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Chen H, Zhou Y, Sun L, Chen Y, Qu X, Chen H, Rajbhandari-Thapa J, Xiao S. Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China. BMC Public Health 2020; 20:839. [PMID: 32493253 PMCID: PMC7268263 DOI: 10.1186/s12889-020-08932-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 05/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background To address change in the gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change over time. Methods The temporal trend in GGLE was evaluated using retrospective demographic analysis with Joinpoint regression. Causes of death were coded in accordance with the International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. The life table technique and decomposition method were used to express changes in GGLE. Results The trend of GGLE in Shanghai experienced two phases, i.e., a decrease from 8.4 to 4.2 years in the descent phase (1973–1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999–2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0–9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory, and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While, importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer, and diabetes in the recent plateau phase. Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai, China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE. This will also ensure improvements in health and health equity in Shanghai China.
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Affiliation(s)
- Hanyi Chen
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Yi Zhou
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Lianghong Sun
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Yichen Chen
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Xiaobin Qu
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hua Chen
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | | | - Shaotan Xiao
- Department of Science Research and Information Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, 200136, China. .,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China.
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Participation of the hospitals in the Republic of Ireland in international research over more than a decade: a bibliometric analysis. Ir J Med Sci 2019; 189:51-69. [PMID: 31463896 DOI: 10.1007/s11845-019-02077-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/24/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study provides an accurate awareness of the present situation of health research in Irish hospitals both public and private. We aimed to analyze factors that may influence it and provide recommendations for active steps to improve the current situation of Irish health research based on our findings. METHODS We performed a bibliometric analysis to assess qualitatively and quantitatively the publications from Ireland over a period between 2007 and 2018. We also investigated the associated variables with the quality of research. Furthermore, we conducted a Joinpoint analysis to see the trends in Irish research over these years. RESULTS From 12,828 included peer-reviewed articles, the average citation count per article was 19.98. Furthermore, we showed that a higher impact factor (IF) and institutions number, present per article, were significantly associated with more citations. Also, the publication count and the mean IF showed an increase over the years according to the Joinpoint analysis. Moreover, the oncology research had the highest output, followed by pediatrics, then neurology while the specialties with least publications were ear, nose, and throat (ENT), urology, plastic surgery, and dentistry. Additionally, cardiovascular, obstetrics and gynecology, oncology, pediatrics, pulmonology, dermatology, ophthalmology, dentistry, and radiology research showed an increased publication count trend in recent years. While anesthesiology, ENT, general surgery, gastroenterology and hepatology, infection and tropical medicine, nephrology, neurology, orthopedics, plastic surgery, and urology showed a decrease in the publications trend. CONCLUSIONS Our findings may serve as a useful approach to benchmark scientific output from hospitals and guide the future allocation of research spending.
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Chen H, Hao L, Yang C, Yan B, Sun Q, Sun L, Chen H, Chen Y. Understanding the rapid increase in life expectancy in shanghai, China: a population-based retrospective analysis. BMC Public Health 2018; 18:256. [PMID: 29444657 PMCID: PMC5813363 DOI: 10.1186/s12889-018-5112-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 01/22/2018] [Indexed: 12/15/2022] Open
Abstract
Background Life expectancy at birth (LE) is a comprehensive measure that accounts for age-specific death rates in a population. Shanghai has ranked first in LE in China mainland for decades. Understanding the reasons behind its sustained gain in LE provides a good reflection of many other cities in China. The aim of this study is intended to explore temporal trend in age- and cause-specific gains in LE in Shanghai and the probable reasons lay behind. Methods Joinpoint regression was applied to evaluate temporal trend in LE and the long time span was then divided accordingly. Contributions to change in LE (1973–2015) were decomposed by age and cause at corresponding periods. Results LE in Shanghai could be divided into four phases ie., descent (1973–1976), recovery (1976–1998), rapid rise (1998–2004) and slow rise (2004–2015). The growing LE was mainly attributed to reductions in mortality from the elderly populations and chronic diseases such as cerebrovascular disease, chronic lower respiratory disease, and gastrointestinal cancers (stomach, liver and esophageal cancer). Conclusions The four-decade sustained gain in LE in Shanghai is due to the reductions in mortality from the elderly and chronic diseases such as cerebrovascular disease, chronic lower respiratory disease, and gastrointestinal cancers. Further growth momentum still comes from the elderly population. Electronic supplementary material The online version of this article (10.1186/s12889-018-5112-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hanyi Chen
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Lipeng Hao
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Chen Yang
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Bei Yan
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Qiao Sun
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China.
