Two-stage algorithms for visually exploring spatio-temporal clustering of avian influenza virus outbreaks in poultry farms

The development of visual tools for the timely identification of spatio-temporal clusters will assist in implementing control measures to prevent further damage. From January 2015 to June 2020, a total number of 1463 avian influenza outbreak farms were detected in Taiwan and further confirmed to be affected by highly pathogenic avian influenza subtype H5Nx. In this study, we adopted two common concepts of spatio-temporal clustering methods, the Knox test and scan statistics, with visual tools to explore the dynamic changes of clustering patterns. Since most (68.6%) of the outbreak farms were detected in 2015, only the data from 2015 was used in this study. The first two-stage algorithm performs the Knox test, which established a threshold of 7 days and identified 11 major clusters in the six counties of southwestern Taiwan, followed by the standard deviational ellipse (SDE) method implemented on each cluster to reveal the transmission direction. The second algorithm applies scan likelihood ratio statistics followed by AGC index to visualize the dynamic changes of the local aggregation pattern of disease clusters at the regional level. Compared to the one-stage aggregation approach, Knox-based and AGC mapping were more sensitive in small-scale spatio-temporal clustering.

Spatiotemporal analysis and the characteristics of the case transmission network of 2019 novel coronavirus disease (COVID-19) in Zhejiang Province, China

Background Zhejiang Province is one of the five provinces in China that had the highest incidence of novel coronavirus disease (COVID-19). Zhejiang, ranked fourth highest in COVID-19 incidence, is located in the Yangtze River Delta region of southeast China. This study was undertaken to identify the space-time characteristics of COVID-19 in Zhejiang. Methods Data on COVID-19 cases in Zhejiang Province from January to July 2020 were obtained from this network system. Individual information on cases and deaths was imported, and surveillance information, including demographic characteristics and geographic and temporal distributions, was computed by the system. The Knox test was used to identify possible space-time interactions to test whether cases that are close in distance were also close in time. Network analysis was performed to determine the relationship among the cases in a transmission community and to try to identify the key nodes. Results In total, 1475 COVID-19 cases and 1 fatal case were reported from January to July 2020 in Zhejiang Province, China. Most of the cases occurred before February 15th, which accounted for 90.10%. The imported cases increased and became the main risk in Zhejiang Province after February 2020. The risk areas showed strong heterogeneity according to the Knox test. The areas at short distances within 1 kilometer and at brief periods within 5 days presented relatively high risk. The numbers of subcommunities for the four clusters were 12, 9, 6 and 4. There was obvious heterogeneity in the modularity of subcommunities. The maximum values of the node centrality for the four clusters were 2.9474, 4.3706, 4.1080 and 2.7500. Conclusions COVID-19 was brought under control over a short period in Zhejiang Province. Imported infections from outside of mainland China then became a new challenge. The effects of spatiotemporal interaction exhibited interval heterogeneity. The characteristics of transmission showed short range and short term risks. The importance to the cluster of each case was detected, and the key patients were identified. It is suggested that we should focus on key patients in complex conditions and in situations with limited control resources.

A modified two-process Knox test for investigating the relationship between law enforcement opioid seizures and overdoses

Recent research has shown an association between monthly law enforcement drug seizure events and accidental drug overdose deaths using cross-sectional data in a single state, whereby increased seizures correlated with more deaths. In this study, we conduct statistical analysis of street-level data on law enforcement drug seizures, along with street-level data on fatal and non-fatal overdose events, to determine possible micro-level causal associations between opioid-related drug seizures and overdoses. For this purpose, we introduce a novel, modified two-process Knox test that controls for self-excitation to measure clustering of overdoses nearby in space and time following law enforcement seizures. We observe a small, but statistically significant ( p < 0.001), effect of 17.7 excess non-fatal overdoses per 1000 law enforcement seizures within three weeks and 250 m of a seizure. We discuss the potential causal mechanism for this association along with policy implications.

