Census Population Research Articles

Public health unit funding per capita and seasonal influenza vaccination among youth and adults in Ontario, Canada in 2013/2014 and 2018/2019

BackgroundInfluenza vaccines are crucial in reducing the risk of influenza symptoms. We aimed to: (1) estimate the association between public health unit (PHU) funding per capita and influenza vaccination among...

Trends in the Incidence of Renal Replacement Therapy Due to Rapidly Progressive Glomerulonephritis in Japan, 2006-2021.

Objective Patients with rapidly progressive glomerulonephritis (RPGN) are at a high risk of progression to end-stage kidney disease (ESKD), requiring renal replacement therapy (RRT). The present study examined recent trends in the incidence of RRT due to RPGN in Japan. Methods The number of patients with incident RRT due to RPGN by sex from 2006 to 2021 was extracted from the Japanese Society of Dialysis Therapy Registry. The incidence rates of RRT were calculated for four-year periods with the census population as the denominator. Standardized incidence ratios (SIRs) and age-specific incidence rates were also calculated. Results From 2006 to 2021, the crude number of patients with incident RRT due to RPGN increased by 34% and 58% in men and women, respectively. The SIRs decreased significantly in 2010-2013 relative to the first period (2006-2009) for both men [0.90 (95% confidence interval (CI) 0.85-0.96)] and women [0.92 (0.86-0.99)] but then increased to 1.01 (0.96-1.07) for men and 1.20 (1.13-1.27) for women in 2018-2021. In the older age groups (≥70 years old), age-specific incidence rates initially decreased in 2010-2013 but increased thereafter, peaking in 2018-2021. Conclusion From 2006 to 2021, the number of patients with incident RRT due to RPGN increased, with an increase in the age-specific incidence of RRT due to RPGN in the older age groups (≥70 years old), suggesting that the number of patients with incident RRT due to RPGN will continue to increase as the population ages in Japan.

Bado type III Monteggia fractures have a high injury- and treatment-related complication rate: a single center study of 73 fractures.

Monteggia fractures can be problematic injuries. The aim of this population-based study is to evaluate the risk of complications according to the Bado types, clinical outcome, and incidence. 72 children (median age 6, range 2-11 years) with 73 Monteggia fractures treated during 2014-2022 were identified from the institutional fracture register. Timing of diagnosis, complications, and method of treatment were registered. Outcomes were assessed at mean 4 years (1-9) follow-up in 68 (94%) children. The census population (< 16 years old) in Helsinki metropolitan area during the study period was assessed. Bado types I (n = 43) and III (n = 27) comprised all but 3 of the fractures. Diagnosis was made on admission in 57, and with a 1-8-day delay in 16 children. 8 children had sustained an associated nerve injury. 35 children were treated operatively, 7 after failed closed treatment. 4 reoperations were performed, including 3 ulnar osteotomies. The risk of complications (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.7-14) and closed treatment failures (OR 12.3, CI 1.3-118) was higher in Bado type III than in type I injuries. 60 children attended for clinical follow-up, all had congruent radio-humeral joints and full range of elbow and forearm motion. Mean PedsQL was 94 (72-100) and QuickDash 3 (0-13). 8 additional children reported normal elbow functions by phone. The calculated mean annual incidence of Monteggia injuries was 2.9/100,000 children. Monteggia fractures are rare (2.9/100,000 yearly). Bado type III injuries are associated with a high risk of complications.

The relationship between violent political rhetoric and suicide rates

ABSTRACT Among the groupings of Social Work Grand Challenges is Individual and Family Well-Being. One threat to individual and family well-being is suicide. Between 2011 and 2022 over half a million Americans committed suicide. Suicide has profound effects on family members. Recent research has found violent political rhetoric (VPR) as an aspect of the social environment is associated with violence, including mass shootings and police shootings of civilians, both threats to individual and family well-being. No studies have investigated the possible relationship between VPR and suicide rates. This study, a secondary analysis of publicly available data, addresses this absence. The dependent variable was suicide rates in the U.S. Census regions. Independent variables included census region populations, VPR, gun ownership, and temperature. Panel analysis methods with Driscoll-Kraay robust standard errors were used. Statistically significant relationships between suicide rates and VPR, changes in gun ownership, and temperature were found, with between-region differences. Violent political rhetoric appears to be associated with increasing suicide rates, and these relationships may differ between regions. Implications of these findings for future research and for social work efforts to combat the effects of VPR and potentially reduce suicide rates, especially for populations targeted by VPR, are considered.

