A method for small-area estimation of population mortality in settings affected by crises

Background Populations affected by crises (armed conflict, food insecurity, natural disasters) are poorly covered by demographic surveillance. As such, crisis-wide estimation of population mortality is extremely challenging, resulting in a lack of evidence to inform humanitarian response and conflict resolution. Methods We describe here a ‘small-area estimation’ method to circumvent these data gaps and quantify both total and excess (i.e. crisis-attributable) death rates and tolls, both overall and for granular geographic (e.g. district) and time (e.g. month) strata. The method is based on analysis of data previously collected by national and humanitarian actors, including ground survey observations of mortality, displacement-adjusted population denominators and datasets of variables that may predict the death rate. We describe the six sequential steps required for the method’s implementation and illustrate its recent application in Somalia, South Sudan and northeast Nigeria, based on a generic set of analysis scripts. Results Descriptive analysis of ground survey data reveals informative patterns, e.g. concerning the contribution of injuries to overall mortality, or household net migration. Despite some data sparsity, for each crisis that we have applied the method to thus far, available predictor data allow the specification of reasonably predictive mixed effects models of crude and under 5 years death rate, validated using cross-validation. Assumptions about values of the predictors in the absence of a crisis provide counterfactual and excess mortality estimates. Conclusions The method enables retrospective estimation of crisis-attributable mortality with considerable geographic and period stratification, and can therefore contribute to better understanding and historical memorialisation of the public health effects of crises. We discuss key limitations and areas for further development.

Thermodynamic formalism for quantum channels: Entropy, pressure, Gibbs channels and generic properties

Denote [Formula: see text] the set of complex [Formula: see text] by [Formula: see text] matrices. We will analyze here quantum channels [Formula: see text] of the following kind: given a measurable function [Formula: see text] and the measure [Formula: see text] on [Formula: see text] we define the linear operator [Formula: see text], via the expression [Formula: see text]. A recent paper by T. Benoist, M. Fraas, Y. Pautrat, and C. Pellegrini is our starting point. They considered the case where [Formula: see text] was the identity. Under some mild assumptions on the quantum channel [Formula: see text] we analyze the eigenvalue property for [Formula: see text] and we define entropy for such channel. For a fixed [Formula: see text] (the a priori measure) and for a given a Hamiltonian [Formula: see text] we present a version of the Ruelle Theorem: a variational principle of pressure (associated to such [Formula: see text]) related to an eigenvalue problem for the Ruelle operator. We introduce the concept of Gibbs channel. We also show that for a fixed [Formula: see text] (with more than one point in the support) the set of [Formula: see text] such that it is [Formula: see text]-Erg (also irreducible) for [Formula: see text] is a generic set. We describe a related process [Formula: see text], [Formula: see text], taking values on the projective space [Formula: see text] and analyze the question of the existence of invariant probabilities. We also consider an associated process [Formula: see text], [Formula: see text], with values on [Formula: see text] ([Formula: see text] is the set of density operators). Via the barycenter, we associate the invariant probability mentioned above with the density operator fixed for [Formula: see text].

Common patient-reported outcomes across ICHOM Standard Sets: the potential contribution of PROMIS®

Background The International Consortium for Health Outcomes Measurement (ICHOM) develops condition-specific Standard Sets of outcomes to be measured in clinical practice for value-based healthcare evaluation. Standard Sets are developed by different working groups, which is inefficient and may lead to inconsistencies in selected PROs and PROMs. We aimed to identify common PROs across ICHOM Standard Sets and examined to what extend these PROs can be measured with a generic set of PROMs: the Patient-Reported Outcomes Measurement Information System (PROMIS®). Methods We extracted all PROs and recommended PROMs from 39 ICHOM Standard Sets. Similar PROs were categorized into unique PRO concepts. We examined which of these PRO concepts can be measured with PROMIS. Results A total of 307 PROs were identified in 39 ICHOM Standard Sets and 114 unique PROMs are recommended for measuring these PROs. The 307 PROs could be categorized into 22 unique PRO concepts. More than half (17/22) of these PRO concepts (covering about 75% of the PROs and 75% of the PROMs) can be measured with a PROMIS measure. Conclusion Considerable overlap was found in PROs across ICHOM Standard Sets, and large differences in terminology used and PROMs recommended, even for the same PROs. We recommend a more universal and standardized approach to the selection of PROs and PROMs. Such an approach, focusing on a set of core PROs for all patients, measured with a system like PROMIS, may provide more opportunities for patient-centered care and facilitate the uptake of Standard Sets in clinical practice.

A Method for Small-Area Estimation of Population Mortality in Settings Affected by Crises

Background Populations affected by crises (armed conflict, food insecurity, natural disaster) are poorly covered by demographic surveillance. As such, crisis-wide estimation of population mortality is extremely challenging, resulting in a lack of evidence to inform humanitarian response and conflict resolution. Methods We describe here a ‘small-area estimation’ method to circumvent these data gaps and quantify both total and excess (i.e. crisis-attributable) death rates and tolls, both overall and for granular geographic (e.g. district) and time (e.g. month) strata. The method is based on analysis of data previously collected by national and humanitarian actors, including ground survey observations of mortality, displacement-adjusted population denominators and datasets of variables that may predict the death rate. We describe the six sequential steps required for the method’s implementation and illustrate its recent application in Somalia, South Sudan and northeast Nigeria, based on a generic set of analysis scripts. Results Descriptive analysis of ground survey data reveals informative patterns, e.g. concerning the contribution of injuries to overall mortality, or household net migration. Despite some data sparsity, for each crisis we have used the method in thus far, available predictor data allow the specification of reasonably predictive mixed effects models of crude and under 5 years death rate, validated using cross-validation. Assumptions about values of the predictors in the absence of a crisis provide counterfactual and excess mortality estimates. Conclusions The method enables retrospective estimation of crisis-attributable mortality with considerable geographic and period stratification, and can therefore contribute to better understanding and historical memorialisation of the public health effects of crises. We discuss key limitations and areas for further development.

