Improving the Rank Precision of Population Health Measures for Small Areas with Longitudinal and Joint Outcome Models

Objectives

The University of Wisconsin Population Health Institute has published the County Health Rankings since 2010. These rankings use population-based data to highlight health outcomes and the multiple determinants of these outcomes and to encourage in-depth health assessment for all United States counties. A significant methodological limitation, however, is the uncertainty of rank estimates, particularly for small counties. To address this challenge, we explore the use of longitudinal and pooled outcome data in hierarchical Bayesian models to generate county ranks with greater precision.

Methods

In our models we used pooled outcome data for three measure groups: (1) Poor physical and poor mental health days; (2) percent of births with low birth weight and fair or poor health prevalence; and (3) age-specific mortality rates for nine age groups. We used the fixed and random effects components of these models to generate posterior samples of rates for each measure. We also used time-series data in longitudinal random effects models for age-specific mortality. Based on the posterior samples from these models, we estimate ranks and rank quartiles for each measure, as well as the probability of a county ranking in its assigned quartile. Rank quartile probabilities for univariate, joint outcome, and/or longitudinal models were compared to assess improvements in rank precision.

Results

The joint outcome model for poor physical and poor mental health days resulted in improved rank precision, as did the longitudinal model for age-specific mortality rates. Rank precision for low birth weight births and fair/poor health prevalence based on the univariate and joint outcome models were equivalent.

Conclusion

Incorporating longitudinal or pooled outcome data may improve rank certainty, depending on characteristics of the measures selected. For measures with different determinants, joint modeling neither improved nor degraded rank precision. This approach suggests a simple way to use existing information to improve the precision of small-area measures of population health.     

Rattus exulans and the catastrophic disappearance of Hawai’i’s native lowland forest

Paleoenvironmental and archaeological investigations from the ’Ewa Plain of O’ahu provide insight into the problem of understanding lowland native forest loss in Hawai’i. Data from pollen analysis of a pond core record, avian paleontology, and archeology, document a precipitous decline of the native forest starting before Polynesian settlement on the ’Ewa Plain but after Polynesian colonization of O’ahu. It is hypothesized that rats, introduced by Polynesian colonizers, increased exponentially in the absence of significant predators or competitors, feeding on a largely endemic vegetation that had evolved in the absence of mammalian predators. Rats radiated ahead of human colonizers on O’ahu, eating their way through the vegetation, perhaps before the colonizers had encountered much of the pristine lowland forest into which the rats had radiated. This hypothesis is supported by several observations, including the almost complete absence of extinct or extirpated avian faunal remains in archaeological deposits, the present distribution of endemic vegetation in Hawai’i, rat ecology, population biology, and other evidence.

Induced Collagen Cross-Links Enhance Cartilage Integration

Articular cartilage does not integrate due primarily to a scarcity of cross-links and viable cells at the interface. The objective of this study was to test the hypothesis that lysyl-oxidase, a metalloenzyme that forms collagen cross-links, would be effective in improving integration between native-to-native, as well as tissue engineered-to-native cartilage surfaces. To examine these hypotheses, engineered cartilage constructs, synthesized via the self-assembling process, as well as native cartilage, were implanted into native cartilage rings and treated with lysyl-oxidase for varying amounts of time. For both groups, lysyl-oxidase application resulted in greater apparent stiffness across the cartilage interface 2–2.2 times greater than control. The construct-to-native lysyl-oxidase group also exhibited a statistically significant increase in the apparent strength, here defined as the highest observed peak stress during tensile testing. Histology indicated a narrowing gap at the cartilage interface in lysyl-oxidase treated groups, though this alone is not sufficient to indicate annealing. However, when the morphological and mechanical data are taken together, the longer the duration of lysyl-oxidase treatment, the more integrated the interface appeared. Though further data are needed to confirm the mechanism of action, the enhancement of integration may be due to lysyl-oxidase-induced pyridinoline cross-links. This study demonstrates that lysyl-oxidase is a potent agent for enhancing integration between both native-to-native and native-to-engineered cartilages. The fact that interfacial strength increased manifold suggests that cross-linking agents should play a significant role in solving the difficult problem of cartilage integration. Future studies must examine dose, dosing regimen, and cellular responses to lysyl-oxidase to optimize its application.     

