean and Land Colour Instrument (OLCI) onboard the Sentinel-3 satellite as the response variable. An Integrated Nested Laplace Approximation (INLA) hierarchical Bayesian spatiotemporal model was applied to forecast World Health Organization (WHO) recreation Alert Level 1 exceedance >12 µg L-1 chlorophyll-a with cyanobacteria dominance for 2192 satellite resolved lakes in the United States across nine climate zones. The INLA model was compared against support vector classifier and random forest machine learning models; and Dense Neural Network, Long Short-Term Memory (LSTM), Recurrent Neural Network (RNN), and Gneural Network (GNU) neural network models. Predictors were limited to data sources relevant to cyanobacterial growth, readily available on a weekly basis, and at the national scale for operational forecasting. Relevant predictors included water surface temperature, precipitation, and lake geomorphology. Overall, the INLA model outperformed the machine learning and neural network models with prediction accuracy of 90% with 88% sensitivity, 91% specificity, and 49% precision as demonstrated by training the model with data from 2017 through 2020 and independently assessing predictions with data from the 2021 calendar year. The probability of true positive responses was greater than false positive responses and the probability of true negative responses was less than false negative responses. This indicated the model correctly assigned lower probabilities of events when they didn't exceed the WHO Alert Level 1 threshold and assigned higher probabilities when events did exceed the threshold. The INLA model was robust to missing data and unbalanced sampling between waterbodies.


Assuntos
Cianobactérias , Proliferação Nociva de Algas , Estados Unidos , Humanos , Lagos/microbiologia , Teorema de Bayes , Cianobactérias/fisiologia , Qualidade da Água , Monitoramento Ambiental
6.
BMC Womens Health ; 23(1): 59, 2023 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-36765315

RESUMO

BACKGROUND: Cervical cancer is the 4th most common cancer in women worldwide. as well as the 4th most common cause of cancer-related death. The main objective of this study was to identify factors that affect the survival time of outpatients with cervical cancer. METHODS: A retrolective study including outpatients with cervical cancer was carried out in a hospital. To achieve the aim, 322 outpatients with cervical cancer were included in the study based on the data taken from the medical records of patients enrolled from May 15, 2018, to May 15, 2022, at the University of Gondar referral hospital, Gondar, Ethiopia. The Kaplan-Meier plots and log-rank test were used for the comparison of survival functions; the Cox-PH model and Bayesian parametric survival models were used to analyze the survival times of outpatients with cervical cancer. Integrated nested Laplace approximation methods have been applied. RESULTS: Out of a total of 322 patients, 118 (36.6%) died as outpatients. The estimated median survival time for patients was 42 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. According to the results of this model, oral contraceptive use, HIV, stage, grade, co-morbid disease, history of abortion, weight, histology type, FIGO stage, radiation, chemotherapy, LVSI, metastatic number, regional nodes examined, and tumor size all have a significant impact on the survival time of outpatients with cervical cancer. The Bayesian log-normal accelerated failure time model accurately predicted the survival time of cervical cancer outpatients. CONCLUSIONS: The findings of this study suggested that reductions in weight, treatment, the presence of comorbid disease, the presence of HIV, squamous cell histology type, having a history of abortion, oral contraceptive use, a large tumor size, an increase in the International Federation of Gynecologists and Obstetricians stage, an increase in metastasis number, an increase in grade, positive regional nodes, lymphatic vascular space invasion, and late stages of cancer all shortened the survival time of cervical cancer outpatients.


