Sickle cell trait in São Tomé e Príncipe: a population-based prevalence study in women of reproductive age.

BACKGROUND: Sickle Cell Disorder is Africa's most prevalent genetic disease. Yet, it remains a neglected condition, with high mortality under-five, and a lack of population-based studies in the region. This is the first of its kind in São Tomé e Príncipe, aiming to estimate the prevalence of sickle cell trait and other haemoglobin variants in women of reproductive age and its associated factors. METHODS: We conducted a cluster survey in 35 neighbourhoods. Haemoglobin was assessed through point-of-care capillary electrophoresis or high-performance liquid chromatography, and sociodemographic data through questionnaires. The weighted prevalence of sickle cell trait (HbAS) and HbC carriers was estimated with a 95% confidence interval (95% CI). We calculated weighted prevalence ratios (95% CI) through robust Poisson regression for its association with age and individual and collective genetic heritage. FINDINGS: The prevalence of sickle cell trait in women of reproductive age in São Tomé e Príncipe (n = 376) was 13.45% (95% CI: 9.05-19.00). The prevalence of HbC carriers was 8.00% (95% CI: 4.71-12.00). Older age and speaking Forro or Angolar were positively associated with having sickle cell trait. INTERPRETATION: The prevalence of sickle cell trait in São Tomé e Príncipe ranks high in the West African region. The country should follow international guidelines, implementing newborn screening and comprehensive healthcare management.

Representative Public Health Surveys Pose Several Challenges: Lessons Learned Across 9 Communities During the COVID-19 Pandemic.

Community surveillance surveys offer an opportunity to obtain important and timely public health information that may help local municipalities guide their response to public health threats. The objective of this paper is to present approaches, challenges, and solutions from SARS-CoV-2 surveillance surveys conducted in different settings by 2 research teams. For rapid assessment of a representative sample, a 2-stage cluster sampling design was developed by an interdisciplinary team of researchers at Oregon State University between April 2020 and June 2021 across 6 Oregon communities. In 2022, these methods were adapted for New York communities by a team of veterinary, medical, and public health practitioners. Partnerships were established with local medical facilities, health departments, COVID-19 testing sites, and health and public safety staff. Field staff were trained using online modules, field manuals describing survey methods and safety protocols, and in-person meetings with hands-on practice. Private and secure data integration systems and public awareness campaigns were implemented. Pilot surveys and field previews revealed challenges in survey processes that could be addressed before surveys proceeded. Strong leadership, robust trainings, and university-community partnerships proved critical to successful outcomes. Cultivating mutual trust and cooperation among stakeholders is essential to prepare for the next pandemic.

Longitudinal course and outcome of social jetlag in adolescents: A 1-year follow-up study of the adolescent sleep health epidemiological cohorts.

The discrepancy in sleep timing between weekdays and weekends - social jetlag (SJL) - is known to negatively affect student quality of life (QOL). However, the association between social jetlag and physical/mental QOL among adolescents and the precise effect of social jetlag on depressive symptoms and daytime sleepiness remains unknown. This study investigated the longitudinal course, risk factors, and effects of social jetlag, a circadian misalignment, in a school-based cohort. The participants were 427 students (13.3 ± 0.6 years, 45.2% girls) from five junior high schools. We performed a baseline survey in 2019 and a 1-year follow-up survey in 2020. Depressive symptoms, QOL, and daytime sleepiness were assessed using the Birleson Depression Self-Rating Scale for Children, Paediatric Quality of Life Inventory, and Paediatric Daytime Sleepiness Scale. In the baseline survey, 49.6% of the students reported SJL ≥1 h, and 17.1% reported SJL ≥2 h. Among them, 37.2% and 6.8% reported persistent SJL at follow-up, respectively. New incidences of SJL ≥1 h were associated with older age, non-attainment of menarche or voice changes, and longer duration of smartphone use, whereas its persistence was associated with a later chronotype. Persistence of SJL ≥1 h and ≥2 h predicted depressive symptoms and daytime sleepiness at follow-up, whereas new incidences of SJL ≥2 h predicted lower QOL. In conclusion, social jetlag has a persistent course, and daytime functioning can deteriorate as social jetlag becomes chronic. Our findings suggest the need for intensive interventions for social jetlag among adolescents.

