Spatial distribution of Echinolitorina peruviana (Lamarck, 1882) for intertidal rocky shore in Antofagasta (23° S, Chile).

The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.

Who meets national early childhood sleep guidelines in Aotearoa New Zealand? A cross-sectional and longitudinal analysis

Study Objectives To investigate the proportion of children in Aotearoa New Zealand (NZ) who do or do not meet sleep duration and sleep quality guidelines at 24 and 45 months of age and associated sociodemographic factors. Methods Participants were children (n=6,490) from the Growing Up in New Zealand longitudinal study of child development with sleep data available at 24 and/or 45 months of age (48.2% girls, 51.8% boys; 22.4% Māori [the Indigenous people of NZ], 12.9% Pacific, 13.4% Asian, 45.2% European/Other). Relationships between sociodemographic factors and maternally-reported child sleep duration (across 24 hours) and night wakings were investigated cross-sectionally and longitudinally. Estimates of children in NZ meeting sleep guidelines were calculated using a range of analytical techniques including Bayesian linear regression, negative binomial multiple regression, and growth curve models. Results In NZ, 29.8% and 19.5% of children were estimated to have a high probability of not meeting sleep duration guidelines and 15.4% and 8.3% were estimated to have a high probability of not meeting night waking guidelines at 24 and 45 months respectively, after controlling for multiple sociodemographic variables. Factors associated cross-sectionally with children’s sleep included ethnicity, socioeconomic deprivation, material standard of living, rurality and heavy traffic, and longitudinal sleep trajectories differed by gender, ethnicity and socioeconomic deprivation. Conclusions A considerable proportion of young children in NZ have a high probability of not meeting sleep guidelines but this declines across the ages of 24 and 45 months. Sleep health inequities exist as early as 24 months of age in NZ.

Waning COVID-19 Vaccine Effectiveness for BNT162b2 and CoronaVac in Malaysia: An Observational Study

Evaluation of vaccine effectiveness over time against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) is important. Evidence on effectiveness over time for the CoronaVac vaccine is lacking despite its widespread use globally. In Malaysia, a diverse set-up of COVID-19 vaccines was rolled out nationwide, and the waning of vaccine protection is a concern. We aimed to investigate and compare waning vaccine effectiveness against COVID-19 infections, COVID-19 related ICU admission and COVID-19 related deaths for BNT162b2 and CoronaVac vaccines. In this observational study, we consolidated nationally representative data on COVID-19 vaccination and patients′ outcomes. Data on all confirmed COVID-19 cases from 1 to 30 September 2021 were used to compare vaccine effectiveness between the ′early′ group (fully vaccinated in April to June 2021) and the ′late′ group (fully vaccinated in Jul to Aug 2021). We used a negative binomial regression model to estimate vaccine effectiveness against COVID-19 infections for both ′early′ and ′late′ groups, by comparing the rates of infection for individuals vaccinated in the two different periods relative to the unvaccinated. Among confirmed COVID-19 cases, we used logistic regression to estimate and compare vaccine effectiveness against ICU admission and deaths between the two different periods. For BNT162b2, vaccine effectiveness against COVID-19 infections declined from 90.8% (95% CI 89.4, 92.0) in the late group to 79.1% (95% CI 75.8, 81.9) in the late group. Vaccine effectiveness for BNT162b2 against ICU admission and deaths were comparable between the two different periods. For CoronaVac, vaccine effectiveness waned against COVID-19 infections from 74.4% in the late group (95% CI 209 70.4, 77.8) to 30.0% (95% CI 18.4, 39.9) in the early group. It also declined significantly against ICU admission, dropping from 56.1% (95% CI 51.4, 60.2) to 29.9% (95% CI 13.9, 43.0). For deaths, however, CoronaVac′s effectiveness did not wane after three to five months of full vaccination. Vaccine effectiveness against COVID-19 infections waned after three to five months of full vaccination for both BNT162b2 and CoronaVac in Malaysia. Additionally, for CoronaVac, protection against ICU admission declined as well. Evidence on vaccine effectiveness over time informs evolving policy decisions on vaccination.

Comparison of Different Count Models for Investigation of Some Environmental Factors Affecting Stillbirth in Holsteins

Background: The objective of this study is comparing different count data models for stillbirth data. In modeling this type of data, Poisson regression or alternative models can be preferred. Methods: The poisson, negative binomial, zero-inflated poisson, zero-inflated negative binomial, poisson-logit hurdle and negative binomial-logit hurdle regressions were compared and used to examine the effects of the gender, parity and herd-year-season independent variables on stillbirth. Furthermore, the Log-Likelihood statistics, Akaike Information Criteria, Bayesian Information Criteria and rootogram graphs were used as comparison criteria for performance of the models. According to these criteria, Negative Binomial-Logit Hurdle Regression model was chosen as the best model. Result: The parameter estimates obtained by Negative Binomial-Logit Hurdle Regression model in relation to the effects of the gender, parity and herd-year-season independent variables on stillbirth were found to be significant (p less than 0.01). It was found that while stillbirth incidence was higher in males than females, it was found to decrease as the parity increased. As a result, the Negative Binomial Logit Hurdle model was found the best model for stillbirth count data with overdispersion.