Assuntos
Infecções por HIV , Neoplasias do Colo do Útero , Humanos , Feminino , Prognóstico , Estadiamento de Neoplasias , Teorema de Bayes , Neoplasias do Colo do Útero/terapia , Neoplasias do Colo do Útero/patologia , Pacientes Ambulatoriais , Estudos Retrospectivos , Anticoncepcionais Orais/uso terapêutico
7.
BMC Public Health ; 23(1): 1400, 2023 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-37474891

RESUMO

BACKGROUND: Acute respiratory infections (ARI) in Cúcuta -Colombia, have a comparatively high burden of disease associated with high public health costs. However, little is known about the epidemiology of these diseases in the city and its distribution within suburban areas. This study addresses this gap by estimating and mapping the risk of ARI in Cúcuta and identifying the most relevant risk factors. METHODS: A spatial epidemiological analysis was designed to investigate the association of sociodemographic and environmental risk factors with the rate of ambulatory consultations of ARI in urban sections of Cúcuta, 2018. The ARI rate was calculated using a method for spatial estimation of disease rates. A Bayesian spatial model was implemented using the Integrated Nested Laplace Approximation approach and the Besag-York-Mollié specification. The risk of ARI per urban section and the hotspots of higher risk were also estimated and mapped. RESULTS: A higher risk of IRA was found in central, south, north and west areas of Cúcuta after adjusting for sociodemographic and environmental factors, and taking into consideration the spatial distribution of the city's urban sections. An increase of one unit in the percentage of population younger than 15 years; the Index of Multidimensional Poverty and the rate of ARI in the migrant population was associated with a 1.08 (1.06-1.1); 1.04 (1.01-1.08) and 1.25 (1.22-1.27) increase of the ARI rate, respectively. Twenty-four urban sections were identified as hotspots of risk in central, south, north and west areas in Cucuta. CONCLUSION: Sociodemographic factors and their spatial patterns are determinants of acute respiratory infections in Cúcuta. Bayesian spatial hierarchical models can be used to estimate and map the risk of these infections in suburban areas of large cities in Colombia. The methods of this study can be used globally to identify suburban areas and or specific communities at risk to support the implementation of prevention strategies and decision-making in the public and private health sectors.


Assuntos
Infecções Respiratórias , Humanos , Cidades , Colômbia/epidemiologia , Teorema de Bayes , Infecções Respiratórias/epidemiologia , Fatores de Risco
8.
Biom J ; 65(8): e2300096, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37890279

RESUMO

Short-term disease forecasting at specific discrete spatial resolutions has become a high-impact decision-support tool in health planning. However, when the number of areas is very large obtaining predictions can be computationally intensive or even unfeasible using standard spatiotemporal models. The purpose of this paper is to provide a method for short-term predictions in high-dimensional areal data based on a newly proposed "divide-and-conquer" approach. We assess the predictive performance of this method and other classical spatiotemporal models in a validation study that uses cancer mortality data for the 7907 municipalities of continental Spain. The new proposal outperforms traditional models in terms of mean absolute error, root mean square error, and interval score when forecasting cancer mortality 1, 2, and 3 years ahead. Models are implemented in a fully Bayesian framework using the well-known integrated nested Laplace estimation technique.


Assuntos
Neoplasias , Humanos , Teorema de Bayes , Previsões , Cidades , Neoplasias/epidemiologia
9.
Biom J ; 65(8): e2300078, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37740134

RESUMO

Measurement error (ME) and missing values in covariates are often unavoidable in disciplines that deal with data, and both problems have separately received considerable attention during the past decades. However, while most researchers are familiar with methods for treating missing data, accounting for ME in covariates of regression models is less common. In addition, ME and missing data are typically treated as two separate problems, despite practical and theoretical similarities. Here, we exploit the fact that missing data in a continuous covariate is an extreme case of classical ME, allowing us to use existing methodology that accounts for ME via a Bayesian framework that employs integrated nested Laplace approximations (INLA) and thus to simultaneously account for both ME and missing data in the same covariate. As a useful by-product, we present an approach to handle missing data in INLA since this corresponds to the special case when no ME is present. In addition, we show how to account for Berkson ME in the same framework. In its broadest generality, the proposed joint Bayesian framework can thus account for Berkson ME, classical ME, and missing data, or any combination of these in the same or different continuous covariates of the family of regression models that are feasible with INLA. The approach is exemplified using both simulated and real data. We provide extensive and fully reproducible Supporting Information with thoroughly documented examples using R-INLA and inlabru.