A novel approach to improve population mapping considering facility-based service capacity and land livability

Social sensing data, including points-of-interest (POI) and mobile position, are important data sources for population mapping. However, existing studies using POI data disregard the heterogeneity in facility size among the same type of POI and urban–rural differences. Moreover, mobile position data face biased issues. This study presents a hybrid model that considers facility-based service capacity (FSC) and land livability to map fine-scale population distributions. Based on extracting the FSC index by integrating POI, mobile phone positioning (MPP), and road network data, the district-level census population was disaggregated into 100-m grids using a random forest model. Subsequently, a regression equation was developed from the land use data to correct the estimated residuals. The results showed that the hybrid model exhibited considerably smaller errors than those of the POI density-based method and direct mapping of MPP (RMSE = 5,393.31, 7,348.91, and 7,824.76, respectively), effectively reducing population misallocation in extreme-density regions. Compared to WorldPop and LandScan datasets and a comparative model, our method reduced the RMSE by 30–60%, proving the effectiveness of integrating various social sensing and remote sensing data for improving population mapping. This study improves on an existing method as a thought-provoking step toward advancement in fine-scale population mapping research.

Population Size in Evolutionary Biology Is More Than the Effective Size.

In population genetics idealized Wright-Fisher (WF) populations are generally considered equivalent to real populations with regard to the major evolutionary processes that influence genotype and allele frequencies. As a result we often model the response of populations by focusing on the effective size N e . The Diversity Partitioning Theorem (DPT) shows that you cannot model the behavior of a system solely on the basis of a diversity (accounting for unevenness among items) without taking richness into account. I show that the census population size (the number of adults, N c ) is equivalent to a richness, and that the effective size N e is equivalent to a true diversity. It follows logically from the DPT that we require both N e and N c to understand how drift, selection, mutation, and gene flow interact to shape the course of evolution of populations. Here I review evidence that both N c and N e affect evolutionary trajectories of populations for neutral and adaptive processes. This also influences how we should consider evolutionary potential and genetic criteria for conservation of populations. The effective size of a population is of huge importance in evolutionary biology, but it should not be the sole focus when population size is concerned. Applied evolutionary studies need to integrate N c in the equation more consistently when modeling the response to selection, mutation, migration, and drift.

Geospatial Data Aggregation Methods for Novel Geographies: Validating Congressional District Life Expectancy Estimates.

Place is a critical determinant of health. Recent novel analyses have explored health outcome estimation for small geographies, such as census tracts, as well as health outcome aggregation to geopolitical geographies with accountable political representatives, such as congressional districts. In one such application, combining these approaches, researchers aggregated census tract estimates of life expectancy to the congressional district level to derive local estimates, but such an approach has not been validated. Here, we compared two sources and approaches to calculating life expectancy data for Pennsylvania congressional districts. We used 2010-2015 census tract life expectancy estimates from the US Small-area Life Expectancy Estimates Project (LEEP) and dasymetric methods to compute population-weighted life expectancy aggregated to the congressional district level. Using georeferenced Vital Statistics data, we aggregated age-specific census tract death and population counts to congressional districts and used abridged life tables to estimate life expectancy. To validate the dasymetric aggregated estimates we compared absolute differences, assessed the correlation, and created Bland-Altman plots to visualize the agreement between the two measures. We found strong agreement between congressional district estimates of life expectancy at birth derived using the dasymetric LEEP model-based approach and Vital Statistics direct estimates approach, though life expectancy at older ages (75 and older) showed weak correlations. This validation contributes to our understanding of geospatial aggregation methods for novel geographies including congressional districts. Health outcome data aggregated to the congressional district geography can support congressional policy making aimed at improving population health outcomes.