Effect of organic carbon,C:N ratio and light on the growth and lipid productivity of microalgae/cyanobacteria coculture

Current culture methods based on monocultures under phototrophic regimes are prone to contamination, predation, and collapse. Native cultures of multiple species are adapted to the local conditions and are more robust against contamination and predation. Growth, lipid and biomass productivity of a Louisiana native coculture of microalgae (Chlorella vulgaris) and cyanobacteria (Leptolyngbya sp.) in heterotrophic and mixotrophic regimes were investigated. Dextrose and sodium acetate at C:N ratios of 15:1 and 30:1 under heterotrophic (dark) and mixotrophic (400 μmol m^?2 s^?1) regimes were compared with autotrophic controls. The carbon source and C:N ratio impacted growth and biomass productivity. Mixotrophic cultures with sodium acetate (C:N 15:1) resulted in the highest mean biomass productivity (156 g m^?3 d^?1) and neutral lipid productivity (24.07 g m^?3 d^?1). The maximum net specific growth rate (U) was higher (0.97 d^?1) in mixotrophic cultures with dextrose (C:N 15:1) but could not be sustained resulting in lower total biomass than in mixotrophic cultures with acetate (C:N 15:1), with a U of 0.67 d^?1. The ability of the Louisiana coculture to use organic carbon for biomass and lipid production makes it a viable feedstock for biofuels and bioproducts.     

Lead-phase and red-stripe color morphs of red-backed salamanders Plethodon cinereus differ in hematological stress indices: A consequence of differential predation pressure?

Throughout the animal kingdom there are species that have two or more phenotypic forms or 'morphs', and many of these are amphibians. In North America, the red-backed salamander Plethodon cinereus can have either a red dorsal stripe or no dorsal stripe (lead-phase form), and evidence to date indicates the lead-phase form incurs a greater number of attacks from predators. In a recent collection of 51 P. Cinereus, blood smears of both color morphs (35 red-stripe, 16 lead-phase) were examined to obtain numbers of circulating leukocytes (via light microscopy), which can be used to indirectly estimate levels of stress hormones in vertebrates via a 'hematological stress index', which is the ratio between the number of two leukocyte types (neutrophils and lymphoeytes). Our results showed that lead-phase salamanders tended to have greater numbers of circulating neutrophils and lower numbers of circulating iymphocytes than red-stripe morphs, leading to higher average neutrophil-lymphocyte ratios in lead-phase individuals. Since the salamanders were held (refrigerated) for 7 days before sampling, we cannot be certain if this effect is a stress reaction to the captivity or the normal level for this morph. However comparison with two sets of related salamanders that were captured and sampled immediately indicates the red-stripe salamanders were either not stressed from the captivity at all, or their white blood cell distributions had returned to normal after 7 days of captivity. Taken together, our results indicate that lead-phase forms of P. Cinereus have higher stress levels than the red-stripe forms, which may be a consequence of their higher exposure to, and/or attacks from, predators. They may also indicate that the lead-phase form is less-suited to captivity than the red-stripe form of this species.     

Investigating the global dispersal of chickens in prehistory using ancient mitochondrial DNA signatures

Data from morphology, linguistics, history, and archaeology have all been used to trace the dispersal of chickens from Asian domestication centers to their current global distribution. Each provides a unique perspective which can aid in the reconstruction of prehistory. This study expands on previous investigations by adding a temporal component from ancient DNA and, in some cases, direct dating of bones of individual chickens from a variety of sites in Europe, the Pacific, and the Americas. The results from the ancient DNA analyses of forty-eight archaeologically derived chicken bones provide support for archaeological hypotheses about the prehistoric human transport of chickens. Haplogroup E mtDNA signatures have been amplified from directly dated samples originating in Europe at 1000 B.P. and in the Pacific at 3000 B.P. indicating multiple prehistoric dispersals from a single Asian centre. These two dispersal pathways converged in the Americas where chickens were introduced both by Polynesians and later by Europeans. The results of this study also highlight the inappropriate application of the small stretch of D-loop, traditionally amplified for use in phylogenetic studies, to understanding discrete episodes of chicken translocation in the past. The results of this study lead to the proposal of four hypotheses which will require further scrutiny and rigorous future testing.