Assuntos
Teorema de Bayes
10.
Am Nat ; 199(1): E15-E27, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34978963

RESUMO

AbstractNesting in dense aggregations is common in central place foragers, such as group-living birds and insects. Both environmental heterogeneity and behavioral interactions are known to induce clustering of nests, but their relative importance remains unclear. We developed an individual-based model that simulated the spatial organization of nest building in a gregarious digger wasp, Bembix rostrata. This process-based model integrates environmental suitability, as derived from a microhabitat model, and relevant behavioral mechanisms related to local site fidelity and conspecific attraction. The drivers behind the nesting were determined by means of inverse modeling in which the emerging spatial and network patterns from simulations were compared with those observed in the field. Models with individual differences in behavior that include the simultaneous effect of a weak environmental cue and strong behavioral mechanisms yielded the best fit to the field data. The nest pattern formation of a central place foraging insect cannot be considered as the sum of environmental and behavioral mechanisms. We demonstrate the use of inverse modeling to understand complex processes that underlie nest aggregation in nature.


Assuntos
Comportamento de Nidação , Vespas , Animais , Aves
11.
Malar J ; 21(1): 311, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36320061

RESUMO

BACKGROUND/M&M: A vital aspect of disease management and policy making lies in the understanding of the universal distribution of diseases. Nevertheless, due to differences all-over host groups and space-time outbreak activities, data are subject to intricacies. Herein, Bayesian spatio-temporal models were proposed to model and map malaria and anaemia risk ratio in space and time as well as to ascertain risk factors related to these diseases and the most endemic states in Nigeria. Parameter estimation was performed by employing the R-integrated nested Laplace approximation (INLA) package and Deviance Information Criteria were applied to select the best model. RESULTS: In malaria, model 7 which basically suggests that previous trend of an event cannot account for future trend i.e., Interaction with one random time effect (random walk) has the least deviance. On the other hand, model 6 assumes that previous event can be used to predict future event i.e., (Interaction with one random time effect (ar1)) gave the least deviance in anaemia. DISCUSSION: For malaria and anaemia, models 7 and 6 were selected to model and map these diseases in Nigeria, because these models have the capacity to receive strength from adjacent states, in a manner that neighbouring states have the same risk. Changes in risk and clustering with a high record of these diseases among states in Nigeria was observed. However, despite these changes, the total risk of malaria and anaemia for 2010 and 2015 was unaffected. CONCLUSION: Notwithstanding the methods applied, this study will be valuable to the advancement of a spatio-temporal approach for analyzing malaria and anaemia risk in Nigeria.


Assuntos
Anemia , Malária , Criança , Humanos , Teorema de Bayes , Análise Espaço-Temporal , Modelos Estatísticos , Nigéria , Fatores de Risco
12.
Cereb Cortex ; 31(12): 5497-5510, 2021 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-34180523

RESUMO

Recent advances in neuroimaging have augmented numerous findings in the human reasoning process but have yielded varying results. One possibility for this inconsistency is that reasoning is such an intricate cognitive process, involving attention, memory, executive functions, symbolic processing, and fluid intelligence, whereby various brain regions are inevitably implicated in orchestrating the process. Therefore, researchers have used meta-analyses for a better understanding of neural mechanisms of reasoning. However, previous meta-analysis techniques include weaknesses such as an inadequate representation of the cortical surface's highly folded geometry. Accordingly, we developed a new meta-analysis method called Bayesian meta-analysis of the cortical surface (BMACS). BMACS offers a fast, accurate, and accessible inference of the spatial patterns of cognitive processes from peak brain activations across studies by applying spatial point processes to the cortical surface. Using BMACS, we found that the common pattern of activations from inductive and deductive reasoning was colocalized with the multiple-demand system, indicating that reasoning is a high-level convergence of complex cognitive processes. We hope surface-based meta-analysis will be facilitated by BMACS, bringing more profound knowledge of various cognitive processes.