Hurricane-induced dramatic decline and natural recovery of a vulnerable sportfish population: Shoal bass (Micropterus cataractae) in the Chipola River, Florida

Freshwater fishes are among the most biodiverse vertebrate groups and among the most threatened by anthropogenic activities. Many occur in small and geographically restricted populations that are increasingly subject to catastrophic events (hurricanes, wildfires, extreme floods and droughts), but it has rarely been possible to assess the impacts of such events. Here we document the decline and recovery of a regularly monitored, small shoal bass (Micropterus cataractae) population in the Chipola River, Florida following a catastrophic hurricane disturbance. The Chipola River population has the lowest level of interspecific hybridization (over 90 % non-introgressed shoal bass) within the species' range, a census population size of 2165 (95 % CI [1,383, 3,801]) in 2009 and a genetically effective population size Ne of 135 (95 % CI [70, 472]). In 2018, Hurricane Michael devastated the Chipola River and watershed. A survey conducted in 2019 indicated a severe decline (91 %) in relative population abundance and a very low Ne at 21 (95 % CI [16, 29]). However, the detection of young-of-year fish indicated that the depleted population had experienced successful reproduction. In fall 2021, the census population had recovered to 1039 fish (95 % CI [660, 1,814]) and Ne at 40 (95 % CI [31, 50]). While the population has shown considerable resilience in the face of hurricane disturbance, it remains vulnerable to future catastrophic events and may also suffer a long-term reduction in its adaptive potential due to a relatively low effective population size. To address these threats, continued monitoring is necessitated and targeted measures such as translocation of non-introgressed individuals from neighboring populations or establishment of a captive population of sufficient effective population size may be required to conserve the species in the long term.

How Big Is Big? The Effective Population Size of Marine Bacteria.

Genome-reduced bacteria constitute most of the cells in surface-ocean bacterioplankton communities. Their extremely large census population sizes (N c) have been unfoundedly translated to huge effective population sizes (N e)-the size of an ideal population carrying as much neutral genetic diversity as the actual population. As N e scales inversely with the strength of genetic drift, constraining the magnitude of N e is key to evaluating whether natural selection can overcome the power of genetic drift to drive evolutionary events. Determining the N e of extant species requires measuring the genomic mutation rate, a challenging step for most genome-reduced bacterioplankton lineages. Results for genome-reduced Prochlorococcus and CHUG are surprising-their N e values are an order of magnitude lower than those of less abundant lineages carrying large genomes, such as Ruegeria and Vibrio. As bacterioplankton genome reduction commonly occurred in the distant past, appreciating their population genetic mechanisms requires constraining their ancient N e values by other methods.

Geographical incidence of testosterone supplementation in total hip and knee arthroplasty

IntroductionPrescription testosterone usage in the United States declined after 2013 following reports of its association with myocardial infarction and stroke. However, more recently there has been a documented increase in testosterone prescriptions. Recently, testosterone levels have also been hypothesized to increase infection risk in patients undergoing elective shoulder arthroplasty. Furthermore, testosterone may increase the risk of venous thromboembolism. These complications are perioperative concerns for total hip and knee arthroplasties (THA/TKA). Therefore, the purpose of our study is to identify trends in the incidence of testosterone prescriptions in patients who underwent THA/TKA with respect to geographical population data. MethodsWe retrospectively reviewed 40,711 primary THAs and 50,893 primary TKAs performed in males between 1/1/2016 and 12/31/2021 using a commercial claims database. Records were reviewed for demographics, geographical location, and supplemental testosterone prescriptions within 1 year prior to surgery. Patient Metropolitan Statistical Area (MSA) was assessed with respect to United States Census Population Data. ResultsWe identified 91,604 males who underwent primary THA (n = 40,711) or TKA (n = 50,893). For THA/TKA, patients who were younger had a higher likelihood of having a supplemental testosterone prescription (OR = 0.99, 95 % CI [0.99–1.00], p < 0.001). TKA patients (2,507, 4.9 %) had a higher rate of testosterone prescriptions than THA patients overall (1,413, 3.4 %), (OR = 1.44 95 % CI [1.35, 1.54], p < 0.001) as well as within each year.For THA and TKA patients, patients in the Midwest (OR = 1.61, p < 0.001), South (OR = 3.04, p < 0.001), and West (OR = 2.28, p < 0.001) regions all had higher testosterone prescription rates than the Northeast. Patients living in a city (MSA population ≥200,000) were more likely to be prescribed testosterone (OR = 1.20, p = 0.002). ConclusionSurgeons conducting TKA/THA should be aware that younger patients, those in higher population areas, and those in the Midwest, South, and West regions are more likely to be prescribed testosterone than those in the Northeast.