| | - Lianghong Sun
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Hua Chen
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Yichen Chen
- Department of Cancer, Injury Prevention and Vital Statistics, Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
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Disparities in Female Breast Cancer Stage at Diagnosis in New Jersey: A Spatial-Temporal Analysis. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 23:477-486. [PMID: 28430705 PMCID: PMC5548504 DOI: 10.1097/phh.0000000000000524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Despite improvements in early detection of breast cancer, disparities persist in stage at diagnosis, which is an important prognostic factor.
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Goovaerts P. The drinking water contamination crisis in Flint: Modeling temporal trends of lead level since returning to Detroit water system. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 581-582:66-79. [PMID: 27720257 PMCID: PMC5303563 DOI: 10.1016/j.scitotenv.2016.09.207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/25/2016] [Accepted: 09/26/2016] [Indexed: 05/03/2023]
Abstract
Since Flint returned to its pre-crisis source of drinking water close to 25,000 water samples have been collected and tested for lead and copper in >10,000 residences. This paper presents the first analysis and time trend modeling of lead data, providing new insights about the impact of this intervention. The analysis started with geocoding all water lead levels (WLL) measured during an 11-month period following the return to the Detroit water supply. Each data was allocated to the corresponding tax parcel unit and linked to secondary datasets, such as the composition of service lines, year built, or census tract poverty level. Only data collected on residential parcels within the City limits were used in the analysis. One key feature of Flint data is their collection through two different sampling initiatives: (i) voluntary or homeowner-driven sampling whereby concerned citizens decided to acquire a testing kit and conduct sampling on their own (non-sentinel sites), and (ii) State-controlled sampling where data were collected bi-weekly at selected sites after training of residents by technical teams (sentinel sites). Temporal trends modeled from these two datasets were found to be statistically different with fewer sentinel data exceeding WLL thresholds ranging from 10 to 50μg/L. Even after adjusting for housing characteristics the odds ratio (OR) of measuring WLL above 15μg/L at non-sentinel sites is significantly >1 (OR=1.480) and it increases with the threshold (OR=2.055 for 50μg/L). Joinpoint regression showed that the city-wide percentage of WLL data above 15μg/L displayed four successive trends since the return to Detroit Water System. Despite the recent improvement in water quality, the culprit for differences between sampling programs needs to be identified as it impacts exposure assessment and might influence whether there is compliance or not with the Lead and Copper Rule.
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Goovaerts P, Xiao H, Adunlin G, Ali A, Tan F, Gwede CK, Huang Y. GEOGRAPHICALLY-WEIGHTED REGRESSION ANALYSIS OF PERCENTAGE OF LATE-STAGE PROSTATE CANCER DIAGNOSIS IN FLORIDA. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2015; 62:191-200. [PMID: 26257450 PMCID: PMC4527353 DOI: 10.1016/j.apgeog.2015.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study assessed spatial context and the local impacts of putative factors on the proportion of prostate cancer diagnosed at late-stages in Florida during the period 2001-2007. A logistic regression was performed aspatially and by geographically-weighted regression (GWR) at the nodes of a 5 km spacing grid overlaid over Florida and using all the cancer cases within a radius of 125 km of each node. Variables associated significantly with high percentages of late-stage prostate cancer included having comorbidities, smoking, being Black and living in census tracts with farmhouses. Having private or public insurance, being married or diagnosed in a for-profit facility, as well as living in census tracts with high household income reduced significantly this likelihood. Geographically-weighted regression allowed the identification of areas where the local odds ratio is significantly different from the ratio estimated using aspatial regression (State-level). For example, the local odds ratios for the comorbidity covariates were significantly smaller than the State-level odds ratio in Tallahassee and Pensacola, while they were significantly larger in Palm Beach. This emphasizes the need for local strategies and cancer control interventions to reduce the percentage of prostate cancer diagnosed at late-stages and ultimately eliminate health disparities.
