Epidemiological trends and clinical features of the ongoing monkeypox epidemic: A preliminary pooled data analysis and literature review.

An emerging outbreak of monkeypox infection is quickly spreading worldwide, being currently reported in more than 30 countries, with slightly less than 1000 cases. In the present preliminary report, we collected and synthesized early data concerning epidemiological trends and clinical features of the ongoing outbreak and we compared them with those of previous outbreaks. Data were pooled from six clusters in Italy, Australia, the Czech Republic, Portugal, and the United Kingdom, totaling 124 cases (for 35 of which it was possible to retrieve detailed information). The ongoing epidemic differs from previous outbreaks in terms of age (54.29% of individuals in their thirties), sex/gender (most cases being males), risk factors, and transmission route, with sexual transmission being highly likely. Also, the clinical presentation is atypical and unusual, being characterized by anogenital lesions and rashes that relatively spare the face and extremities. The most prevalent sign/symptom reported was fever (in 54.29% of cases) followed by inguinal lymphadenopathy (45.71%) and exanthema (40.00%). Asthenia, fatigue, and headache were described in 22.86% and 25.71% of the subjects, respectively. Myalgia was present in 17.14% of the cases. Both genital and anal lesions (ulcers and vesicles) were reported in 31.43% of the cases. Finally, cervical lymphadenopathy was described in 11.43% of the sample, while the least commonly reported symptoms were diarrhea and axillary lymphadenopathy (5.71% of the case series for both symptoms). Some preliminary risk factors can be identified (being a young male, having sex with other men, engaging in risky behaviors and activities, including condomless sex, human immunodeficiency virus positivity (54.29% of the sample analyzed), and a story of previous sexually transmitted infections, including syphilis). On the other hand, being fully virally suppressed and undetectable may protect against a more severe infectious course. However, further research in the field is urgently needed.

Methods for two nonstandard problems arising from the Luria-Delbrück experiment.

The fluctuation experiment, devised by Luria and Delbrück in 1943, remains the method of choice for measuring microbial mutation rates in the laboratory. While most inference problems commonly encountered in a fluctuation experiment can be tackled by existing standard algorithms, investigators from time to time run into nonstandard problems not amenable to any existing algorithms. A major obstacle to solving these nonstandard problems is the construction of confidence intervals for mutation rates. This note describes methods for two important categories of nonstandard problems, namely, pooling data from separate experiments and analyzing grouped mutant count data, focusing on the construction of likelihood ratio confidence intervals. In addition to illustrative examples using real-world data, simulation results are presented to help assess the proposed methods.

Application of estimand framework in ICH E9 (R1) to safety evaluation.

Defining the right question of interest is important to a clinical study. ICH E9 (R1) introduces the framework of an estimand and its five attributes, which provide a basis for connecting different components of a study with its clinical questions. Most of the applications of the estimand framework focus on efficacy instead of safety assessment. In this paper, we expand the estimand framework into the safety evaluation and compare/contrast the similarity and differences between safety and efficacy estimand. Furthermore, we present and discuss applications of a safety estimand to oncology trials and pooled data analyses. At last, we also discuss the potential usage of safety estimand to handle the impacts of COVID-19 pandemic on safety assessment.

Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis.

BACKGROUND: Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. METHODS: We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to "conventional" ECMO management (Supine group) in patients with severe ARDS. RESULTS: 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42-1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). CONCLUSIONS: In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials.

Maternal health care service utilization among young married women in India, 1992-2016: trends and determinants.