[Application of Risk Management Combined With Precision Nursing in Physical Function Maintenance and Safety Management of Older Patients With Chronic Diseases].

Objective: To examine the application effect of risk management combined with precision nursing in the maintenance of physical functions and the safety management of older patients with chronic diseases and to provide the basis for the formulation of physical function maintenance and fall prevention programs for older inpatients with chronic diseases. Methods: The control group and the observation group were randomly selected by cluster sampling from geriatric wards of similar conditions in West China University, Sichuan University. The control group received conventional nursing care and the observation group had risk management combined with precision nursing on top of the conventional nursing care. The primary outcome indicator was activities of daily living (ADL). The secondary outcome indicators were the whole-day ambulation time and infusion time, the incidence of falls, and length-of-stay among patients. Results: A total of 109 patients in the control group and 110 patients in the observation group completed the study. At the time of admission, there was no statistically significant difference between the ADL scores of the two groups ( P>0.05). Among the patients in the intervention group, the post-intervention ADL scores of the observation group (75.74±22.71) were higher than the pre-intervention ADL scores (68.74±17.32) and the difference was statistically significant ( t=2.435, P<0.05). Among the patients in the control group, the post-intervention ADL scores of the control group (70.36±21.90) were higher than the pre-intervention ADL scores (69.14±18.29) and the difference was not statistically significant ( t=0.549, P>0.05). In addition, the post-intervention ADL score of the observation group was higher than that of the control group, and the difference was statistically significant ( t=2.973, P<0.05). After intervention, patients in the observation group had higher whole-day ambulation time during hospitalization (7.35±2.07) than those in the control group did (4.11±2.62), showing significant difference ( t=1.508, P<0.05). The whole-day infusion time during hospitalization of the observation group (1.68±0.19) was lower than that of the control group (2.39±0.31), showing significant difference ( t=-2.339, P<0.05). There was no significant difference in the incidence of falls or the length-of-stay between the two groups ( P>0.05). Conclusion: Risk management combined with precision nursing helps improve patients' ability to perform activities of daily in older patients with chronic diseases, increase their whole-day ambulation time, and reduce the whole-day infusion time without increasing the incidence of falls, which has a positive effect on physical function maintenance and fall prevention in hospital safety management of older patients with chronic diseases.

Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic is characterized by rapid increases in infection burden owing to the emergence of new variants with higher transmissibility and immune escape. To date, monitoring the COVID-19 pandemic has mainly relied on passive surveillance, yielding biased epidemiological measures owing to the disproportionate number of undetected asymptomatic cases. Active surveillance could provide accurate estimates of the true prevalence to forecast the evolution of the pandemic, enabling evidence-based decision-making. OBJECTIVE: This study compared 4 different approaches of active SARS-CoV-2 surveillance focusing on feasibility and epidemiological outcomes. METHODS: A 2-factor factorial randomized controlled trial was conducted in 2020 in a German district with 700,000 inhabitants. The epidemiological outcome comprised SARS-CoV-2 prevalence and its precision. The 4 study arms combined 2 factors: individuals versus households and direct testing versus testing conditioned on symptom prescreening. Individuals aged ≥7 years were eligible. Altogether, 27,908 addresses from 51 municipalities were randomly allocated to the arms and 15 consecutive recruitment weekdays. Data collection and logistics were highly digitized, and a website in 5 languages enabled low-barrier registration and tracking of results. Gargle sample collection kits were sent by post. Participants collected a gargle sample at home and mailed it to the laboratory. Samples were analyzed with reverse transcription loop-mediated isothermal amplification (RT-LAMP); positive and weak results were confirmed with real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Recruitment was conducted between November 18 and December 11, 2020. The response rates in the 4 arms varied between 34.31% (2340/6821) and 41.17% (2043/4962). The prescreening classified 16.61% (1207/7266) of the patients as COVID-19 symptomatic. Altogether, 4232 persons without prescreening and 7623 participating in the prescreening provided 5351 gargle samples, of which 5319 (99.4%) could be analyzed. This yielded 17 confirmed SARS-CoV-2 infections and a combined prevalence of 0.36% (95% CI 0.14%-0.59%) in the arms without prescreening and 0.05% (95% CI 0.00%-0.108%) in the arms with prescreening (initial contacts only). Specifically, we found a prevalence of 0.31% (95% CI 0.06%-0.58%) for individuals and 0.35% (95% CI 0.09%-0.61%) for households, and lower estimates with prescreening (0.07%, 95% CI 0.0%-0.15% for individuals and 0.02%, 95% CI 0.0%-0.06% for households). Asymptomatic infections occurred in 27% (3/11) of the positive cases with symptom data. The 2 arms without prescreening performed the best regarding effectiveness and accuracy. CONCLUSIONS: This study showed that postal mailing of gargle sample kits and returning home-based self-collected liquid gargle samples followed by high-sensitivity RT-LAMP analysis is a feasible way to conduct active SARS-CoV-2 population surveillance without burdening routine diagnostic testing. Efforts to improve participation rates and integration into the public health system may increase the potential to monitor the course of the pandemic. TRIAL REGISTRATION: Deutsches Register Klinischer Studien (DRKS) DRKS00023271; https://tinyurl.com/3xenz68a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-021-05619-5.