Assuntos
Imageamento por Ressonância Magnética , Resolução de Problemas , Teorema de Bayes , Encéfalo , Humanos , Imageamento por Ressonância Magnética/métodos , Neuroimagem
13.
Environ Res ; 204(Pt D): 112388, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34808128

RESUMO

While most countries have networks of stations for monitoring pollutant concentrations, they do not cover the whole territory continuously. Therefore, to be able to carry out a spatial and temporal study, the predictions for air pollution from unmeasured sites and time periods need to be used. The objective of this study is to predict the air pollutant concentrations of PM10, O3, NO2, SO2 and CO in sites throughout Catalonia (Spain) and time periods without a monitoring station. Compositional data (CoDa) studies the relative importance of pollutants. A novel feature in this article is combining CoDa with an indicator of total pollution. Predictions are then made using a combination of spatio-temporal models and the Bayesian Laplace Integrated Approach (INLA) inference method. The most relevant results obtained indicate that the log-ratio between NO2 and O3 has the highest variance and the best predictive accuracy in time and space. Total pollution levels are second in variance but have low spatial predictive accuracy. Third in variance is the low temporal accuracy found in the log-ratio between SO2 and the remaining pollutants. Globally, the combination of CoDa and the INLA method is suitable for making effective spatio-temporal predictions of air pollutants.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Teorema de Bayes , Monitoramento Ambiental/métodos , Material Particulado/análise , Espanha
14.
BMC Public Health ; 22(1): 1779, 2022 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-36123680

RESUMO

BACKGROUND: Cholera is a diarrheal disease caused by infection of the intestine with the gram-negative bacteria Vibrio cholera. It is caused by the ingestion of food or water and infected all age groups. This study aimed at identifying risk factors associated with cholera disease in Ethiopia using the Bayesian hierarchical model. METHODS: The study was conducted in Ethiopia across regions and this study used secondary data obtained from the Ethiopian public health institute. Latent Gaussian models were used in this study; which is a group of models that contains most statistical models used in practice. The posterior marginal distribution of the Latent Gaussian models with different priors is determined by R-Integrated Nested Laplace Approximation. RESULTS: There were 2790 cholera patients in Ethiopia across the regions. There were 81.61% of patients are survived from cholera outbreak disease and the rest 18.39% have died. There was 39% variation across the region in Ethiopia. Latent Gaussian models including random and fixed effects with standard priors were the best model to fit the data based on deviance. The odds of surviving from cholera outbreak disease for inpatient status are 0.609 times less than the outpatient status. CONCLUSIONS: The authors conclude that the fitted latent Gaussian models indicate the predictor variables; admission status, aged between 15 and 44, another sick person in a family, dehydration status, oral rehydration salt, intravenous, and antibiotics were significantly associated with cholera outbreak disease.


Assuntos
Cólera , Adolescente , Adulto , Antibacterianos/uso terapêutico , Teorema de Bayes , Cólera/tratamento farmacológico , Cólera/epidemiologia , Etiópia/epidemiologia , Humanos , Água , Adulto Jovem
15.
BMC Public Health ; 22(1): 1309, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799159

RESUMO

BACKGROUND: Overweight and obesity are one of the most significant risk factors of the twenty-first century related to an increased risk in the occurrence of non-communicable diseases and associated increased healthcare costs. To estimate the future impact of overweight, the current study aimed to project the prevalence of overweight and obesity to the year 2030 in Belgium using a Bayesian age-period-cohort (APC) model, supporting policy planning. METHODS: Height and weight of 58,369 adults aged 18+ years, collected in six consecutive cross-sectional health interview surveys between 1997 and 2018, were evaluated. Criteria used for overweight and obesity were defined as body mass index (BMI) ≥ 25, and BMI ≥ 30. Past trends and projections were estimated with a Bayesian hierarchical APC model. RESULTS: The prevalence of overweight and obesity has increased between 1997 and 2018 in both men and women, whereby the highest prevalence was observed in the middle-aged group. It is likely that a further increase in the prevalence of obesity will be seen by 2030 with a probability of 84.1% for an increase in cases among men and 56.0% for an increase in cases among women. For overweight, it is likely to see an increase in cases in women (57.4%), while a steady state in cases among men is likely. A prevalence of 52.3% [21.2%; 83.2%] for overweight, and 27.6% [9.9%; 57.4%] for obesity will likely be achieved in 2030 among men. Among women, a prevalence of 49,1% [7,3%; 90,9%] for overweight, and 17,2% [2,5%; 61,8%] for obesity is most likely. CONCLUSIONS: Our projections show that the WHO target to halt obesity by 2025 will most likely not be achieved. There is an urgent necessity for policy makers to implement effective prevent policies and other strategies in people who are at risk for developing overweight and/or obesity.