BACKGROUND: Maternal deaths among young women (15-24 years) shares 38% of total maternal mortality in India. Utilizing maternal health care services can reduce a substantial proportion of maternal mortality. However, there is a paucity of studies focusing on young women in this context. This paper, therefore, aimed to examine the trends and determinants of full antenatal care (ANC) and skilled birth attendance (SBA) utilization among young married women in India. METHODS: The study analysed data from the four rounds of National Family Health Surveys conducted in India during the years 1992-93, 1998-99, 2005-06 and 2015-16. Young married women aged 15-24 years with at least one live birth in the 3 years preceding the survey were considered for analysis in each survey round. We used descriptive statistics to assess the prevalence and trends in full ANC and SBA use. Pooled multivariate logistic regression was conducted to identify the demographic and socioeconomic determinants of the selected maternity care services. The significance level for all analyses was set at p ≤ 0.05. RESULTS: The use of full ANC among young mothers increased from 27 to 46% in India, and from 9 to 28% in EAG (Empowered Action Group) states during 1992-2016. SBA utilization was 88 and 83% during 2015-16 by showing an increment of 20 and 50% since 1992 in India and EAG states, respectively. Findings from multivariate analysis revealed a significant difference in the use of selected maternal health care services by maternal age, residence, education, birth order and wealth quintile. Additionally, Muslim women, women belonging to scheduled caste (SC)/ scheduled tribe (ST) social group, and women unexposed to mass media were less likely to utilize both the maternal health care services. Concerning the time effect, the odds of the utilization of full ANC and SBA among young women was found to increase over time. CONCLUSIONS: In India coverage of full ANC among young mothers remained unacceptably low, with a wide and persistent gap in utilization between EAG and non-EAG states since 1992. Targeted health policies should be designed to address low coverage of ANC and SBA among underprivileged young mothers and increased efforts should be made to ensure effective implementation of ongoing programs, especially in EAG states.

Unsafe child feces disposal status in Ethiopia: what factors matter? Analysis of pooled data from four demographic and health surveys.

BACKGROUND: The only safest way to dispose of a child's feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe. This study aimed to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia. METHODS: This was a cross-sectional study using pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000, 2005, 2011, and 2016). Data on child feces disposal practice was collected for all children born during the 5 years preceding survey. Mothers were asked for the youngest child born, "The last time child passed stools, what was done to dispose of the stools?".Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal. RESULTS: The pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months [AOR: 0.68, 95% CI: (0.60-0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60-0.72)] were lower odds of unsafe child's feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56-0.79)] odds of unsafe child's feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19-0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25-34 and ≥ 35 years) were factors that associated with lower odds of unsafe child's feces disposal. CONCLUSIONS: Three in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved toilet facility, the child's age (older age), and both higher maternal and paternal education levels were important factors that significantly associated with lower odds of unsafe child feces disposal.

Comparison of Minimally Invasive and Traditionally Open Surgeries in Correction of Hallux Valgus: A Meta-Analysis.

This meta-analysis aimed to compare the clinical outcomes of minimally invasive surgery (MIS) and traditional open surgery for the correction of symptomatic hallux valgus. A literature search was conducted, and a total of 11 studies with 1166 (52.98%, cases) patients treated with MIS and 1035 (47.02%, cases) patients treated with traditionally open surgery were included in the meta-analyses. The pooled data (odds ratio [OR] 6.28, 95% confidence interval [CI] 3.20 to 12.32, Z = 5.35, p < .01) indicated that patients treated with MIS had a significantly higher rate of excellent-good radiographic angular results than did patients treated with open surgery. However, the incidences of complications (OR 0.67, 95% CI 0.24 to 1.91, Z = 0.75, p = .45), recovery time (standard mean difference ‒3.09, 95% CI ‒7.98 to 1.80, Z = 1.24, p = .22), and patient-reported satisfaction (OR 2.76, 95% CI 0.72 to 10.65, Z = 1.48, p = .14) were similar between patients with hallux valgus treated with MIS and patients treated with open surgery. Heterogeneity between the sources of the pooled data threatened the validity of our observations, and we used statistical methods that aimed to limit such biases. At this time, more high-quality studies are needed to confirm or refute the results of this investigation.

Peer influence or projection bias? Predicting respondent delinquency with perceptual measures of peer delinquency in 22 samples.