Diagnostic Strategies for Ruminant Populations.

Veterinarians may be asked to assess the presence, absence, or prevalence of a disease in an animal population or to compare the effects of management factors on disease status or production performance. The scope of diagnostic investigations in ruminant populations is often limited by the availability of time, money, and animal handling infrastructure. Selecting the correct number and type of animals to sample maximizes the benefits of the investigation, while minimizing costs. To meet the objectives of the study, the veterinarian must understand the statistical elements that need to be considered to calculate the appropriate sample size.

Ratio-cum-product Type Estimators for Rare and Hidden Clustered Population.

The use of multi-auxiliary variables helps in increasing the precision of the estimators, especially when the population is rare and hidden clustered. In this article, four ratio-cum-product type estimators have been proposed using two auxiliary variables under adaptive cluster sampling (ACS) design. The expressions of the mean square error (MSE) of the proposed ratio-cum-product type estimators have been derived up to the first order of approximation and presented along with their efficiency conditions with respect to the estimators presented in this article. The efficiency of the proposed estimators over similar existing estimators have been assessed on four different populations two of which are of the daily spread of COVID-19 cases. The proposed estimators performed better than the estimators presented in this article on all four populations indicating their wide applicability and precision.

National health surveys: overview of sampling techniques and data collected using complex designs / Encuestas nacionales de salud: descripción general de las técnicas de muestreo y los datos recopilados por diseños complejos / Inquéritos nacionais de saúde: visão geral sobre técnicas de amostragem e dados coletados por desenhos complexos

Abstract This article aimed to present an overview of national health surveys, sampling techniques, and components of statistical analysis of data collected using complex sampling designs. Briefly, surveys aimed at assessing the nutritional status of Brazilians and maternal and child health care were described. Surveys aimed at investigating access to and use of health services and funding, those aimed at surveillance of chronic noncommunicable diseases and associated behaviors, and those focused on risk practices regarding sexually transmitted infections were also addressed. Health surveys through social networks, including online networks, deserved specific attention in the study. The conclusion is that the development of health surveys in Brazil, in different areas and using different sampling methodologies, has contributed enormously to the advancement of knowledge and to the formulation of public policies aimed at the health and well-being of the Brazilian population.

Resumen Este estudio tuvo como objetivo presentar una descripción de las encuestas nacionales de salud, las técnicas de muestreo y los componentes del análisis estadístico de diseños de muestreo complejos. Brevemente, se describieron encuestas destinadas a evaluar el estado nutricional y la atención a la salud materno-infantil. También se abordaron las encuestas dirigidas a investigar el acceso y uso de los servicios de salud y el financiamiento, las dirigidas a la vigilancia de las enfermedades crónicas no transmisibles y comportamientos asociados, y las enfocadas a las prácticas de riesgo para las infecciones de transmisión sexual. Las encuestas de salud a través de las redes sociales, incluidas las virtuales, merecieron atención específica en el estudio. Se concluye que el desarrollo de encuestas de salud en Brasil ha contribuido enormemente para el avance del conocimiento y para la formulación de políticas públicas dirigidas a la salud y el bienestar de la población brasileña.