Assuntos
Obesidade , Sobrepeso , Adulto , Teorema de Bayes , Bélgica/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência
16.
Biometrics ; 77(3): 785-795, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-32671828

RESUMO

A case-crossover analysis is used as a simple but powerful tool for estimating the effect of short-term environmental factors such as extreme temperatures or poor air quality on mortality. The environment on the day of each death is compared to the one or more "control days" in previous weeks, and higher levels of exposure on death days than control days provide evidence of an effect. Current state-of-the-art methodology and software (integrated nested Laplace approximation [INLA]) cannot be used to fit the most flexible case-crossover models to large datasets, because the likelihood for case-crossover models cannot be expressed in a manner compatible with this methodology. In this paper, we develop a flexible and scalable modeling framework for case-crossover models with linear and semiparametric effects which retains the flexibility and computational advantages of INLA. We apply our method to quantify nonlinear associations between mortality and extreme temperatures in India. An R package implementing our methods is publicly available.


Assuntos
Projetos de Pesquisa , Software , Teorema de Bayes , Modelos Estatísticos
17.
Value Health ; 24(2): 188-195, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33518025

RESUMO

OBJECTIVES: To measure access to opioid treatment programs (OTPs) and office-based buprenorphine treatment (OBBTs) at the smallest geographic unit for which the Census Bureau publishes demographic and socioeconomic data (ie, block group) and to explore disparities in access to treatment across the rural-urban and area deprivation continua across the United States. METHODS: Access to OTPs and OBBTs at the block group in 2019 was quantified using an innovative 2-step floating catchment area technique that accounts for the supply of treatment facilities relative to the population size, proximity of facilities relative to the location of population in block groups, and time as a barrier within catchments. Block groups were stratified into tertiles based on the rural-urban continuum codes (metropolitan, micropolitan, small town, or rural) and area deprivation index (least-deprived, middle-deprived, most-deprived). The Integrated Nested Laplace Approximation approach was used for statistical analysis. RESULTS: Across the United States, 3329 block groups corresponding to 2 915 949 adults lacked access to OTPs within a 2-hour drive of their community and 130 block groups corresponding to 86 605 adults did not have access to OBBTs. Disparities in access to treatment were observed across the urban-rural and area deprivation continua including (1) lowest mean access score to OBBTs were found among most-deprived small towns, and (2) lower mean access score to OTPs were found among micropolitan and small towns. CONCLUSIONS: The results of this study revealed disparities in access to medication-assisted treatment. The findings call for creative initiatives and local and regional policies to develop to mitigate access problems.


Assuntos
Buprenorfina/uso terapêutico , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Antagonistas de Entorpecentes/uso terapêutico , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Buprenorfina/administração & dosagem , Estudos Transversais , Acessibilidade aos Serviços de Saúde/economia , Humanos , Antagonistas de Entorpecentes/administração & dosagem , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Características de Residência , População Rural/estatística & dados numéricos , Análise de Pequenas Áreas , Fatores Socioeconômicos , Estados Unidos , População Urbana/estatística & dados numéricos
18.
Popul Health Metr ; 19(1): 27, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059063