INTRODUCTION: The current study was designed to determine whether the peer influence effect is the direct result of respondents projecting their own delinquency onto peers in a process referred to as projection bias. METHODS: Data from 22 gender-homogeneous U.S. and British samples (Ns = 154 to 4098) of individuals under the age of 17 at the time of initial assessment were used to create partial correlations between perceptual measures of peer delinquency and subsequent respondent offending, controlling for concurrent respondent offending. RESULTS: Significant partial correlations surfaced between peer delinquency and subsequent respondent offending in 21 out of 22 samples, for a significant pooled effect size (rp1o2.o1) of 0.158 (95% CI = 0.124‒.193). Although the peer‒offending relationship, controlling for prior offending, was moderated by data recentness-with less recent samples (>16 years old) achieving a higher pooled effect size than more recent samples (≤16 years old)-a small but significant pooled effect size was recorded for both more and less recent samples. CONCLUSIONS: These results are inconsistent with projection bias as a complete explanation for the peer influence effect and suggest that perceived peer delinquency has a demonstrable and meaningful effect on future offending in adolescents. Despite the lack of support for the projection hypothesis, there is still a need to include additional variables in the analyses (i.e., direct measures of peer delinquency and differential respondent opportunities to observe peer behavior) while entertaining alternative explanations of the perceived peer delinquency‒future offending relationship (i.e., hearsay and rejecting delinquency/non-delinquency).

Multidomain intervention for the prevention of cognitive decline after stroke - a pooled patient-level data analysis.

BACKGROUND AND PURPOSE: The aim of this pooled patient-level data analysis was to test if multidomain interventions, addressing several modifiable vascular risk factors simultaneously, are more effective than usual post-stroke care for the prevention of cognitive decline after stroke. METHODS: This pooled patient-level data analysis included two randomized controlled trials using a multidomain approach to target vascular risk factors in stroke patients and cognition as primary outcome. Changes from baseline to 12 months in the trail making test (TMT)-A, TMT-B and 10-words test were analysed using stepwise backward linear mixed models with study as random factor. Two analyses were based on the intention-to-treat (ITT) principle using different imputation approaches and one was based on complete cases. RESULTS: Data from 322 patients (157 assigned to multidomain intervention and 165 to standard care) were analysed. Differences between randomization groups for TMT-A scores were found in one ITT model (P = 0.014) and approached significance in the second ITT model (P = 0.087) and for complete cases (P = 0.091). No significant intervention effects were found for any of the other cognitive variables. CONCLUSION: We found indications that multidomain interventions compared with standard care can improve the scores in TMT-A at 1 year after stroke but not those for TMT-B or the 10-words test. These results have to be interpreted with caution due to the small number of patients.

Using Vaccine Safety Data to Demonstrate the Potential of Pooled Data Analysis.

In Canada, vaccine safety studies are often conducted at the provincial/territorial level where the primary data on vaccination reside. Combining health services data from multiple jurisdictions using a pooled data analytic approach would reduce the amount of time needed to detect vaccine safety signals. To determine the difference in the time it would take to identify safety signals using different proportions of the Canadian population, we conducted power and sample size calculations for a hypothetical self-controlled case series-based surveillance analysis. We used scenarios modeled after the real-world examples of myocarditis and vaccine-induced immune thrombotic thrombocytopenia (VITT) following COVID-19 vaccination as our base cases. Our calculations demonstrated that in the case of a myocarditis-type event, a pooled analysis would reduce the time needed to detect a safety signal by over 60% compared to using Ontario data alone. In the case of a VITT-type event, a pooled analysis could detect a safety signal 49 days sooner than using Ontario data alone, potentially averting as many as 30 events. Our analysis demonstrates that there is substantial value in using pan-Canadian health services data to evaluate the safety of vaccines. Efforts should be made to develop a pan-Canadian vaccine data source to allow for an earlier evaluation of suspected adverse events following immunization.

Joint effects of ill-health, health shocks and social protection on the intensive margin of labour supply: evidence from Malawi.

BACKGROUND: There is sparse evidence on the joint effects of ill-health, health shocks and social protection on the intensive margin of labour supply, particularly in developing countries. We interact ill-health and health shocks with access to social protection and estimate their joint effects on weekly hours of work. METHODS: We employ a zero-inflated Poisson model to assess joint effects of ill-health, health shocks and social protection on weekly hours of work exploiting pooled repeated cross-sectional data from Malawi. RESULTS: We find that overall, individuals who suffered from ill-health or a health shock, including an illness/injury, a hospital admission or a chronic illness and benefited from social protection, reduced their weekly hours of work. CONCLUSIONS: The study provides novel empirical evidence on the potential joint effects of ill-health, health shocks and social protection on the intensive margin of labour supply, shedding light on the role social protection can play in developing countries.

Factors Associated with the Antihypertensive Effect of Esaxerenone and Serum Potassium Elevation: A Pooled Analysis of Seven Phase III Studies.