Resumo O artigo teve por finalidade apresentar um panorama dos inquéritos nacionais de saúde, técnicas de amostragem e componentes da análise estatística de dados coletados por desenhos complexos de amostragem. Foram descritos, brevemente, os inquéritos dirigidos à avaliação do estado nutricional dos brasileiros e da atenção à saúde materno-infantil. Inquéritos voltados à investigação do acesso, utilização dos serviços e financiamento da saúde, aqueles dedicados à vigilância das doenças crônicas não transmissíveis e comportamentos associados e os focados nas práticas de risco às infecções sexualmente transmissíveis foram também abordados. As pesquisas de saúde por redes sociais, incluindo as virtuais, mereceram atenção específica. Conclui-se que o desenvolvimento de inquéritos de saúde no Brasil, em diferentes áreas e por distintas metodologias de amostragem, contribuiu enormemente para o avanço do conhecimento e a formulação de políticas públicas dirigidas à saúde e bem-estar da população brasileira.

Impact of hepatitis B vaccination programs in Vietnam evaluated by estimating HBsAg prevalence.

Background: Vietnam introduced a 3-dose hepatitis B (HBV) immunization program comprising 1 dose immediately after birth and 2 or 3 in infancy in the past 20 years, but the impact of the vaccine has not been systematically evaluated. Thus, we conducted this survey aiming to estimate the age-specific chronic HBV prevalence in the general population and to evaluate HBV immunization effectiveness. Methods: Population-based, four-stage cluster sampling was used in the South Central Coast region of Vietnam. The point-of-care Determine rapid test was used to assess hepatitis B surface antigen (HBsAg) positivity. Results: A total of 2,075 samples were included in the study. HBsAg prevalence was significantly higher among adults aged 20-39 years than in the population aged 1-19 years (8.0% [95% confidence interval 5.0-12.0] vs. 2.0% [95% confidence interval 1.0-6.0], p<0.01). HBsAg prevalence decreased after implementation of the 3-dose vaccination schedule during infancy from 1997 to 2002, whereas the change in prevalence after implementation of the birth dosing was not significant. A slight increase in HBsAg prevalence was observed for the cohort born in 2011, 2012, and 2013, when there was a vaccine shortage and media reports of immunization resistance. Conclusions: This is the first population-based assessment of the introduction of the HBV vaccine in Vietnam performed by estimating the HBsAg prevalence across a wide range of ages. The results showed that the HBV immunization policy effectively reduces HBsAg prevalence in general, although birth dosing of the vaccine and low immunization coverage should be carefully monitored.

Predictors of quality of life among geriatric population in a tribal dominant state of India: A community based analytical study.

Background: Improving the quality of life of the geriatric population along with maintaining their health and promoting social participation still poses a major public health challenge in the twenty-first century. Hence, we planned to measure the quality of life (QOL) in each domain namely physical, psychological, social, and environmental using the world health organization quality of life brief version (WHO QOL-BREF) questionnaire and to assess the predictors of QOL among the elderly population. Methodology: A community-based cross-sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of 6 months. The study was carried out among 206 geriatric populations fulfilling the eligibility criteria. The data collected were entered in MS Excel and analyzed using SPSS version 20. The QOL scores were expressed in terms of mean and standard deviation, and the difference between mean scores was tested by using student t-test/analysis of variance (ANOVA). The predictor associated with QOL was done by multiple linear regression analysis. P value less than 0.05 was considered statistically significant. Results: A total of 206 geriatric people fulfilling the study criteria were enrolled during the study. The majority of the people were of the age between 60 and69 years (71.8%). Most of them 202 (98.1%) resided in rural areas, 108 (52.4%) of them were illiterate by education, and nearly half 102 (49.5%) depended on pension for livelihood. Nontribal ethnicity, backward category, illiteracy, low socio-economic status, nuclear family, elderly person having no own source of income, currently living alone, person having more co-morbidity, and less activities of daily living (ADL) score were significantly associated with low QOL score. Conclusion: Overall QOL was good to excellent in Ranchi, Jharkhand. We concluded that QOL is affected by many different factors.