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Affiliation(s)
| | - Hong Xiao
- University of Florida, Gainesville, FL, USA
| | | | - Askal Ali
- University of Florida, Gainesville, FL, USA
| | - Fei Tan
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Youjie Huang
- Florida Department of Health, Tallahassee, FL, USA
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Hung BT, Long NP, Hung LP, Luan NT, Anh NH, Nghi TD, Van Hieu M, Trang NTH, Rafidinarivo HF, Anh NK, Hawkes D, Huy NT, Hirayama K. Research trends in evidence-based medicine: a joinpoint regression analysis of more than 50 years of publication data. PLoS One 2015; 10:e0121054. [PMID: 25849641 PMCID: PMC4388379 DOI: 10.1371/journal.pone.0121054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/27/2015] [Indexed: 11/18/2022] Open
Abstract
Background Evidence-based medicine (EBM) has developed as the dominant paradigm of assessment of evidence that is used in clinical practice. Since its development, EBM has been applied to integrate the best available research into diagnosis and treatment with the purpose of improving patient care. In the EBM era, a hierarchy of evidence has been proposed, including various types of research methods, such as meta-analysis (MA), systematic review (SRV), randomized controlled trial (RCT), case report (CR), practice guideline (PGL), and so on. Although there are numerous studies examining the impact and importance of specific cases of EBM in clinical practice, there is a lack of research quantitatively measuring publication trends in the growth and development of EBM. Therefore, a bibliometric analysis was constructed to determine the scientific productivity of EBM research over decades. Methods NCBI PubMed database was used to search, retrieve and classify publications according to research method and year of publication. Joinpoint regression analysis was undertaken to analyze trends in research productivity and the prevalence of individual research methods. Findings Analysis indicates that MA and SRV, which are classified as the highest ranking of evidence in the EBM, accounted for a relatively small but auspicious number of publications. For most research methods, the annual percent change (APC) indicates a consistent increase in publication frequency. MA, SRV and RCT show the highest rate of publication growth in the past twenty years. Only controlled clinical trials (CCT) shows a non-significant reduction in publications over the past ten years. Conclusions Higher quality research methods, such as MA, SRV and RCT, are showing continuous publication growth, which suggests an acknowledgement of the value of these methods. This study provides the first quantitative assessment of research method publication trends in EBM.
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Affiliation(s)
- Bui The Hung
- University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Online Research Club, http://onlineresearchclub.org
| | - Nguyen Phuoc Long
- University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Online Research Club, http://onlineresearchclub.org
| | - Le Phi Hung
- University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Online Research Club, http://onlineresearchclub.org
| | - Nguyen Thien Luan
- University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Online Research Club, http://onlineresearchclub.org
| | - Nguyen Hoang Anh
- Online Research Club, http://onlineresearchclub.org
- School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | - Tran Diem Nghi
- Online Research Club, http://onlineresearchclub.org
- School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | - Mai Van Hieu
- Online Research Club, http://onlineresearchclub.org
- School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | - Nguyen Thi Huyen Trang
- Online Research Club, http://onlineresearchclub.org
- University of Medicine and Pharmacy at Hue City, Hue, 53000, Vietnam
| | - Herizo Fabien Rafidinarivo
- Online Research Club, http://onlineresearchclub.org
- Nagasaki University Graduate School of Pharmaceutical Sciences, Nagasaki, 852–8523, Japan
| | - Nguyen Ky Anh
- University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Online Research Club, http://onlineresearchclub.org
| | - David Hawkes
- Online Research Club, http://onlineresearchclub.org
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Victoria, 3010, Australia
- * E-mail: (NTH); (DH); (KH)
| | - Nguyen Tien Huy
- Online Research Club, http://onlineresearchclub.org
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852–8523, Japan
- * E-mail: (NTH); (DH); (KH)
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852–8523, Japan
- * E-mail: (NTH); (DH); (KH)
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Comparing methods of measuring geographic patterns in temporal trends: an application to county-level heart disease mortality in the United States, 1973 to 2010. Ann Epidemiol 2015; 25:329-335.e3. [PMID: 25776848 DOI: 10.1016/j.annepidem.2015.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/02/2015] [Accepted: 02/16/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To demonstrate the implications of choosing analytical methods for quantifying spatiotemporal trends, we compare the assumptions, implementation, and outcomes of popular methods using county-level heart disease mortality in the United States between 1973 and 2010. METHODS We applied four regression-based approaches (joinpoint regression, both aspatial and spatial generalized linear mixed models, and Bayesian space-time model) and compared resulting inferences for geographic patterns of local estimates of annual percent change and associated uncertainty. RESULTS The average local percent change in heart disease mortality from each method was -4.5%, with the Bayesian model having the smallest range of values. The associated uncertainty in percent change differed markedly across the methods, with the Bayesian space-time model producing the narrowest range of variance (0.0-0.8). The geographic pattern of percent change was consistent across methods with smaller declines in the South Central United States and larger declines in the Northeast and Midwest. However, the geographic patterns of uncertainty differed markedly between methods. CONCLUSIONS The similarity of results, including geographic patterns, for magnitude of percent change across these methods validates the underlying spatial pattern of declines in heart disease mortality. However, marked differences in degree of uncertainty indicate that Bayesian modeling offers substantially more precise estimates.