The protein domains of vertebrate species in which selection is more effective have greater intrinsic structural disorder.

The nearly neutral theory of molecular evolution posits variation among species in the effectiveness of selection. In an idealized model, the census population size determines both this minimum magnitude of the selection coefficient required for deleterious variants to be reliably purged, and the amount of neutral diversity. Empirically, an 'effective population size' is often estimated from the amount of putatively neutral genetic diversity and is assumed to also capture a species' effectiveness of selection. A potentially more direct measure of the effectiveness of selection is the degree to which selection maintains preferred codons. However, past metrics that compare codon bias across species are confounded by among-species variation in %GC content and/or amino acid composition. Here, we propose a new Codon Adaptation Index of Species (CAIS), based on Kullback-Leibler divergence, that corrects for both confounders. We demonstrate the use of CAIS correlations, as well as the Effective Number of Codons, to show that the protein domains of more highly adapted vertebrate species evolve higher intrinsic structural disorder.

Green Supply Chain Management Practices and Productivity of Manufacturing Firms in Port Harcourt

This study examines the relationship between green supply chain management practices and productivity of manufacturing firms in Port Harcourt. Correlational survey design was adopted for this study. The population of this study is thirty-two (32) manufacturing companies in Rivers State which are registered with the Rivers State branch of Manufacturers Association of Nigeria (MAN). The study adopted the census population. 3 managers were selected from each firm multiplied by 32 firms gives us a total of ninety-two (92) for the study. Structured questionnaire instrument title the application of linear programming in assembly-line balancing of manufacturing firms in Port Harcourt questionnaire was developed on five-point likert scale. The result of the Cronbach's Alpha reliability test indicates .769 which is above .70 which implies that the items are reliable. PPMC (person product moment correlation) was used to test hypotheses on SPSS version 25. There is a significant relationship between green Design and productivity of manufacturing firms in Port Harcourt. There is a significant relationship between green Production and productivity of manufacturing firms in Port Harcourt. The study concluded that green supply chain management practices have a significant relationship with productivity of manufacturing firms in Port Harcourt. The study recommended Manufacturing firms in Port Harcourt should integrate sustainability considerations into their overall supply chain strategies to ensure that environmental concerns are addressed at every stage of the production process.

Measuring changes in Plasmodium falciparum census population size in response to sequential malaria control interventions.

Here we introduce a new endpoint ″census population size″ to evaluate the epidemiology and control of Plasmodium falciparum infections, where the parasite, rather than the infected human host, is the unit of measurement. To calculate census population size, we rely on a definition of parasite variation known as multiplicity of infection (MOI var ), based on the hyper-diversity of the var multigene family. We present a Bayesian approach to estimate MOI var from sequencing and counting the number of unique DBLα tags (or DBLα types) of var genes, and derive from it census population size by summation of MOI var in the human population. We track changes in this parasite population size and structure through sequential malaria interventions by indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC) from 2012 to 2017 in an area of high-seasonal malaria transmission in northern Ghana. Following IRS, which reduced transmission intensity by > 90% and decreased parasite prevalence by ~40-50%, significant reductions in var diversity, MOI var , and population size were observed in ~2,000 humans across all ages. These changes, consistent with the loss of diverse parasite genomes, were short lived and 32-months after IRS was discontinued and SMC was introduced, var diversity and population size rebounded in all age groups except for the younger children (1-5 years) targeted by SMC. Despite major perturbations from IRS and SMC interventions, the parasite population remained very large and retained the var population genetic characteristics of a high-transmission system (high var diversity; low var repertoire similarity) demonstrating the resilience of P. falciparum to short-term interventions in high-burden countries of sub-Saharan Africa.