Using Small Area Prevalence Survey Methods to Conduct Blood Lead Assessments among Children.

INTRODUCTION: Prevalence surveys conducted in geographically small areas such as towns, zip codes, neighborhoods or census tracts are a valuable tool for estimating the extent to which environmental risks contribute to children's blood lead levels (BLLs). Population-based, cross-sectional small area prevalence surveys assessing BLLs can be used to establish a baseline lead exposure prevalence for a specific geographic region. MATERIALS AND METHODS: The required statistical methods, biological and environmental sampling, supportive data, and fieldwork considerations necessary for public health organizations to rapidly conduct child blood lead prevalence surveys at low cost using small area, cluster sampling methodology are described. RESULTS: Comprehensive small area prevalence surveys include partner identification, background data collection, review of the assessment area, resource availability determinations, sample size calculations, obtaining the consent of survey participants, survey administration, blood lead analysis, environmental sampling, educational outreach, follow-up and referral, data entry/analysis, and report production. DISCUSSION: Survey results can be used to estimate the geographic distribution of elevated BLLs and to investigate inequitable lead exposures and risk factors of interest. CONCLUSIONS: Public health officials who wish to assess child and household-level blood lead data can quickly apply the data collection methodologies using this standardized protocol here to target resources and obtain assistance with these complex procedures. The standardized methods allow for comparisons across geographic areas and over time.

Prevalence and Determinants of Depression among Multi Drug Resistant (MDR) TB cases registered under National Tuberculosis Elimination Program in Ahmedabad City.

Background: Multidrug-resistant tuberculosis (MDR-TB) increases the risk of depression, lowers treatment compliance leading to poor outcomes. Objectives: To (1) document the prevalence of depression among MDR-TB cases registered at tuberculosis units (TUs) of Ahmedabad city and (2) assess determinants of depression. Methodology: Adult MDR-TB patients registered at all (23) TUs of Ahmedabad city, were studied using semi-structured questionnaire along with Gujarati translated version of the Hamilton Depression Rating Scale (HAM-D) to assess the severity of depression based on 17 items. The sample size at 95% level of significance, was 251. Probability proportional to size sampling was adopted for selecting participants from each of the 23 TUs. Proportions and odds ratio with confidence interval with probability value were calculated. Results: Of 251, only 185 (73.7%) cases could be contacted. Mortality proportion among selected cases was 18.7%. More than one-fifth (22%) had ≥1 comorbidity and 9.7% had another active TB case in the family. 161 (87.1) experienced ≥1 adverse event. Financial, social, or psychological stressors were reported by 22% of cases. Based on the HAM-D scale, 16.2% suffered from depression, determinants of depression by univariate analysis showed significant association with recent family issues, discrimination, financial/other troubling issues, and the presence of adverse drug event. Conclusion: MDR-TB cases are more vulnerable for developing depression as the prevalence was 16.2% among them. Hence, cases need to be monitored closely for depression at TU as well at community level.

Space-time clusters of severe acute respiratory syndrome and COVID-19 and hierarchical urban network in the state of Mato Grosso, Brazil, 2020-2021 / Clusters espaço-temporais de síndrome respiratória aguda grave e COVID-19 e rede urbana hierárquica no estado de Mato Grosso, Brasil, 2020-2021 / Agrupaciones espacio-temporales de síndrome respiratorio agudo severo y COVID-19 y red urbana jerárquica en el estado de Mato Grosso, Brasil, 2020-2021

Objective: to analyze the space-time distribution of COVID-19 in the state of Mato Grosso, Brazil. Methods: Weekly case records of Severe Acute Respiratory Syndrome were obtained from the Ministry of Health's Database related to this syndrome, including data from COVID-19. Temporal and spatiotemporal analysis using scanning statistics to identify clusters of severe acute respiratory syndrome cases were performed with the software SaTScan. Results: A total of 27,093 cases was observed, with an incidence of 768.33/100,000 inhabitants. The spatial distribution considering the period of study evidenced the heterogeneity of values in the state. The highest incidence rates were observed in more populous municipalities. Conclusion: We highlight priority areas for interventions, aiming at controlling the transmission of the disease and reducing transmission risks to more remote areas of the state of Mato Grosso.