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Du PL, Wu KS, Fang JY, Zeng Y, Xu ZX, Tang WR, Xu XL, Lin K. Cervical Cancer Mortality Trends in China, 1991-2013, and Predictions for the Future. Asian Pac J Cancer Prev 2015; 16:6391-6. [PMID: 26434848 DOI: 10.7314/apjcp.2015.16.15.6391] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To analyze cervical cancer mortality trends in China from 1991-2013 and forecast the mortality distribution in future five years (2014-2018), and provide clues for prevention and treatment. MATERIALS AND METHODS Mortality data for cervical cancer in China from 1991 to 2013 were used to describe the epidemiological characteristics and distribution, including the trend of the standardized mortality rate, urban-rural differences, and age variation. Trend-surface analysis was used to analyze the geographical distribution of mortality. Curve estimation, time series, gray modeling, and joinpoint regression were performed to predict and forecast mortality trends. RESULTS In recent years, the mortality rate of cervical cancer has increased, and there is also a steady increase in the incidence from 2003 to 2013 in China. Mortality rates in rural areas are higher than in urban areas. The mortality dramatically increases in the 40+ yr age group, reaching a peak in the >85 yr age group. In addition, geographical analysis showed that the cervical cancer mortality increased from the southwest to west-central and from the southeast to northeast of the country. CONCLUSIONS The incidence rate and the mortality rate are increasing from 1991 to 2013, and the predictions show this will continue in the future. Thus, implementation of prevention and management programs for cervical cancer are necessary in China, especially for rural areas, young women in urban areas, and high risk regions (the west-central).
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Affiliation(s)
- Pei-Ling Du
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China E-mail :
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Kracalik I, Abdullayev R, Asadov K, Ismayilova R, Baghirova M, Ustun N, Shikhiyev M, Talibzade A, Blackburn JK. Changing patterns of human anthrax in Azerbaijan during the post-Soviet and preemptive livestock vaccination eras. PLoS Negl Trop Dis 2014; 8:e2985. [PMID: 25032701 PMCID: PMC4102439 DOI: 10.1371/journal.pntd.0002985] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/16/2014] [Indexed: 11/19/2022] Open
Abstract
We assessed spatial and temporal changes in the occurrence of human anthrax in Azerbaijan during 1984 through 2010. Data on livestock outbreaks, vaccination efforts, and human anthrax incidence during Soviet governance, post-Soviet governance, preemptive livestock vaccination were analyzed. To evaluate changes in the spatio-temporal distribution of anthrax, we used a combination of spatial analysis, cluster detection, and weighted least squares segmented regression. Results indicated an annual percent change in incidence of (+)11.95% from 1984 to 1995 followed by declining rate of -35.24% after the initiation of livestock vaccination in 1996. Our findings also revealed geographic variation in the spatial distribution of reporting; cases were primarily concentrated in the west early in the study period and shifted eastward as time progressed. Over twenty years after the dissolution of the Soviet Union, the distribution of human anthrax in Azerbaijan has undergone marked changes. Despite decreases in the incidence of human anthrax, continued control measures in livestock are needed to mitigate its occurrence. The shifting patterns of human anthrax highlight the need for an integrated "One Health" approach that takes into account the changing geographic distribution of the disease.
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Affiliation(s)
- Ian Kracalik
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | | | | | | | | | - Narmin Ustun
- Republican Anti-plague Station, Baku, Azerbaijan
| | | | | | - Jason K. Blackburn
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
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