PERBANDINGAN MODEL REGRESI BINOMIAL NEGATIF BIVARIAT DENGAN MODEL GEOGRAPHICALLY WEIGHTED NEGATIVE BINOMIAL BIVARIAT REGRESSION (GWNBBR) PADA KASUS ANGKA KEMATIAN BAYI DAN KEMATIAN IBU DI JAWA TENGAH

Infant mortality (0-11 months) and maternal mortality (during pregnancy, childbirth, and postpartum) are significant indicators in determining the level of public health. Central Java Province which has 35 regencies/cities is included in the top five regions with the highest number of infant and maternal mortality in Indonesia. The data characteristics of the number of infants and maternal mortality are count data. Therefore, the Poisson Regression method can be used to analyze the factors that influence the number of infants and maternal mortality. In Poisson regression analysis, there must be a fulfilled assumption, called equidispersion. Frequently, the variance of count data is greater than the mean, which is known as the overdispersion. The research, binomial negative bivariate regression is used as a solutions to overcome the problem of overdispersion in poisson regression. This method produce a global model. In reality, the geographical, socio-cultural, and economic conditions of each region will be different. This illustrates the effect of spatial heterogeneity, so it needs to be developed into Geographically Weighted Negative Binomial Bivariate Regression (GWNBBR). The model of GWNBBR provides weighting based on the position or distance from one observation area to another. Significant variables for modeling infant mortality cases included the percentage of obstetric complications treated (X1), the percentage of infants who were exclusively breastfed (X3), and the percentage of poor people (X5). Significant variable for modeling maternal mortality cases is the percentage of poor people (X5). Based on the AIC value, GWNBBR model is better than binomial negatif bivariat regression model because it has a smaller AIC value.

Price elasticity of demand for new and recurring opioid prescriptions

Objective: Several U.S. states have recently enacted excise taxes to curb prescription opioid use and other states are considering similar measures. We assessed the effects of increasing out-of-pocket costs (OPC) on new and recurring opioid fills. Methods: We conducted a retrospective cohort study of opioid-naive individuals presenting with acute back pain using data from a nationwide claims repository. We estimated the effect of OPC on the initiation of opioid treatment in logistic regressions, controlling for socio-demographics, medical history, healthcare utilization, insurance type, and region. With the same covariates plus morphine milligram equivalents and days supplied, we estimated the effect of OPC on the number of opioid fills in negative binomial regressions. We report the price elasticity of demand (PED) for prescription opioids, defined as the percentage change in outcome resulting from a two-fold increase in OPC. Results: Of 25,531 adults diagnosed with acute back pain in Q1 of 2018, 2,451 (9.6%) filled at least one opioid prescription. In multivariable regression, the association between OPC and initiating opioid treatment was not significant (PED= -1.9%; 95% CI: -5.5%, 1.7%). However, by region, the PED was -10.3% (95% CI: -18.1%, -2.4%) in the coastal states and 1.6% (95% CI: -2.5%, 5.7%) in the central-southern states. The PED for the number of prescription fills was -3.7% (95% CI: -7.3%, -0.1%), which also differed by region. In the coastal states, the PED was -15.2% (95% CI: -24.7%, -5.7%) and in the central-southern states -1.5% (95% CI: -5.4%, 2.4%). Conclusions: Opioid fills were price sensitive in the coastal states but not in the central-southern states. Policies that would increase OPC might have a restraining effect on opioid consumption in parts, but not all of the U.S.

Rural-Urban Differences in Diagnosed Cervical Artery Dissection in New York State

<b><i>Background:</i></b> Cervical artery dissection (CeAD) is a leading cause of stroke in young adults. Incidence estimates may be limited by under- or overdiagnosis. <b><i>Objective:</i></b> We aimed to investigate if CeAD diagnosis would be higher in urban centers compared to rural regions of New York State (NYS). <b><i>Methods:</i></b> For this ecological study, administrative codes were used to identify CeAD discharges in the NYS Statewide Planning and Research Cooperative System (SPARCS) from 2009 to 2014. Rural Urban Commuting Area (RUCA) codes were taken from the US Department of Agriculture and included the classifications metropolitan, micropolitan, small town, and rural. Negative binomial models were used to calculate effect estimates and 95% confidence limits (e^β; 95% CL) for the association between RUCA classification and the number of dissections per ZIP code. Models were further adjusted by population. <b><i>Results:</i></b> Population information was obtained from the US Census Bureau on 1,797 NYS ZIP codes (70.7% of NYS ZIP codes), 826 of which had at least 1 CeAD-related discharge from 2009 to 2014. Nonrural ZIP codes were more likely to report more CeAD cases relative to rural areas even after adjusting for population (metropolitan effect = e^β 5.00; 95% CI: 3.75–6.66; micropolitan effect 3.02; 95% CI: 2.16–4.23; small town effect 2.34; 95% CI: 1.58–3.47). <b><i>Conclusions:</i></b> CeAD diagnosis correlates with population density as defined by rural-urban status. Our results could be due to underdiagnosis in rural areas or overdiagnosis with increasing urbanicity.