Objetivo: Analisar distribuição espaço-temporal de COVID-19 no estado de Mato Grosso, Brasil. Métodos: Registros de casos semanais de Síndrome Respiratória Aguda Grave foram obtidos junto ao Banco de Dados dessa síndrome do Ministério da Saúde, incluindo dados de COVID-19. Análises temporal e espaço-temporal utilizando varreduras estatísticas para identificação de clusters de casos de síndrome respiratória aguda grave foram realizadas com o programa SaTScan. Resultados: Foram observados 27.093 casos, com incidência de 768,33/100.000 habitantes. A distribuição espacial considerando o período de estudo evidenciou heterogeneidade de valores no estado. As maiores taxas de incidência foram observadas em municípios mais populosos. Conclusão: Destacam-se áreas prioritárias para intervenções, priorizando controle da transmissão da doença e redução dos riscos de transmissão para áreas mais remotas do estado de Mato Grosso.

Objetivo: Analizar la distribución espacio-temporal de COVID-19 en la provincia estado de Mato Grosso, Brasil. Métodos: Se obtuvieron registros semanales de casos de Síndrome Respiratorio Agudo Severo (SRAG) de la Base de Datos SRAG del Ministerio de Salud, incluyendo datos de COVID-19. Se realizaron análisis temporales y espaciotemporales utilizando exploraciones estadísticas para identificar grupos de casos SRAG con el programa SaTScan. Resultados: se observaron 27.093 casos, con una incidencia de 768,33 / 100.000 habitantes. La distribución espacial considerando el período de estudio mostró heterogeneidad de valores en el estado. Las tasas de incidencia más altas se observaron en los municipios más poblados. Conclusión: Se destacan las áreas prioritarias para las intervenciones, priorizando el control de la transmisión de enfermedades y la reducción de los riesgos de transmisión a áreas más remotas del estado de Mato Grosso.

Prevalence of current and past COVID-19 in Ohio adults.

Purpose To estimate the prevalence of current and past COVID-19 in Ohio adults. Methods We used stratified, probability-proportionate-to-size cluster sampling. During July 2020, we enrolled 727 randomly-sampled adult English- and Spanish-speaking participants through a household survey. Participants provided nasopharyngeal swabs and blood samples to detect current and past COVID-19. We used Bayesian latent class models with multilevel regression and poststratification to calculate the adjusted prevalence of current and past COVID-19. We accounted for the potential effects of non-ignorable non-response bias. Results The estimated statewide prevalence of current COVID-19 was 0.9% (95% credible interval: 0.1%-2.0%), corresponding to ∼85,000 prevalent infections (95% credible interval: 6,300-177,000) in Ohio adults during the study period. The estimated statewide prevalence of past COVID-19 was 1.3% (95% credible interval: 0.2%-2.7%), corresponding to ∼118,000 Ohio adults (95% credible interval: 22,000-240,000). Estimates did not change meaningfully due to non-response bias. Conclusions Total COVID-19 cases in Ohio in July 2020 were approximately 3.5 times as high as diagnosed cases. The lack of broad COVID-19 screening in the United States early in the pandemic resulted in a paucity of population-representative prevalence data, limiting the ability to measure the effects of statewide control efforts.

Estimating the growth rate of infection during the early phase of a pandemic like COVID-19.

