Hierarchical Bivariate Time Series Models: A Combined Analysis of the Effects of Particulate Matter on Morbidity and Mortality

In this paper we develop a hierarchical bivariate time series model to characterize the relationship between particulate matter less than 10 microns in aerodynamic diameter (PM10) and both mortality and hospital admissions for cardiovascular diseases. The model is applied to time series data on mortality and morbidity for 10 metropolitan areas in the United States from 1986 to 1993. We postulate that these time series should be related through a shared relationship with PM10. At the first stage of the hierarchy, we fit two seemingly unrelated Poisson regression models to produce city-specific estimates of the log relative rates of mortality and morbidity associated with exposure to PM10 within each location. The sample covariance matrix of the estimated log relative rates is obtained using a novel generalized estimating equation approach that takes into account the correlation between the mortality and morbidity time series. At the second stage, we combine information across locations to estimate overall log relative rates of mortality and morbidity and variation of the rates across cities. Using the combined information across the 10 locations we find that a 10 mu g/m3 increase in average PM10 at the current day and previous day is associated with a 0:26% increase in mortality (95% posterior interval -0:37; 0:65), and a 0:71% increase in hospital admissions (95% posterior interval 0:35; 0:99). The log relative rates of mortality and morbidity have a similar degree of heterogeneity across cities: the posterior means of the between-city standard deviations of the mortality and morbidity air pollution effects are 0:42 (95% interval 0:05; 1:18), and 0:31 (95% interval 0:10; 0:89), respectively. The city-specific log relative rates of mortality and morbidity are estimated to have very low correlation, but the uncertainty in the correlation is very substantial (posterior mean = 0:20; 95% interval -0:89; 0:98). With the parameter estimates from the model, we can predict the hospitalization log relative rate for a new city for which hospitalization data are unavailable, using that city\u27s estimated mortality relative rate. We illustrate this prediction using New York as an example

A survey of X-ray emission from 100 kpc radio jets

We have completed a Chandra snapshot survey of 54 radio jets that are extended on arcsec scales. These are associated with flat spectrum radio quasars spanning a redshift range z=0.3 to 2.1. X-ray emission is detected from the jet of approximately 60% of the sample objects. We assume minimum energy and apply conditions consistent with the original Felten-Morrison calculations in order to estimate the Lorentz factors and the apparent Doppler factors. This allows estimates of the enthalpy fluxes, which turn out to be comparable to the radiative luminosities.Comment: Conference Proceedings IAU Symposium No. 313, Extragalactic jets from every angle, pp. 219-224, 4 figure

Healthcare choice: Discourses, perceptions, experiences and practices

Policy discourse shaped by neoliberal ideology, with its emphasis on marketisation and competition, has highlighted the importance of choice in the context of healthcare and health systems globally. Yet, evidence about how so-called consumers perceive and experience healthcare choice is in short supply and limited to specific healthcare systems, primarily in the Global North. This special issue aims to explore how choice is perceived and utilised in the context of different systems of healthcare throughout the world, where choice, at least in policy and organisational terms, has been embedded for some time. The articles are divided into those emphasising: embodiment and the meaning of choice; social processes associated with choice; the uncertainties, risks and trust involved in making choices; and issues of access and inequality associated with enacting choice. These sociological studies reveal complexities not always captured in policy discourse and suggest that the commodification of healthcare is particularly problematic

Designing a System for Patients Controlling Providers’ Access to their Electronic Health Records: Organizational and Technical Challenges

BACKGROUND Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients’ rights to control their personal information with providers’ data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients’ preferences for patient-controlled EHR access and applying those preferences to an existing EHR. METHODS We established an online system for capturing patients’ preferences for who could view their EHRs (listing all participating clinic providers individually and categorically—physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients’ preferences to guide data displays to providers. RESULTS Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a “Break the Glass” button to override patients’ restrictions, recording the date, time, and next screen viewed. Establishing patient-control over EHR data displays was complex and required ethical, clinical, database, and programming expertise and difficult choices to overcome technical and health system constraints. CONCLUSIONS Assessing patients’ preferences for access to their EHRs and applying them in clinical practice requires wide-ranging technical, clinical, and bioethical expertise, to make tough choices to overcome significant technical and organization challenges

A pentapeptide as minimal antigenic determinant for MHC class I-restricted T lymphocytes