Implementing distributed leadership in Irish voluntary secondary schools from the principals’ perspective

ABSTRACT In 2018, the Irish Department of Education and Skills (DES) officially recommended a distributed leadership model as a new approach to leadership and management in post-primary schools. Policy implementation guidance was circulated to school management via DES circular CL003/2018. This study investigates the perspective of voluntary secondary school principals implementing CL003/2018 within the voluntary secondary school sector, where the role of the school principal is pivotal in its implementation. A pragmatic approach to the research methodology led to the adoption of a case study methodology within a mixed-method sequential quantitative > qualitative research design. The quantitative research instrument was an online survey distributed to a census population of voluntary secondary school principals in Ireland. Using Zoom, semi-structured interviews with ten voluntary secondary school principals informed the qualitative research. The findings are examined and interpreted within the literature on distributed leadership, with the concepts of power, accountability, and sustainability emerging from the research. The research identifies recommendations on professional learning for principals to develop sustainable leadership capacity within the voluntary secondary school sector, and the essential time to hold strategic leadership team meetings.

Utilization of Emergency Medical Services by Culturally and Linguistically Diverse Patients: A Population-Based Retrospective Study

Objectives To compare emergency medical services (EMS) utilization between culturally and linguistically diverse (CALD) and non-CALD patients in Victoria, Australia. Methods A retrospective study of EMS attendances and transports in Victoria from January 2015 to June 2019, utilizing linked EMS, hospital emergency and admissions data. The CALD and non-CALD patients who received EMS care and transport to a Victorian public emergency department were included. The incidence of EMS use for CALD and non-CALD patients based on the 2016 Census population and expressed per 100,000 person-years. Results In 1,261,167 included patients, there were 272,100 (21.6%) CALD and 989,067 (78.4%) non-CALD patients. Before adjustment for age and sex, EMS utilization for CALD patients was 13% lower than non-CALD patients (incidence rate ratio [IRR] 0.87, 95% CI: 0.87–0.87). When stratified by age groups, CALD patients aged under 70 years had significantly lower rates of EMS utilization than non-CALD patients, while CALD patients aged 75 years or older were more likely than non-CALD patients to use EMS (IRR 1.08, 95% CI: 1.07–1.09). The CALD patients were less likely to utilize EMS for trauma/external injury (IRR = 0.67, 95% CI: 0.66–0.68) and mental health/alcohol/drug problems (IRR = 0.39, 95% CI: 0.38–0.40). After adjustment for differences in the age and sex distribution of CALD and non-CALD populations, CALD patients were 51% less likely to utilize EMS than non-CALD patients (IRR 0.49, 95% CI: 0.42–0.56). Conclusions The CALD patients used EMS less frequently than non-CALD patients with significant variation observed across age groups, countries of birth, and clinical presentation. Further research is needed to understand the factors that may be contributing to these disparities.

Trends of diabetes in Beijing, China.

The global rise in diabetes prevalence is a pressing concern. Despite initiatives like "The Healthy Beijing Action 2020-2030" advocating for increased awareness, treatment, and control, the specific situation in Beijing remains unexplored. This study aimed to analyze the trends in diabetes prevalence, awareness, treatment, and control among Beijing adults. Through a stratified multistage probability cluster sampling method, a series of representative cross-sectional surveys were conducted in Beijing from 2005 to 2022, targeting adults aged 18-79 years. A face-to-face questionnaire, along with body measurements and laboratory tests, were administered to 111,943 participants. Data from all survey were age- and/or gender-standardized based on the 2020 Beijing census population. Annual percentage rate change (APC) or average annual percentage rate change (AAPC) was calculated to determine prevalence trends over time. Complex sampling logistic regression models were employed to explore the relationship between various characteristics and diabetes. From 2005 to 2022, the total prevalence of diabetes among Beijing adults aged 18-79 years increased from 9.6% (95% CI: 8.8-10.4%) to 13.9% (95% CI: 13.1-14.7%), with an APC/AAPC of 2.1% (95% CI: 1.1-3.2%, P<0.05). Significant increases were observed among adults aged 18-39 years and rural residents. Undiagnosed diabetes rose from 3.5% (95% CI: 3.2-4.0%) to 7.2% (95% CI: 6.6-7.9%) with an APC/AAPC of 4.1% (95% CI: 0.5-7.3%, P<0.05). However, diabetes awareness and treatment rates showed annual declines of 1.4% (95% CI: -3.0% to -0.2%, P<0.05) and 1.3% (95% CI: -2.6% to -0.2%, P<0.05), respectively. The diabetes control rate decreased from 21.5% to 19.1%, although not statistically significant (APC/AAPC=-1.5%, 95% CI: -5.6% to 1.9%). Overweight and obesity were identified as risk factors for diabetes, with ORs of 1.65 (95% CI: 1.38-1.98) and 2.48 (95% CI: 2.07-2.99), respectively. The prevalence of diabetes in Beijing has significantly increased between 2005 and 2022, particularly among young adults and rural residents. Meanwhile, there has been a concerning decrease in diabetes awareness and treatment rates, while control rates have remained stagnant. Regular blood glucose testing, especially among adults aged 18-59 years, should be warranted. Furthermore, being male, elderly, overweight, or obese was associated with higher diabetes risk, suggesting the needs for targeted management strategies.