At the very outbreak of a pandemic, it is very important to be able to assess the spreading rate of the disease i.e., the rate of increase of infected people in a specific locality. Combating the pandemic situation critically depends on an early and correct prediction of, to what extent the disease may possibly grow within a short period of time. This paper attempts to estimate the spreading rate by counting the total number of infected persons at times. Adaptive clustering is especially suitable for forming clusters of infected persons distributed spatially in a locality and successive sampling is used to measure the growth in number of infected persons. We have formulated a 'chain ratio to regression type estimator of population total' in two occasions adaptive cluster successive sampling and studied the properties of the estimator. The efficacy of the proposed strategy is demonstrated through simulation technique as well as real life population which is followed by suitable recommendation.

The Spatiotemporal Data Fusion (STDF) Approach: IoT-Based Data Fusion Using Big Data Analytics.

Enormous heterogeneous sensory data are generated in the Internet of Things (IoT) for various applications. These big data are characterized by additional features related to IoT, including trustworthiness, timing and spatial features. This reveals more perspectives to consider while processing, posing vast challenges to traditional data fusion methods at different fusion levels for collection and analysis. In this paper, an IoT-based spatiotemporal data fusion (STDF) approach for low-level data in-data out fusion is proposed for real-time spatial IoT source aggregation. It grants optimum performance through leveraging traditional data fusion methods based on big data analytics while exclusively maintaining the data expiry, trustworthiness and spatial and temporal IoT data perspectives, in addition to the volume and velocity. It applies cluster sampling for data reduction upon data acquisition from all IoT sources. For each source, it utilizes a combination of k-means clustering for spatial analysis and Tiny AGgregation (TAG) for temporal aggregation to maintain spatiotemporal data fusion at the processing server. STDF is validated via a public IoT data stream simulator. The experiments examine diverse IoT processing challenges in different datasets, reducing the data size by 95% and decreasing the processing time by 80%, with an accuracy level up to 90% for the largest used dataset.

Analysis of the exposure to risk factors for strokes of the high-risk population in Zunyi City, Guizhou Province of China.

BACKGROUND: To determine the exposure rates of the risk factors and the distribution characteristics of the population at high risk for stroke in Zunyi City, and thereby provide references for health management of the population. METHODS: Cluster sampling was applied to collect the medical histories, laboratory tests, and physical examinations of permanent residents in Zunyi City, Guizhou Province, for the purpose of analyzing the characteristics of risk factors in the population at high risk for stroke. RESULTS: A total of 1,382 residents were screened as the high-risk population [681 males (49.3%), 701 females (50.7%)] with a detection rate of 11.11%. For the high-risk population, the top 5 risk factors for stroke were hypertension (78.9%), dyslipidemia (64.5%), obesity (54.1%), lack of exercise (48.8%), and smoking (35.1%). The exposure rates of females at high risk of hypertension, diabetes, dyslipidemia, and obesity were significantly higher than those of males, while the smoking rate of the high-risk males was significantly higher than that of the females. Significantly different exposure rates of stroke from hypertension, smoking, dyslipidemia, lack of exercise, overweight or obesity, and family history were shown in high-risk populations of different ages, while the incidence of stroke/transient ischemic attack (TIA) showed an increasing trend with aging. CONCLUSIONS: Hypertension, dyslipidemia, and obesity are the main risk factors for stroke in Zunyi City, with the detection rate of high-risk females being slightly higher than that of the males, and the population with a history of stroke/TIA performed better than the population with more than 3 risk factors.

Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan.

BACKGROUND: Previous epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults. METHODS: We conducted face-to-face surveys of 525 adults, who were aged 40-91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40-97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia. RESULTS: Sarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject's calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8-9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants. CONCLUSIONS: Sarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia. TRIAL REGISTRATION: UMIN000036880, registered prospectively May 29, 2019,  https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027.

A numerical approach to maximize the number of testing of COVID-19 using conditional cluster sampling method.