RESUMO

BACKGROUND: The number of deaths attributable to COVID-19 in Spain has been highly controversial since it is problematic to tell apart deaths having COVID as the main cause from those provoked by the aggravation by the viral infection of other underlying health problems. In addition, overburdening of health system led to an increase in mortality due to the scarcity of adequate medical care, at the same time confinement measures could have contributed to the decrease in mortality from certain causes. Our aim is to compare the number of deaths observed in 2020 with the projection for the same period obtained from a sequence of previous years. Thus, this computed mortality excess could be considered as the real impact of the COVID-19 on the mortality rates. METHODS: The population was split into four age groups, namely: (< 50; 50-64; 65-74; 75 and over). For each one, a projection of the death numbers for the year 2020, based on the interval 2008-2020, was estimated using a Bayesian spatio-temporal model. In each one, spatial, sex, and year effects were included. In addition, a specific effect of the year 2020 was added ("outbreak"). Finally, the excess deaths in year 2020 were estimated as the count of observed deaths minus those projected. RESULTS: The projected death number for 2020 was 426,970 people, the actual count being 499,104; thus, the total excess of deaths was 72,134. However, this increase was very unequally distributed over the Spanish regions. CONCLUSION: Bayesian spatio-temporal models have proved to be a useful tool for estimating the impact of COVID-19 on mortality in Spain in 2020, making it possible to assess how the disease has affected different age groups accounting for effects of sex, spatial variation between regions and time trend over the last few years.


Assuntos
COVID-19/mortalidade , Causas de Morte , Pandemias , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Mortalidade/tendências , SARS-CoV-2 , Espanha/epidemiologia , Análise Espaço-Temporal
19.
Phytopathology ; 111(7): 1184-1192, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33231497

RESUMO

Circular leaf spot (CLS), caused by Plurivorosphaerella nawae, is a serious disease affecting persimmon (Diospyros kaki) that is characterized by necrotic lesions on leaves, defoliation, and fruit drop. Under Mediterranean conditions, P. nawae forms pseudothecia in the leaf litter in winter, and ascospores are released in spring, infecting susceptible leaves. Persimmon growers are advised to apply fungicides for CLS control during the period of inoculum availability, which was previously defined based on ascospore counts under the microscope. A model of inoculum availability of P. nawae was developed and evaluated as an alternative to ascospore counts. Leaf litter samples were collected weekly in L'Alcúdia (Spain) from 2010 to 2015. Leaves were soaked and placed in a wind tunnel, and the released ascospores of P. nawae were counted. Hierarchical Bayesian beta regression methods were used to model the dynamics of ascospore production in the leaf litter. The selected model included accumulated degree-days (ADDs) and ADDs taking into account the vapor pressure deficit (ADDvpd) as fixed effects and year as random effect. This model had a mean absolute error of 0.042 and a root mean square error of 0.062. The beta regression model was evaluated in four orchards from 2010 to 2015. Higher accuracy was obtained at the beginning and the end of the ascospore production period, which are the events of interest to schedule fungicide sprays for CLS control in Spain. This same modeling framework can be extended to other fungal plant pathogens whose inoculum dynamics are expressed as proportion data.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.


Assuntos
Diospyros , Ascomicetos , Teorema de Bayes , Frutas , Doenças das Plantas
20.
Entropy (Basel) ; 23(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33921077

RESUMO

We conduct a case study in which we empirically illustrate the performance of different classes of Bayesian inference methods to estimate stochastic volatility models. In particular, we consider how different particle filtering methods affect the variance of the estimated likelihood. We review and compare particle Markov Chain Monte Carlo (MCMC), RMHMC, fixed-form variational Bayes, and integrated nested Laplace approximation to estimate the posterior distribution of the parameters. Additionally, we conduct the review from the point of view of whether these methods are (1) easily adaptable to different model specifications; (2) adaptable to higher dimensions of the model in a straightforward way; (3) feasible in the multivariate case. We show that when using the stochastic volatility model for methods comparison, various data-generating processes have to be considered to make a fair assessment of the methods. Finally, we present a challenging specification of the multivariate stochastic volatility model, which is rarely used to illustrate the methods but constitutes an important practical application.

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