Simulation models of smoking behaviour provide vital forecasts of exposure to inform policy targets, estimates of the burden of disease, and impacts of tobacco control interventions. A key element of useful model-based forecasts is a clear picture of uncertainty due to the data used to inform the model, however, assessment of this parameter uncertainty is incomplete in almost all tobacco control models. As a remedy, we demonstrate a Bayesian approach to model calibration that quantifies parameter uncertainty. With a model calibrated to Australian data, we observed that the smoking cessation rate in Australia has increased with calendar year since the late 20th century, and in 2016 people who smoked would quit at a rate of 4.7 quit-events per 100 person-years (90% equal-tailed interval (ETI): 4.5–4.9). We found that those who quit smoking before age 30 years switched to reporting that they never smoked at a rate of approximately 2% annually (90% ETI: 1.9–2.2%). The Bayesian approach demonstrated here can be used as a blueprint to model other population behaviours that are challenging to measure directly, and to provide a clearer picture of uncertainty to decision-makers.
This chapter focuses on the song “Rock Island Lime”, which was performed by Robert Kelly Pace, a twenty-one-year-old convict, along with a group of inmates at Cummins Camp One, a unit of the Arkansas penal system. Their performance involved a closely patterned call-and-response, their voices dispersed in three- and sometimes four-part harmony. Between the choruses one of them imitated a train whistle. “Rock Island Line” began its journey in Little Rock, Arkansas, at the repair shops of the Chicago, Rock Island, and Pacific Railroad. Based on a traditional form and arising within a commercial setting, the song soon moved beyond this work site making new stops, shifting its contents, and streamlining its load. It migrated from a gospel quartet that the Arkansas prisoners performed to a rhythmic fable that Huddie Ledbetter created as he traveled with John Lomax as chauffeur, auto mechanic, and musical demonstrator. Eventually the song reached an incalculable number of players, singers, and listeners via skiffle, rock and roll, country, pop, and the folksong revival.
Abstract Introduction Liver cancer is the only cancer in Australia for which mortality rates have consistently risen, despite tests to identify high-risk individuals. Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Curative treatment for HCC is typically only available if detected early. Australian clinical guidelines recommend routine 6-monthly ultrasound surveillance, with or without serum alpha-fetoprotein, for individuals with liver cirrhosis. This study assesses the health and economic implications of this recommendation, utilizing novel modeling techniques. Methods We designed the sojourn time density model mathematical framework to develop a model of the evolving risk of HCC, liver disease, and death based on time since diagnosis, incorporating data on liver decompensation, HCC incidence, and HCC survival, and the impact of surveillance on cancer stage and survival. Results We estimated that adherence to 6-monthly ultrasound, with or without alpha-fetoprotein, can increase early-stage diagnosis rates, reducing HCC mortality by 22%. We estimate a cost-effectiveness ratio of $33,850 per quality-adjusted life-year (QALY) saved for 6-monthly ultrasound HCC surveillance, under the $50,000/QALY cost-effectiveness threshold. HCC surveillance was also estimated to be cost-effective at any interval from 3-24 months. Conclusions These findings support the current clinical guideline recommendation for 6-monthly ultrasound surveillance, affirming its health benefits and cost-effectiveness, and show that alternative surveillance intervals would remain beneficial and cost-effective. Our model may be used to refine surveillance recommendations for other at-risk population subgroups and inform evidence-based clinical practice recommendations, and the framework can be adapted for other epidemiological modelling. Supporting the clinical guidelines and their ongoing development as evidence evolves may be key to reversing increasing HCC mortality rates in Australia, which are predicted to increase by more than 20% by 2040.
PD-L1 expression is an important biomarker for the management of non-small cell lung cancer (NSCLC) but has been highly heterogeneous across studies. We developed a statistical model to reconcile conflicting estimates of PD-L1 prevalence by accounting for between-study variation in test sensitivity, specimen age, and laboratory count. In doing so, we obtained refined estimates for PD-L1 expression prevalence and identified differences by histological subtype, mutational status, and stage. Across 92 studies published between 2015 and 2023, the detectability of PD-L1 declined with increasing specimen age while the consistency of detection rates was greater for studies incorporating data from a higher number of laboratories. Using the 22C3 antibody as a benchmark, we predicted that 58.3% (95% CrI 49.8–66.1%) and 27.0% (95% CrI 21.2–33.1%) of NSCLC will have PD-L1 tumour proportion scores at the ≥ 1% and ≥ 50% threshold. PD-L1 expression was lower in EGFR-mutated NSCLC and higher in NSCLC with ALK, KRAS, MET, ROS1, and RET alterations. PD-L1 expression was more common with later-stage disease. Overall, this work highlights the continuing challenge of consistency in PD-L1 testing. Although the underlying prevalence of PD-L1 expression varies in the lung cancer population based on tumour-related factors, controllable differences in testing parameters also account for variations in PD-L1 prevalence.
This book presents the rich backstories of thirteen performances captured on Library of Congress field recordings between 1934 and 1942 in locations reaching from Southern Appalachia to the Mississippi Delta and the Great Plains. These performances were recorded in kitchens and churches, on porches and in prisons, in hotel rooms and school auditoriums. Documented during the golden age of the Library of Congress recordings, they capture not only the words and tunes of traditional songs but also the sounds of life in which the performances were embedded: children laugh, neighbors comment, trucks pass by. The book's author sought out the performers on these recordings, their families, fellow musicians, and others who remembered them. The book reconstructs the sights and sounds of the recording sessions themselves and how the music worked in all their lives. Some of these performers developed musical reputations beyond these field recordings, but for many, these tracks represent their only appearances on record: for example, prisoners at the Arkansas State Penitentiary jumping on “the Library's recording machine” in a rendering of Rock Island Line. The profiles and abundant photos in the book bring to life largely unheralded individuals—domestics, farm laborers, state prisoners, schoolchildren, cowboys, housewives and mothers, loggers and miners—whose music has become part of the wider American musical soundscape. By exploring how these singers and instrumentalists exerted their own creativity on inherited forms, “amplifying tradition's gifts,” the book shows how a single artist can make a difference within a democracy.