INTRODUCTION: This study investigated factors associated with the antihypertensive effects of esaxerenone and the incidence of serum potassium elevation in patients with hypertension. METHODS: Using pooled data from seven phase III studies, the study analyzed factors associated with changes in office systolic (SBP) and diastolic (DBP) blood pressure from baseline to 12 weeks, and factors associated with incidence of serum potassium levels ≥ 5.5 mEq/L in esaxerenone-treated patients. RESULTS: Overall, 1466 and 1472 patients were included in the full analysis and safety analysis sets, respectively. Male sex (4.02/2.40 mmHg), weight ≥ 78.4 kg (4.62/2.09 mmHg), hypertension duration ≥ 10 years (2.66/1.71 mmHg), prior antihypertensive treatment (2.38/1.40 mmHg), plasma aldosterone concentration ≥ 120 pg/mL (1.66/1.17 mmHg), urinary albumin-to-creatinine ratio (UACR) ≥ 300 mg/gCr (8.94/4.85 mmHg) or 30-299 mg/gCr (5.17/4.15 mmHg), and smoking (2.62/1.27 mmHg) were associated with mean changes in SBP and DBP. Fasting blood glucose ≥ 126 mg/dL (- 2.73 mmHg) was associated with the mean change in SBP only, and older age (65-74 years, - 2.12 mmHg; and ≥ 75 years, - 3.06 mmHg) with mean change in DBP only. Factors significantly associated with incidence of serum potassium levels ≥ 5.5 mEq/L were higher baseline serum potassium (≥ 4.5 mEq/L, odds ratio [OR] 6.702); lower estimated glomerular filtration rate (≥ 90 mL/min/1.73 m2, OR 0.148; 60-89 mL/min/1.73 m2, OR 0.331 vs 30-59 mL/min/1.73 m2, respectively); higher UACR (30-299 mg/gCr, OR 7.317); higher DBP (≥ 100 mmHg, OR 3.248); and grade I hypertension (OR 2.168). CONCLUSION: Esaxerenone is effective in patients with a broad range of backgrounds, though some factors may predict increased benefit. Regarding elevated serum potassium, careful therapeutic management is recommended for patients with higher baseline serum potassium and reduced renal function. CLINICAL TRIAL REGISTRATION: UMIN000047026.

Multilevel analysis of matching behavior: A comparison of maximum likelihood and Bayesian estimation.

While trying to infer laws of behavior, accounting for both within-subjects and between-subjects variance is often overlooked. It has been advocated recently to use multilevel modeling to analyze matching behavior. Using multilevel modeling within behavior analysis has its own challenges though. Adequate sample sizes are required (at both levels) for unbiased parameter estimates. The purpose of the current study is to compare parameter recovery and hypothesis rejection rates of maximum likelihood (ML) estimation and Bayesian estimation (BE) of multilevel models for matching behavior studies. Four factors were investigated through simulations: number of subjects, number of measurements by subject, sensitivity (slope), and variance of the random effect. Results showed that both ML estimation and BE with flat priors yielded acceptable statistical properties for intercept and slope fixed effects. The ML estimation procedure generally had less bias, lower RMSE, more power, and false-positive rates closer to the nominal rate. Thus, we recommend ML estimation over BE with uninformative priors, considering our results. The BE procedure requires more informative priors to be used in multilevel modeling of matching behavior, which will require further studies.

State and regional estimates using seven cycles of pooled nationally representative HINTS data.

BACKGROUND: The Health Information National Trends Survey (HINTS) is a probability-based, nationally representative survey conducted routinely to gather information about the American public's cancer-related beliefs and behaviors, including the use of cancer-related information. HINTS was created to produce national estimates and has lacked the ability to create accurate and precise state and regional estimates. The motivation for this current work was to create state- and regional-level estimates using a national sample (HINTS) through standard calibration methods. Health estimates at a local level can inform policy decisions that better target the cancer needs within a community. Local-level data allow researchers an opportunity to examine local populations in finer detail without additional costly data collection. METHODS: By combining seven cycles of HINTS data from 2012 to 2018 and then raking the previously created person-level weights, we were able to create tables and maps of HINTS subnational survey estimates for key outcomes that have small variances and little potential bias. RESULTS AND CONCLUSION: This paper describes the methods used to harmonize and aggregate data across cycles, create state- and regional-level estimates from the pooled data, and produce survey weights for the pooled datasets. It demonstrates both the opportunities and the challenges of pooled data analysis.