Unraveling Urban Form and Collision Risk: The Spatial Distribution of Traffic Accidents in Zanjan, Iran

Official statistics demonstrate the role of traffic accidents in the increasing number of fatalities, especially in emerging countries. In recent decades, the rate of deaths and injuries caused by traffic accidents in Iran, a rapidly growing economy in the Middle East, has risen significantly with respect to that of neighboring countries. The present study illustrates an exploratory spatial analysis’ framework aimed at identifying and ranking hazardous locations for traffic accidents in Zanjan, one of the most populous and dense cities in Iran. This framework quantifies the spatiotemporal association among collisions, by comparing the results of different approaches (including Kernel Density Estimation (KDE), Natural Breaks Classification (NBC), and Knox test). Based on descriptive statistics, five distance classes (2–26, 27–57, 58–105, 106–192, and 193–364 meters) were tested when predicting location of the nearest collision within the same temporal unit. The empirical results of our work demonstrate that the largest roads and intersections in Zanjan had a significantly higher frequency of traffic accidents than the other locations. A comparative analysis of distance bandwidths indicates that the first (2–26 m) class concentrated the most intense level of spatiotemporal association among traffic accidents. Prevention (or reduction) of traffic accidents may benefit from automatic identification and classification of the most risky locations in urban areas. Thanks to the larger availability of open-access datasets reporting the location and characteristics of car accidents in both advanced countries and emerging economies, our study demonstrates the potential of an integrated analysis of the level of spatiotemporal association in traffic collisions over metropolitan regions.

Adjusting the Knox test by accounting for spatio-temporal crime risk heterogeneity to analyse near-repeats

The near-repeat phenomenon usually occurs with any crime. Hence, to implement preventive measures, it is of great interest to figure out at which spatio-temporal scale crimes are more likely to be repeated by offenders. The Knox test is the most used statistical tool for evaluating the presence of the near-repeat phenomenon given a dataset of crimes that are located in space and time. The classic version of this test assumes that crime risk is homogeneous in both space and time, although this assumption rarely holds in reality. Therefore, the main goal of this article is to highlight the necessity of adjusting the standard version of the Knox test, including spatial and temporal effects that allow for the consideration of crime risk heterogeneity. In this regard, a methodology that has already been proposed for addressing this issue is described and adapted. This methodology is then put into practice through a dataset of burglaries recorded in the city of Valencia (Spain) in 2016 and 2017. The results yielded by both versions (standard and adjusted) of the Knox test confirm that the near-repeat phenomenon took place for the burglaries that occurred in Valencia during the period under investigation. However, using the adjusted version of the Knox test leads to a reduction in the number of spatio-temporal intervals that are declared as statistically significant. This fact should be born in mind before making decisions on preventive measures.

Spatiotemporal clustering of in-hospital Clostridioides difficile infection

Objective:To determine whether Clostridioides difficile infection (CDI) exhibits spatiotemporal interaction and clustering.Design:Retrospective observational study.Setting:The University of Iowa Hospitals and Clinics.Patients:This study included 1,963 CDI cases, January 2005 through December 2011.Methods:We extracted location and time information for each case and ran the Knox, Mantel, and mean and maximum component size tests for time thresholds (T = 7, 14, and 21 days) and distance thresholds (D = 2, 3, 4, and 5 units; 1 unit = 5–6 m). All tests were implemented using Monte Carlo simulations, and random CDI cases were constructed by randomly permuting times of CDI cases 20,000 times. As a counterfactual, we repeated all tests on 790 aspiration pneumonia cases because aspiration pneumonia is a complication without environmental factors.Results:Results from the Knox test and mean component size test rejected the null hypothesis of no spatiotemporal interaction (P < .0001), for all values of T and D. Results from the Mantel test also rejected the hypothesis of no spatiotemporal interaction (P < .0003). The same tests showed no such effects for aspiration pneumonia. Our results from the maximum component size tests showed similar trends, but they were not consistently significant, possibly because CDI outbreaks attributable to the environment were relatively small.Conclusion:Our results clearly show spatiotemporal interaction and clustering among CDI cases and none whatsoever for aspiration pneumonia cases. These results strongly suggest that environmental factors play a role in the onset of some CDI cases. However, our results are not inconsistent with the possibility that many genetically unrelated CDI cases occurred during the study period.