Racial and Ethnic Disparities in the Incidence of Anti-NMDA Receptor Encephalitis.

To estimate the incidence of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. We conducted a retrospective cohort study of >10 million person-years of observation from members of Kaiser Permanente Southern California, 2011-2022. The electronic health record of individuals with text-string mention of NMDA and encephalitis were reviewed to identify persons who met diagnostic criteria for anti-NMDAR encephalitis. Age-standardized and sex-standardized incidences stratified by race and ethnicity were estimated according to the 2020 US Census population. We identified 70 patients who met diagnostic criteria for anti-NMDAR encephalitis. The median age at onset was 23.7 years (IQR = 14.2-31.0 years), and 45 (64%) were female patients. The age-standardized and sex-standardized incidence of anti-NMDAR encephalitis per 1 million person-years was significantly higher in Black (2.94, 95% CI 1.27-4.61), Hispanic (2.17, 95% CI 1.51-2.83), and Asian/Pacific Island persons (2.02, 95% CI 0.77-3.28) compared with White persons (0.40, 95% CI 0.08-0.72). Ovarian teratomas were found in 58.3% of Black female individuals and 10%-28.6% in other groups. Anti-NMDA receptor encephalitis disproportionately affected Black, Hispanic, or Asian/Pacific Island persons. Ovarian teratomas were a particularly common trigger in Black female individuals. Future research should seek to identify environmental and biological risk factors that disproportionately affect minoritized individuals residing in the United States.

Epidemiology of Extrapulmonary Nontuberculous Mycobacterial Disease – 4 Emerging Infection Program Sites, 2021

Background: Extrapulmonary nontuberculous mycobacteria (ENTM) infections are difficult to treat and often require prolonged therapy or surgery. Few population-based studies describe ENTM epidemiology, though well-known healthcare-associated outbreaks have occurred. Using the first year of multi-site ENTM surveillance, we characterized rates and how frequently ENTM infections may be related to healthcare. Methods: CDC’s Emerging Infections Program conducted active, laboratory- and population-based surveillance for ENTM cases in 4 sites (Colorado [5 counties], Minnesota [statewide], New York [1 county], and Oregon [statewide]) in 2021. An incident ENTM case was NTM isolation from a non-pulmonary specimen, excluding stool or rectal swabs, in a resident of the surveillance area without either medical record documentation of prior ENTM infection or isolation of ENTM in the prior 12 months. Demographic, clinical, information on selected healthcare and community exposures, and laboratory data were collected via medical record review. We calculated incidence per 100,000 population using U.S. Census population estimates and performed descriptive analyses. Results: A total of 180 incident ENTM cases were reported in 2021. The crude annual incidence rate was 1.3 per 100,000 persons. Incidence increased with age (from 0.95 per 100,000 among 0–17 year-olds to 2.65 per 100,000 among persons ≥65), ranged from 0.8 among non-Hispanic Asian persons to 1.6 per 100,000 in non-Hispanic Black persons, and was similar among males (1.3 per 100,000) and females (1.4 per 100,000; Figure 1). Mycobacterium avium complex (64 [35.6%]) was the most frequently isolated species group, followed by Mycobacterium chelonae complex (31 [17.2%]). Skin and soft tissue infections were the most frequent infection type (37 [20.6%]); 27 cases (15.0%) were associated with disseminated and/or only bloodstream infection, and 56 cases (31.1%) had no infection type documented. Among 93 cases with localized ENTM infections (i.e., infections that were not disseminated and/or only bloodstream infections), 38.7% had only healthcare-related exposures, 14% had only community-related exposures and 6.5% had both exposure types at the site of infection (Figure 2). Healthcare-related exposures at the infection site included surgery (23.7%), injection/infusion (21.5%), and medical devices (18.3%). The most frequent community-related exposure at the infection site was trauma (17.2%). Only one case was part of a known outbreak, which was healthcare-associated. Conclusions: ENTM infections are relatively rare, but nearly half of patients with localized ENTM infections had prior healthcare-related exposures. This indicates that the burden of ENTM infections related to healthcare may be much larger than what has been suggested from reported outbreaks.