Systematic Review Reveals Lack of Causal Methodology Applied to Pooled Longitudinal Observational Infectious Disease Studies.

OBJECTIVES: Among ID studies seeking to make causal inferences and pooling individual-level longitudinal data from multiple infectious disease cohorts, we sought to assess what methods are being used, how those methods are being reported, and whether these factors have changed over time. STUDY DESIGN AND SETTING: Systematic review of longitudinal observational infectious disease studies pooling individual-level patient data from 2+ studies published in English in 2009, 2014, or 2019. This systematic review protocol is registered with PROSPERO (CRD42020204104). RESULTS: Our search yielded 1,462 unique articles. Of these, 16 were included in the final review. Our analysis showed a lack of causal inference methods and of clear reporting on methods and the required assumptions. CONCLUSION: There are many approaches to causal inference which may help facilitate accurate inference in the presence of unmeasured and time-varying confounding. In observational ID studies leveraging pooled, longitudinal IPD, the absence of these causal inference methods and gaps in the reporting of key methodological considerations suggests there is ample opportunity to enhance the rigor and reporting of research in this field. Interdisciplinary collaborations between substantive and methodological experts would strengthen future work.

Transcriptome profiles of latently- and reactivated HIV-1 infected primary CD4+ T cells: A pooled data-analysis.

The main obstacle to cure HIV-1 is the latent reservoir. Antiretroviral therapy effectively controls viral replication, however, it does not eradicate the latent reservoir. Latent CD4+ T cells are extremely rare in HIV-1 infected patients, making primary CD4+ T cell models of HIV-1 latency key to understanding latency and thus finding a cure. In recent years several primary CD4+ T cell models of HIV-1 latency were developed to study the underlying mechanism of establishing, maintaining and reversing HIV-1 latency. In the search of biomarkers, primary CD4+ T cell models of HIV-1 latency were used for bulk and single-cell transcriptomics. A wealth of information was generated from transcriptome analyses of different primary CD4+ T cell models of HIV-1 latency using latently- and reactivated HIV-1 infected primary CD4+ T cells. Here, we performed a pooled data-analysis comparing the transcriptome profiles of latently- and reactivated HIV-1 infected cells of 5 in vitro primary CD4+ T cell models of HIV-1 latency and 2 ex vivo studies of reactivated HIV-1 infected primary CD4+ T cells from HIV-1 infected individuals. Identifying genes that are differentially expressed between latently- and reactivated HIV-1 infected primary CD4+ T cells could be a more successful strategy to better understand and characterize HIV-1 latency and reactivation. We observed that natural ligands and coreceptors were predominantly downregulated in latently HIV-1 infected primary CD4+ T cells, whereas genes associated with apoptosis, cell cycle and HLA class II were upregulated in reactivated HIV-1 infected primary CD4+ T cells. In addition, we observed 5 differentially expressed genes that co-occurred in latently- and reactivated HIV-1 infected primary CD4+ T cells, one of which, MSRB2, was found to be differentially expressed between latently- and reactivated HIV-1 infected cells. Investigation of primary CD4+ T cell models of HIV-1 latency that mimic the in vivo state remains essential for the study of HIV-1 latency and thus providing the opportunity to compare the transcriptome profile of latently- and reactivated HIV-1 infected cells to gain insights into differentially expressed genes, which might contribute to HIV-1 latency.

Sleep and high-risk behavior in military service members: a mega-analysis of four diverse U.S. Army units.