Peptides that are antigenic for T lymphocytes are ligands for two receptors, the class I or II glycoproteins that are encoded by genes in the major histocompatibility complex, and the idiotypic / chain T-cell antigen receptor1–9. That a peptide must bind to an MHC molecule to interact with a T-cell antigen receptor is the molecular basis of the MHC restriction of antigen-recognition by T lymphocytes10,11. In such a trimolecular interaction the amino-acid sequence of the peptide must specify the contact with both receptors: agretope residues bind to the MHC receptor and epitope residues bind to the T-cell antigen receptor12,13. From a compilation of known antigenic peptides, two algorithms have been proposed to predict antigenic sites in proteins. One algorithm uses linear motifs in the sequence14, whereas the other considers peptide conformation and predicts antigenicity for amphipathic -helices15,16. We report here that a systematic delimitation of an antigenic site precisely identifies a predicted pentapeptide motif as the minimal antigenic determinant presented by a class I MHC molecule and recognized by a cytolytic T lymphocyte clone

Exploring a string-like landscape

We explore inflationary trajectories within randomly-generated two-dimensional potentials, considered as a toy model of the string landscape. Both the background and perturbation equations are solved numerically, the latter using the two-field formalism of Peterson and Tegmark which fully incorporates the effect of isocurvature perturbations. Sufficient inflation is a rare event, occurring for only roughly one in $10^5$ potentials. For models generating sufficient inflation, we find that the majority of runs satisfy current constraints from WMAP. The scalar spectral index is less than 1 in all runs. The tensor-to-scalar ratio is below the current limit, while typically large enough to be detected by next-generation CMB experiments and perhaps also by Planck. In many cases the inflationary consistency equation is broken by the effect of isocurvature modes.Comment: 24 pages with 8 figures incorporated, matches version accepted by JCA

Non-global Structure of the O({\alpha}_s^2) Dijet Soft Function

High energy scattering processes involving jets generically involve matrix elements of light- like Wilson lines, known as soft functions. These describe the structure of soft contributions to observables and encode color and kinematic correlations between jets. We compute the dijet soft function to O({\alpha}_s^2) as a function of the two jet invariant masses, focusing on terms not determined by its renormalization group evolution that have a non-separable dependence on these masses. Our results include non-global single and double logarithms, and analytic results for the full set of non-logarithmic contributions as well. Using a recent result for the thrust constant, we present the complete O({\alpha}_s^2) soft function for dijet production in both position and momentum space.Comment: 55 pages, 8 figures. v2: extended discussion of double logs in the hard regime. v3: minor typos corrected, version published in JHEP. v4: typos in Eq. (3.33), (3.39), (3.43) corrected; this does not affect the main result, numerical results, or conclusion

Why Are Regulations Changed? A Parcel Analysis of Upzoning in Los Angeles

Planners, officials, and neighborhood groups often debate zoning changes, yet there is little empirical evidence explaining why zoning and other land use regulations are changed. I use logistic regression models to examine density-enabling rezoning (“upzoning”) in Los Angeles. I find that upzoning occurs where there are development opportunities combined with limited political resistance. Upzoning is most likely on well-located parcels zoned for low-intensity, nonresidential uses. Meanwhile, homeowners—and particularly homeowners with access to valuable amenities—are associated with regulatory stasis. I conclude by recommending strategies for addressing homeowners’ concerns about higher density housing

Lynx X-Ray Observatory: An Overview

Lynx, one of the four strategic mission concepts under study for the 2020 Astrophysics Decadal Survey, provides leaps in capability over previous and planned x-ray missions and provides synergistic observations in the 2030s to a multitude of space- and ground-based observatories across all wavelengths. Lynx provides orders of magnitude improvement in sensitivity, on-axis subarcsecond imaging with arcsecond angular resolution over a large field of view, and high-resolution spectroscopy for point-like and extended sources in the 0.2- to 10-keV range. The Lynx architecture enables a broad range of unique and compelling science to be carried out mainly through a General Observer Program. This program is envisioned to include detecting the very first seed black holes, revealing the high-energy drivers of galaxy formation and evolution, and characterizing the mechanisms that govern stellar evolution and stellar ecosystems. The Lynx optics and science instruments are carefully designed to optimize the science capability and, when combined, form an exciting architecture that utilizes relatively mature technologies for a cost that is compatible with the projected NASA Astrophysics budget