Incorporating spatial autocorrelation in dasymetric mapping: A hierarchical Poisson spatial disaggregation regression model

The growing demand for spatially detailed population products in various fields continues to rise, as users shift their focus from aggregated areal totals to high-resolution grid estimates. Aggregating demographic data to areas, such as census tracts or block groups, can mask localized heterogeneities within those areas. This paper presents a new pycnophylactic (density-preserving) geospatial model for disaggregating population to high-resolution grids. We describe a Bayesian Hierarchical Poisson Spatial Disaggregation Regression Model (HPSDRM), which incorporates land cover covariates and two levels of spatial autocorrelation. We evaluated the model's predictive ability first with simulation studies, and then by disaggregating census population data for Davidson County, TN, from the census tract-level to a fine grid and comparing predicted to actual block-level population counts. The interpolated population map successfully identified spatial heterogeneities, such as hot- and cold-spots within census tracts. The HPDSRM model out-performed three other types of disaggregation modeling, which suggests the value of incorporating spatial autocorrelation. Based upon this study, HPSDRM has potential for disaggregating other demographic data, such as socioeconomic indicators.

Incidence of Hospitalization due to Influenza-Associated Severe Acute Respiratory Infection During 2010-2019 in Bangladesh.

Global influenza-associated acute respiratory infections contribute to 3-5 million severe illnesses requiring hospitalization annually, with 90% of hospitalizations occurring among children < 5 years in developing countries. In Bangladesh, the inadequate availability of nationally representative, robust estimates of influenza-associated hospitalizations limits allocation of resources for prevention and control measures. This study used data from the hospital-based influenza surveillance (HBIS) system in Bangladesh from 2010 to 2019 and healthcare utilization surveys to determine hospital utilization patterns in the catchment area. We estimated annual influenza-associated hospitalization numbers and rates for all age groups in Bangladesh using WHO methods, adjusted for a 6-day-a-week enrollment schedule, selective testing of specimens from children under five, and healthcare-seeking behavior, based on the proportion of symptomatic community participants seeking healthcare within the past week. We then estimated national hospitalization rates by multiplying age-specific hospitalization rates with the corresponding annual national census population. Annual influenza-associated hospitalization rates per 100,000 population for all ages ranged from 31 (95% CI: 27-36) in 2011 to 139 (95% CI: 130-149) in 2019. Children < 5 years old had the highest rates of influenza-associated hospitalization, ranging from 114 (95% CI: 90-138) in 2011 to 529 (95% CI: 481-578) in 2019, followed by adults aged ≥ 65 years with rates ranging from 46 (95% CI: 34-57) in 2012 to 252 (95% CI: 213-292) in 2019. The national hospitalization estimates for all ages during 2010-2019 ranged from 47,891 to 236,380 per year. The impact of influenza-associated hospitalizations in Bangladesh may be considerable, particularly for young children and older adults. Targeted interventions, such as influenza vaccination for these age groups, should be prioritized and evaluated.