The COVID-19 pandemic is the defining health crisis of the world in 2020 and the world economy is affected as well. Bangladesh is also one of the impacted countries, which needs to conduct sufficient tests to identify patients and accordingly adopt measures to limit the massive outbreak of this viral infection. But due to economic drawbacks and also unavailability of testing equipment, Bangladesh is lagging critically behind in test numbers. This study shows a pool testing method named Conditional Cluster Sampling (CCS) that utilizes soft computing and data analysis techniques to reduce the expense of total testing equipment. The proposed method also demonstrates its effectiveness compared to the traditional individual testing method. Firstly, according to patients' symptoms and severity of their conditions, they are classified into four classes- Minor, Moderate, Major, Critical. After that Random Forest Classifier (RFC) is used to predict the class. Then random sampling is done from each class according to CCS. Finally, using Monte Carlo Simulation (MCS) for 100 cycles, the effectiveness of CCS is demonstrated for different probability levels of infection. It is shown that the CCS method can save up to 22% of the test kits that can save a huge amount of money as well as testing time.

Sampling plan and methodological aspects: a household healthcare survey in Piauí / Plano de amostragem e aspectos metodológicos: inquérito de saúde domiciliar no Piauí

ABSTRACT OBJECTIVE To describe the methodological aspects of the Piauí home healthcare survey (ISAD-PI) and assess the relation between sampling plan, precision, and design effects, assuming that population health surveys are relevant instruments for health monitoring. METHODS ISAD-PI was a population-based cross-sectional study that analyzed the living conditions and health status of the population residing in urban areas in the municipalities of Teresina and Picos, in Piauí. Sampling was carried out by conglomerates in two stages: Primary Sampling Units and households. To calculate the sample size, we considered the stratification of the population in both cities, according to the age of the individuals. We evaluated the "non-response" rate (NRR) and estimated the proportions according to sex and age, as well as the prevalence of social determinants of health in order to assess the compliance of the sampling plan. Analyses related to the precision according to the coefficient of proportion variation of the standard error (Cv-pˆ) and the design effect (deff). Cv-pˆ less than 20% and deff less than 1.5 were considered adequate. The total NRR of households was 38.2% in Teresina and 38.3% in Picos. We carried out twenty-four proportion estimates in relation to age and sex and 48 prevalence of social and health determinants estimates, totaling 72 estimates. Among them, 71 had Cv-pˆ less than 20% and 61 had deff less than or equal to 1.5. CONCLUSION Data generated from the ISAD-PI may contribute to the assessment of health and morbidity conditions in the population. Furthermore, methodological aspects employed in this research may serve as a basis for studies carried out in other cities in Brazil.

RESUMO OBJETIVO Descrever os aspectos metodológicos do Inquérito de Saúde Domiciliar no Piauí (ISAD-PI), bem como avaliar a conformidade do plano amostral em relação à precisão e aos efeitos do desenho, dado que os inquéritos populacionais de saúde constituem instrumentos importantes para o monitoramento da situação de saúde da população. MÉTODOS O ISAD-PI foi um estudo de base populacional, transversal, que analisou as condições de vida e situação de saúde da população residente nas áreas urbanas dos municípios de Teresina e Picos, no Piauí. A amostragem foi realizada por conglomerados, em dois estágios: Unidades Primárias de Amostragem e domicílios. Para o cálculo do tamanho da amostra, considerou-se a estratificação da população de ambas as cidades, de acordo com a idade dos indivíduos, para ambos os sexos. Para avaliação da conformidade do plano amostral, foi avaliada a taxa de "não-resposta" (TNR) e, além disso, as estimativas de proporções segundo sexo e idade, bem como as prevalências de determinantes sociais de saúde, que foram analisadas em relação à precisão por meio do coeficiente de variação da proporção do erro padrão (Cv-pˆ) e do efeito do delineamento (deff). Foram considerados adequados Cv-pˆ menores que 20%, e deff menores que 1,5. A TNR-Total dos domicílios foi de 38,2% em Teresina e de 38,3% em Picos. Foram realizadas 24 estimativas de proporção em relação à idade e ao sexo e 48 estimativas de prevalência de determinantes sociais e de saúde, totalizando 72 estimativas, das quais 71 apresentaram Cv-pˆ menor que 20% e 61 apresentaram deff menor ou igual a 1,5. CONCLUSÃO Dados gerados a partir do ISAD-PI poderão contribuir para a avaliação das condições de saúde e morbidade na população. Ademais, aspectos metodológicos empregados nesta pesquisa poderão servir de base para estudos realizados em outras cidades do Brasil.