Generic solving of one-compartment toxicokinetic models

This paper gives the full analytical solution of the generic set of ordinary differential equations that define one-compartment toxicokinetic models. These models describe uptake and elimination processes taking place within living organisms when exposed to chemical substances. The models solved in this paper consider living organisms as a unique compartment, into which a parent compound enters via several possible exposure routes and from which it is eliminated as well as its potential metabolites. Benefiting from generic solutions of one-compartment toxicokinetic models is particularly useful when fitting them to experimental data, facilitating the writing of the inference algorithms leading to parameter estimates. Additionally, these models are of crucial interest in environmental risk assessment for the calculation of bioaccumulation metrics as required by regulators in support of decision making when they evaluate dossiers for marketing authorisation of active substances.

Text-setting in Kaytetye

Singing is a universal human activity. Across the vast range of song traditions throughout the world, native speakers have consistent intuitions about how the syllables in a given line of song text should be set to the tunes and/or rhythms within their various song traditions. This paper presents an Optimality Theoretic analysis of text-setting in a set of ceremonial songs traditionally sung and passed on orally by groups of Kaytetye-speaking women in Central Australia. Australian Aboriginal songs are renowned for the degree to which they diverge from speech. For our analysis, we use a computational method to exhaustively generate all permitted ways sung forms may diverge from their spoken equivalents along with all possible ways each form may be set to rhythm. We show that the seemingly idiosyncratic nature of text-setting strategies in this song set can be accounted for through a relatively generic set of constraints (even when thousands of competing candidates are considered), reflecting many of the fundamental processes that govern the interaction of language, meter, and music.

A Systematic Review on Inclusive Education of Students with Visual Impairment

This was a systematic review on the inclusive education of students with visual impairment. This study focused on two of the most addressed topics: the perceptions of general education teachers and challenges faced by students with visual impairment in accessing academic subjects. It synthesized the findings of 18 peer-reviewed articles published in English from 1980 to 2020. General education teachers’ attitudes toward the inclusion of students with visual impairment were both positive and negative and were influenced by teacher-, student-, and environment-related factors. Feeling unprepared, one of the main teacher-related factors, seemed to have a great effect. In terms of access to academic subjects, the most discussed subjects were Mathematics, Science, and Physical Education. Although students with visual impairment seemed to be studying at or above their grade level, their exclusion from participation in classroom activities was apparent. Unfortunately, these challenges lead to short- and long-term consequences. Key elements in increasing accessibility to subjects were: general education teachers possessing a generic set of effective pedagogical strategies, effective teaching-learning tools, and external support. The importance of teacher training and a holistic support system were emphasized.

Estimation of Lens Stray Light with Regard to the Incapacitation of Imaging Sensors

We present our efforts on estimating light scattering characteristics from commercial off-the-shelf (COTS) camera lenses in order to deduce thereof a set of generic scattering parameters valid for a specific lens class (double Gauss lenses). In previous investigations, we developed a simplified theoretical light scattering model to estimate the irradiance distribution in the focal plane of a camera lens. This theoretical model is based on a 3-parameter bidirectional scattering distribution function (BSDF), which describes light scattering from rough surfaces of the optical elements. Ordinarily, the three scatter parameters of the BSDF are not known for COTS camera lenses, which makes it necessary to assess them by own experiments. Besides the experimental setup and the measurement process, we present in detail the subsequent data exploitation. From measurements on seven COTS camera lenses, we deduced a generic set of scatter parameters. For a deeper analysis, the results of our measurements have also been compared with the output of an optical engineering software. Together with our theoretical model, now stray light calculations can be accomplished even then, when specific scatter parameters are not available from elsewhere. In addition, the light scattering analyses also allow considering the glare vulnerability of optical systems in terms of laser safety.

Is the EU ready for a generic set of indicators for health system performance? A qualitative study

Background As part of the EU funded BRIDGE Health project, 23 headline indicators for assessing and comparing the performance of public health systems were proposed. They were shortlisted out of the currently existing and often overlapping pool of over 2000 health system performance assessment (HSPA) indicators. In this qualitative study, we explored their validity and perceived national-level utility for policy making and factors affecting the potential uptake of an indicator hierarchy (headline, operational & explanatory levels) at Member States' and EU levels. Methods Semi-structured interviews with a purposive sample of 24 policy makers and senior policy advisors from 15 EU Member States and one candidate country were performed between July and November 2018. All interviews were transcribed and coded using summative and directed content analysis to generate thematic categories in MAXQDA. Results Preliminary results suggest that experts positively perceived the overall balance of the shortlist across performance domains reflecting most of the important policy areas. However, some further amendments to the generic set of indicators were recommended to increase their policy relevance and measurement validity while keeping the size manageable. The concept and usage of headline HSPA indicators is mostly viewed as a communication tool whereas more granular information at explanatory levels is perceived to be more appropriate for data driven policymaking and cross-country learning. Conclusions Interviews showed a considerable heterogeneity in the feasibility of applying a generic HSPA framework in an EU-wide health strategy as a compass for improvement through comparisons of health systems. Factors such as flexibility in adaptation to the national context, improvement in building knowledge capacity, potential misinterpretation in the 'European Semester' context, as well as lack of appropriately defined benchmarks were recurrent themes in hindering its uptake. Key messages Policy makers assess explanatory level indicators to be more actionable than headline level indicators. To facilitate the use of headline indicators at EU-level as a navigation tool for health systems, the list has to be stable to create trends and sufficiently flexible in adapting to new priorities.