Experimental sleep restriction and deprivation lead to risky decision-making. Further, in naturalistic settings, short sleep duration and poor sleep quality have been linked to real-world high-risk behaviors (HRB), such as reckless driving or substance use. Military populations, in general, tend to sleep less and have poorer sleep quality than nonmilitary populations due to a number of occupational, cultural, and psychosocial factors (e.g. continuous operations, stress, and trauma). Consequently, it is possible that insufficient sleep in this population is linked to HRB. To investigate this question, we combined data from four diverse United States Army samples and conducted a mega-analysis by aggregating raw, individual-level data (n = 2,296, age 24.7 ± 5.3). A negative binomial regression and a logistic regression were used to determine whether subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], and duration [h]) predicted instances of military-specific HRB and the commission of any HRB (yes/no), respectively. Poor sleep quality slightly elevated the risk for committing HRBs (PSQI Exp(B): 1.12 and ISI Exp(B): 1.07), and longer duration reduced the risk for HRBs to a greater extent (Exp(B): 0.78), even when controlling for a number of relevant demographic factors. Longer sleep duration also predicted a decreased risk for commission of any HRB behaviors (Exp(B): 0.71). These findings demonstrate that sleep quality and duration (the latter factor, in particular) could be targets for reducing excessive HRB in military populations. These findings could therefore lead to unit-wide or military-wide policy changes regarding sleep and HRB.

A Multilevel Analysis of Factors Associated with Childhood Diarrhea in Ethiopia.

BACKGROUND: Childhood diarrhea is the major contributor to the deaths of children under the age of 5 years in Ethiopia, but evidence at the national level to identify the contributing factors associated with diarrhea by considering the clustering effects is limited. Hence, this study aimed to identify factors associated with childhood diarrhea at the individual and community levels. METHODS: A secondary data analysis was conducted using the 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 23 321 children with their mothers were included in this study, and multilevel logistic regression models were applied for the data analysis. RESULTS: The odds of diarrhea among female children were 13% lower (AOR = 0.87; 95% CI: 0.79-0.94) compared with male children. The odds of diarrhea among children aged between 13 and 24 months were 31% higher than (AOR = 1.31; 95% CI: 1.17-1.47) their younger counter parts. Children aged ⩾25 months (AOR = 0.50; 95% CI: 0.45-0.56), those whose mothers were unemployed (AOR = 0.79; 95% CI: 0.73-0.87), and children live in households between 2 and 3 under-5 children (AOR = 0.87; 95% CI: 0.79-0.96) were associated with lower odds of experiencing diarrhea. The odds of diarrhea among children whose mother had no formal education were 49% higher than (AOR = 1.49; 95% CI: 1.08-2.07) their counterparts. Besides, children residing in city administrations (AOR = 0.69; 95% CI: 0.58-0.82) had lower odds of experiencing diarrhea than children living in agrarian regions. CONCLUSIONS: At the individual level (sex and age of the child, mother's employment status, and educational level, and the number of under-5 children) and the community-level (contextual region) were found to be significant factors associated with childhood diarrhea in Ethiopia.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020.

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

Cohort Profile: The Ganka-Ekigaku Network (GEN), a Network of Japanese Ophthalmological Epidemiology Studies.

PURPOSE: Japan has been known as a super-aged society, and ageing is a well-known risk factor for blinding eye diseases. However, epidemiological studies in ophthalmology are still scarce in Japan, and the sizes of the cohorts are relatively small. "Ganka-Ekigaku Network" (GEN, an acronym for the epidemiological network in ophthalmology in Japanese) is established to develop a capacity to boost each epidemiological study and enrich a potential inter-study collaboration to identify risk factors of visual impairment in aged society. METHODS: We reviewed cohort studies in Japan with the inclusion criteria as: (1) at least n = 1000 at baseline, (2) multiple modalities of ophthalmic data, and (3) diagnosis reviewed by ophthalmologist(s), and (4) ophthalmologists are involved in the investigators group. As of January 2020, GEN includes 4 individual Japanese epidemiological studies namely, Hisayama study, Yamagata Study (Funagata), Tsuruoka Metabolomics Cohort study, and the Nagahama Prospective Genome Cohort for Comprehensive Human Bioscience. RESULTS: GEN includes approximately 25,000 Japanese participants. The baseline surveys started from 1998 to 2012, and since then the data has been prospectively collected approximately every 5 years. A variety of ophthalmic measurements and other factors have been collected in each study in GEN: ophthalmic measurements (fundus photography, optical coherence tomography, etc.), systemic conditions (laboratory data, etc.), and others (DNA, etc.). CONCLUSION: GEN is an open platform for observational ophthalmic epidemiological studies to share standardized methodologies. While each study in GEN pursues specific and original research questions, standardization of the methods will enable us to conduct reliable meta-analysis/pooled data analyses.