Digital asset management, as part of a larger organisational data strategy, is arguably a firm’s most valuable asset. Proprietary data encompass theanalytical actualities of the day-to-day, and illuminate the value-add assets driving business strategy. It is difficult to replicate; it can be a powerful device. The New Zealand microcosm can spark innovative and integrated insights into digitally enabled asset management initiatives. For big data that is raw, structured, unstructured or high-dimensional, nascent technologies are creating entirely new frontiers that organisations may ignore at their peril. By viewing a small, tech-savvy ecosystem within a culture that values sustainability, environmental regeneration and stewardship, paradigms that lead to novel or agile innovations arise. This research indicates new trends in high-dimensional digital asset management that can be leveraged intrapreneurially to develop world-class opportunities of global consequence. Asset reallocation considerations are indicated, while issues and challenges are explored. In particular, emerging high dimensional research advances are highlighted with an evolutionary focus. Applications for these data are discussed as a preface for shedding light on fields that are opening in more entrepreneurial settings, because of the digital ecosystem that is developing. The summary groups applications most likely to return transformational outcomes when targeted digital asset strategies underpin organisational operations, albeit with supportive management.
Abstract Background Health surveys are commonly somewhat non-representative of their target population, potentially limiting the generalisability of prevalence estimates for health/behaviour characteristics and disease to the population. To reduce bias, weighting methods have been developed, though few studies have validated weighted survey estimates against generally accepted high-quality independent population benchmark estimates. Methods We applied post-stratification and raking methods to the Australian 45 and Up Study using Census data and compared the resulting prevalence of characteristics to accepted population benchmark estimates and separately, the incidence rates of lung, colorectal, breast and prostate cancer to whole-of-population estimates using Standardised Incidence Ratios (SIRs). Results The differences between 45 and Up Study and population benchmark estimates narrowed following sufficiently-informed raking, e.g. 13.6% unweighted prevalence of self-reported fair/poor overall health, compared to 17.0% after raking and 17.9% from a population benchmark estimate. Raking also improved generalisability of cancer incidence estimates. For example, unweighted 45 and Up Study versus whole-of-population SIRs were 0.700 (95%CI:0.574–0.848) for male lung cancer and 1.098 (95%CI:1.002–1.204) for prostate cancer, while estimated SIRs after sufficiently-informed raking were 0.828 (95%CI:0.684–0.998) and 1.019 (95%CI:0.926–1.121), respectively. Conclusion Raking may be a useful tool for improving the generalisability of exposure prevalence and disease incidence from surveys to the population.
Abstract Australia’s National Lung Cancer Screening Program will commence in July 2025, targeted at individuals aged 50-70 years with a 30 pack-year smoking history, who either currently smoke or have quit within the last 10 years. We forecasted the number of screening-eligible individuals over the first 5 years of the program using data from the 2019 National Drug Strategy Household Survey, and the 2022 Australian Bureau of Statistics population projections. Multiple imputation integrated with predictive modelling of future or unmeasured smoking characteristics was used to address missing data and simultaneously, to project individuals’ smoking histories to 2030. In 2025, 930,500 (95% prediction interval 852,200-1,019,000) individuals were estimated to be eligible, with the number meeting the criteria declining slightly over the years 2025-2030 in all Australian jurisdictions. Overall, 26-30% of those eligible will have quit smoking, and 70-74% will currently smoke. These estimates can be used in resource planning and as an indicative denominator to track participation rates for the program over time.
The Beautiful Music All Around Us presents extraordinarily rich backstories of thirteen performances captured on Library of Congress field recordings between 1934 and 1942 in locations reaching from Southern Appalachia to Mississippi Delta and Great Plains. Including children's play song Shortenin' Bread, fiddle tune Bonaparte's Retreat, blues Another Man Done Gone, and spiritual Ain't No Grave Can Hold My Body Down, these performances were recorded in kitchens and churches, on porches and in prisons, in hotel rooms and school auditoriums. Documented during golden age of Library of Congress recordings, they capture not only words and tunes of traditional songs but also sounds of life in which performances were embedded: children laugh, neighbors comment, trucks pass by. Musician and researcher Stephen Wade sought out performers on these recordings, their families, fellow musicians, and others who remembered them. He reconstructs sights and sounds of recording sessions themselves and how music worked in all their lives. Some of these performers developed musical reputations beyond these field recordings, but for many, these tracks represent their only appearances on record: prisoners at Arkansas State Penitentiary jumping on the Library's recording machine in a rendering of Rock Island Line; Ora Dell Graham being called away from schoolyard to sing jump-rope rhyme Pullin' Skiff; Luther Strong shaking off a hungover night in jail and borrowing a fiddle to rip into Glory in Meetinghouse. Alongside loving and expert profiles of these performers and their locales and communities, Wade also untangles histories of these iconic songs and tunes, tracing them through slave songs and spirituals, British and homegrown ballads, fiddle contests, gospel quartets, and labor laments. By exploring how these singers and instrumentalists exerted their own creativity on inherited forms, amplifying tradition's gifts, Wade shows how a single artist can make a difference within a democracy. Reflecting decades of research and detective work, profiles and abundant photos in The Beautiful Music All Around Us bring to life largely unheralded individuals--domestics, farm laborers, state prisoners, schoolchildren, cowboys, housewives and mothers, loggers and miners--whose music has become part of wider American musical soundscape. The paperback edition does not include an accompanying CD.
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