Beyond Reassurance: The Reputational Effect of Cultural Reforms in Peace Agreements

We explore whether including cultural reforms in an intra-state peace accord facilitates its success. We distinguish between accommodationist and integrationist cultural provisions and employ a mixed research method combining negative binomial regression on a data set of all intra-state political agreements concluded between 1989 and 2017, and an in-depth analysis of the 1998 Good Friday Agreement for Northern Ireland. We recognize the important reassuring effect of accommodationist cultural reforms in separatist conflicts. However, we also find that they have an important and hitherto overlooked reputational effect across all conflict types. By enhancing the reputation of negotiating leaders, accommodationist cultural provisions contribute to ending violence by preventing leadership challenges, rebel fragmentation and remobilization across all civil conflicts. By the same logic, and despite the overwhelming emphasis of peace agreements on integrationist cultural initiatives, integrationist cultural reforms problematize leaders' ability to commit to pacts and to ensure compliance among their rank and file.

Disease-Modifying Drug Uptake and Health Service Use in the Ageing MS Population

BackgroundEvidence regarding the efficacy or effectiveness of the disease-modifying drugs (DMDs) in the older multiple sclerosis (MS) population is scarce. This has contributed to a lack of evidence-based treatment recommendations for the ageing MS population in practice guidelines. We examined the relationship between age (&lt;55 and ≥55 years), DMD exposure and health service use in the MS population.MethodsWe conducted a population-based observational study using linked administrative health data from British Columbia, Canada. We selected all persons with MS and followed from the most recent of their first MS or demyelinating event, 18th birthday or 01-January-1996 (index date) until the earliest of emigration, death or 31-December-2017 (study end). We assessed DMD exposure status over time, initially as any versus no DMD, then by generation (first or second) and finally by each individual DMD. Age-specific analyses were conducted with all-cause hospitalizations and number of physician visits assessed using proportional means model and negative binomial regression with generalized estimating equations.ResultsWe included 19,360 persons with MS (72% were women); 10,741/19,360 (56%) had ever reached their 55th birthday. Person-years of follow-up whilst aged &lt;55 was 132,283, and 93,594 whilst aged ≥55. Any DMD, versus no DMD in the &lt;55-year-olds was associated with a 23% lower hazard of hospitalization (adjusted hazard ratio, aHR0.77; 95%CI 0.72-0.82), but not in the ≥55-year-olds (aHR0.95; 95%CI 0.87-1.04). Similar patterns were observed for the first and second generation DMDs. Exposure to any (versus no) DMD was not associated with rates of physician visits in either age group (&lt;55 years: adjusted rate ratio, aRR1.02; 95%CI 1.00-1.04 and ≥55 years: aRR1.00; 95%CI 0.96-1.03), but variation in aRR was observed across the individual DMDs.ConclusionOur study showed beneficial effects of the DMDs used to treat MS on hospitalizations for those aged &lt;55 at the time of exposure. In contrast, for individuals ≥55 years of age exposed to a DMD, the hazard of hospitalization was not significantly lowered. Our study contributes to the broader understanding of the potential benefits and risks of DMD use in the ageing MS population.

National Hospitalization Trends and the Role of Preventable Hospitalizations among Centenarians in the United States (2000–2009)

Increases in life expectancy mean that an unprecedented number of individuals are reaching centenarian status, often with complex health concerns. We analyzed nationally representative hospital admissions data (200–2009) from the National Inpatient Study (NIS) for 52,618 centenarians (aged 100–115 years, mean age 101.4). We predicted length of stay (LOS) via negative binomial models and total inflation adjusted costs via fixed effects regression analysis informed by descriptive data. We also identified hospitalizations due to ambulatory care-sensitive conditions defined by AHRQ Prevention Quality Indicators. Mean LOS decreased from 6.1 to 5.1 days, while over the same time period the mean total adjusted charges rose from USD 13,373 to USD 25,026 in 2009 dollars. Black, Hispanic, Asian, or other race centenarians had higher cost stays compared to White, but only Black and Hispanic centenarians had significantly greater mean length of stay. Comorbidities predicted greater length of stay and higher costs. Centenarians admitted on weekends had higher costs but shorter length of stay. In total, 29.4% of total costs were due to potentially preventable hospitalizations for total charges (2000–2009) of USD 341.8M in 2009 dollars. Centenarian hospitalizations cost significantly more than hospitalization for any other group of elderly in the U.S.