{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:00:01Z","timestamp":1780380001496,"version":"3.54.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DA052214"],"award-info":[{"award-number":["R01DA052214"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA048174"],"award-info":[{"award-number":["K01DA048174"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The opioid epidemic is a significant public health challenge in North Carolina, but limited data restrict our understanding of its complexity. Examining trends and relationships among different outcomes believed to reflect opioid misuse provides an alternative perspective to understand the opioid epidemic. We use a Bayesian dynamic spatial factor model to capture the interrelated dynamics within six different county-level outcomes, such as illicit opioid overdose deaths, emergency department visits related to drug overdose, treatment counts for opioid use disorder, patients receiving prescriptions for buprenorphine, and newly diagnosed cases of acute and chronic hepatitis C virus and human immunodeficiency virus. We design the factor model to yield meaningful interactions among predefined subsets of these outcomes, causing a departure from the conventional lower triangular structure in the loadings matrix and leading to familiar identifiability issues. To address this challenge, we propose a novel approach that involves decomposing the loadings matrix within a Markov chain Monte Carlo algorithm, allowing us to estimate the loadings and factors uniquely. As a result, we gain a better understanding of the spatio-temporal dynamics of the opioid epidemic in North Carolina.<\/jats:p>","DOI":"10.1093\/biostatistics\/kxae052","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T15:24:45Z","timestamp":1733498685000},"source":"Crossref","is-referenced-by-count":2,"title":["Understanding the opioid syndemic in North Carolina: A novel approach to modeling and identifying factors"],"prefix":"10.1093","volume":"26","author":[{"given":"Eva","family":"Murphy","sequence":"first","affiliation":[{"name":"Department of Statistical Sciences, College of Arts and Sciences, Wake Forest University, \u00a0 127 Manchester Hall, Winston-Salem, NC, 27109,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6183-3303","authenticated-orcid":false,"given":"David","family":"Kline","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, 475 Vine Street , Winston-Salem, NC, 27101,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen L","family":"Egan","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Implementation Science, Wake Forest University School of Medicine, 475 Vine Street , Winston-Salem, NC, 27101,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E","family":"Lancaster","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Implementation Science, Wake Forest University School of Medicine, 475 Vine Street , Winston-Salem, NC, 27101,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C","family":"Miller","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina Chapel Hill, 135 Dauer Drive , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5002-8886","authenticated-orcid":false,"given":"Lance A","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd. 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